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[IP] Fwd: Diabetes News Newsletter #140


Thought some of you might enjoy reading this.  I receive a free weekly article
from this diabetes newsletter.  It comes to me via e-mail.  


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NEWS                  a weekly e-newsletter for people with diabetes
Copyrighted 1996, Diabetes Interview

This week's newsletter #140
Adjusting to the Pump is More than a Button Push
by Kim Boaz-Christy, RN, BSN, CDE

As a diabetes educator I have worked with a number of people in helping
them tackle the tasks of achieving control with an insulin infusion pump.
Sometimes the process is quick and easy. Other times it's long and
frustrating. As a person who has lived with type 1 diabetes for 25 years
and has worn an insulin pump for over three years, I know what my patients
must be experiencing. My own situation is simple; pump therapy is the best
choice I could have ever made for my diabetes. However, I do not think I
fully understood the depth of its true value until the past year or so.

I remember the first time I put in an infusion set. "Wow," I thought. Not
good or bad, simply, "wow." It suddenly hit me that everything in my life
was about to change. What an overwhelming realization.

For the next week I constantly felt like I was forgetting something. The
simple fact was that after 22 years of receiving daily injections, suddenly
I was doing things differently. I never dreamed such a strange sensation
would result from simply changing the way I gave myself insulin.

Is it all in Your Mind?

Over the past several years, an increasing number of people with diabetes
have chosen insulin pump therapy over conventional, daily insulin
injections. Most likely, the majority of these people have been extremely
satisfied with the accomplishments they have made concerning their diabetes
control with the aid of their insulin pumps.

But what about adjusting psychologically to pump therapy? Is it as simple
as learning what buttons to push, how to put in the infusion set and
carbohydrate counting?

Research has shown us that those who choose intensive therapy are at a much
lower risk of future complications. One study showed that of 886 pump
users, 82 percent reported an improvement of their health status as
compared to 16 percent reporting no change. (Association for Insulin Pump
Therapy, Diabetes 1991: 40:#1807). Other studies suggest pump users have
"lower anxiety and depression scores, greater family cohesion, and improved
interpersonal sensitivity."(Shapiro, 1984 and Skyler, 1982)

Although there are statistics to support the overwhelming value of pump
therapy, it is not fair to say that adjusting to pump therapy is easily
done. There is a psychological adjustment that each pump user must overcome
first. The extent and length of this adjustment period will differ among
individuals depending on each person's initial resources, both internal and

Once the decision is made to begin pump therapy, many people experience
some degree of excitement. When the time comes to sit down and actually
begin pumping, reality often hits hard, and the reality of change can be
During a pump initiation, I will ask patients if they have any fears or
concerns before continuing. Body language will often tell me more about a
person's feelings than actual verbal communication. If people are unable to
fully express concerns, many nod and grin when I ask them, "Maybe a little
fear of the unknown?"

Change can induce antagonistic points of view or create everything from
joyous excitement to terror. It is this ambivalence that can cause people
to question the decisions they've made. To choose pump therapy is usually
not an easy decision and requires careful investigation, thought and

Voices of Experience

I questioned several pump users concerning the impact of pump therapy on
their lives. Here are a few of their responses:

Theresa, 39 years old; dietitian and certified diabetes educator. Theresa
has had diabetes for 30 years and has been on the pump for five years.
"From a woman's perspective, weight control is much easier; with a pump you
feed yourself, not your insulin," she explained. "I think the thing that
has helped me adjust to pump therapy the most is knowing I have the support
of other diabetes educators if I need them."

Andrew, 16 years old; high school student. Andrew has had diabetes for 14
years and been on the pump for one year.
"I think I adjusted faster than I should have because not long after going
on the pump I went to diabetes camp. Once I had a leak in my tubing, and my
blood sugar got really high. The camp staff helped me through it. I've got
to admit, I was scared."

Andrew was adamant about one thing: "The pump gives you freedom. It's not a
miracle worker, but if you're willing to put work into it - it's great! I
fell into a period where I got real lazy and my control showed it, but I'm
doing much better now."

Mike, 48 years old; general manager of a manufacturing company. Mike has
had diabetes for 14 years and been on the pump for six years.
"I was on small doses of Regular and using NPH so it took a while to get
used to using only Regular without fearing lows ... I'd get real frustrated
sometimes and it really helped to have another pump user I could call and
talk to."
Mike explained that he was one of the first people in the country with
diabetes to be granted certification from the FFA to solo a flight without
another pilot on board.

"I would contribute my good control to my pump," he said. Now that Mike is
a seasoned pump user, he added, "When I take my pump out to shower it's
like I took my arm off, it's so strange."

Although this isn't a scientifically conducted study, it seems the most
common thread these people shared adjusting to the pump was the idea of
support. If you are considering pump therapy or if you are new to pump
therapy, and you are experiencing some frustration, remember that you are
not alone. I urge you to take advantage of a support group or consult with
your diabetes team to find another pump user you can talk with. Support can
make a big difference as you journey into the exciting territory of
improving your diabetes control and not allowing diabetes to control you.
And by all means, get pumped up!


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