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RE: [IP] To pump or not to pump questions

When I consulted with Jay Skyler at DRI in Miami, he told me that MDI was
just as effective as the pump if you manage it rigorously.  By that he meant
4 or 5 core injections daily, with adjustments as necessary, 7 or more bg
measurements each day, diligent record-keeping and thoughtful analysis.
That was 10 years ago; I wonder what his opinion would be now.  Using a
combination of U and H is very much the same concept as calibrating basal
rates and bolus' with the pump.  It sounds like that is what you are doing.
Key word here is YOU.  When Gabe is a little older and takes on all the
responsibility for managing his diabetes, will he be as diligent if it means
taking as many as seven injections a day?  There is such simplicity in
bolusing and making pp adjustments with the pump when compared to MDI.
Also, MDI does not allow you to make adjustments in the basal rate to
compensate for a body's behavior at different points during the day.  My
basal requirements differ almost hour to hour.  When you find yourself going
low, you cannot suspend a U injection for half an hour while you recover.

The Minimed 508 has a vibrate mode that you can use for alerts that can
barely be heard by a person sitting next to me.  I don't think that would
disturb anyone in silent prayer.  Its replacement, the Paradigm, will be
available this summer.  There are enough significant improvements in this
model that I would wait until it is available before starting pump therapy.

There are a couple of excellent books about pump therapy that you might want
to read.  One is "Optimal Pumping" and the other is "The Insulin Pump
Therapy Book".  Both are available on the Minimed website.  They will give
you some more insight into the advantages of pump therapy.
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