It’s easy to assume that anyone and everyone with type 1 diabetes would want to use an insulin pump. Delivering incredibly specific insulin doses at the press of a few buttons? That’s gotta be better than a vial and a syringe, right?
Maybe, for most.
But not for me.
I used an insulin pump for the first 7 or so years of living with type 1 diabetes—and I absolutely recommend that everyone give it a try. I tried using a pump again around ‘year 17’ with type 1 diabetes, and I couldn’t even stick with it for a full month before desperately converting back to my syringes.
#1. My A1C doesn’t care
The way we each manage type 1 diabetes is very personal and unique. We each have our own quirks and approaches and methods. For me, using syringes and MDI hasn’t prevented me from achieving A1Cs in the 5s during pregnancy, and an A1C around 5.7 to 6.3 overall. The way you deliver your insulin doesn’t matter if you’re committed to the bigger picture—the habits that lead to lower A1Cs. Those habits are simple: thoughtful eating, thoughtful dosing, frequent blood sugar checks, exercise, and plenty of self-study. If you prefer to get that A1C with a pump, that’s awesome, but you can totally achieve it with syringes, too.
When I give myself an injection, there’s no doubt that the insulin successfully got into my body. With a pump, especially for me, failures with the cannula were so much more stressful than having to use syringes. A friend of mine who loves pumping said, “Well, sure, we all have infusion site and cannula failures...but that’s just part of pumping.” And that’s exactly the problem for me. The stress that comes with those failures—which are usually discovered thanks to sudden high blood sugars and large ketones—is not worth it for me.
#3. Cost of a pump is prohibitive
For a good handful of years in my early 20s, I didn’t have insurance. Paying for monthly insulin pump supplies would come with an extremely hefty out-of-pocket price-tag. And even now that I do have insurance, it’s still far more affordable to use syringes and vials. Actually, I even use pens but stick syringes into them because pens are cheaper than vials, and there’s less insulin in them so I’m able to use them up before they expire. (I don’t like pen needles, they leak! I don’t care how long you leave the needle in your skin, it always leaks a few drops.)
#4. Believe it or not, it’s more work
Taking an injection might seem tedious if you’re used to pressing buttons, but in reality, a quick injection takes less than 30 seconds. But managing an insulin pump with new infusion sites, priming, hoping there isn’t too much inflammation at the new site that might cause high blood sugars during the first few hours, yada yada yada! And as a mom of two, I find it extremely stressful to be worrying about a 300 mg/dL because the insulin isn’t getting through a new infusion site properly than simply taking 1 basal insulin injection and 4 to 6 rapid-acting bolus injections per day. No worrying. No tedious technical management. No malfunctions.
#5. It can enable sloppy choices
With an insulin pump, it’s so easy to stop and start your basal rate, to press the button and deliver another bolus a mere few minutes after the first one...you can be a lot more “loose” with your decisions. You can eat a cupcake and then 10 minutes later, decide to eat another one. With injections, I think about my meals pretty carefully because I don’t want to take several injections. It requires me to be very thoughtful about every decision around food. It doesn’t mean I don’t eat cupcakes, but I when I do eat a cupcake, I’m very thoughtful about my insulin dosing and how many cupcakes I plan to eat. Additionally, a pump knows all your calculations and all your basal rates—it does a lot of the “thinking” for you. And this is a great thing, until your pump fails and you can’t remember how to calculate doses for the food on your plate. With syringes, I know my insulin doses better than I know the back of my hand.
#6. I like my body to be “gadget-free”
There’s a joke in the diabetes community that if you take a shower when you don’t happen to have an infusion site for your pump and a sensor for your CGM in your skin, it’s a “naked shower.” With syringes and MDI, my entire day is basically a naked shower! And I really, really appreciate that. While wearing a CGM sensor isn’t that cumbersome, it’s still a gadget attached to my body and inserted into my skin. It’s still something. An insulin pump is even more cumbersome (I even tried the Omnipod). If you’re used to it and you prefer anything over syringes, then you get used to it. But knowing I actually prefer syringes only makes me that much more aware of how just how “gadget-free” my body is.
At the end of the day, it’s great that we have a choice. If you love your pump, then by all means, pump away! But if you’re not so fond of your pump and you think you’re crazy for wanting to go back to syringes, I’m here to say that I totally get it! And you totally can manage type 1 diabetes the old-school way.