Freedom at the End of a Leash

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Some time after I started using an insulin pump, my endocrinologist (or “endo,” as I call him) asked me what I liked best about it.

“I can scrub the front porch whenever I want,” I responded after some thought.

It may sound like a strange answer, but it pretty much summed up the new flexibility I gained when I went from multiple daily injections to pumping.

Before the pump, if I went out for my morning coffee and noticed it was getting a bit dusty out there, I’d have to go through all kinds of calculations. What was my blood glucose? What kind of insulin did I have in me? When did I take it? Had I eaten? Did I need to eat and, if so, how much? Did I have time to figure all that out, scrub the porch, take a shower, and get to wherever I needed to be that day on time?

With the pump, I checked my blood glucose, turned down my basal rate if necessary…and scrubbed the porch.

To me, the ability to scrub the porch when I wanted to was a summation of my new ability to “turn on a dime,” as it were. I could ride my bike when I wanted. Skip a meal. Sleep in. Nibble my way through a party. As a fellow pumper I met online once put it, “I never knew freedom came at the end of a leash,” a reference to the fact that you’re literally attached to an insulin pump via a length of tubing.

Because rapid-acting insulin analogs are used in most pumps, using a pump is infinitely more flexible than having long-acting insulin in you. Because you can program the basal rate to match your body’s rhythms, you don’t have those annoying blood glucose peaks and valleys that come when the long-acting insulin you’ve taken doesn’t match your body’s needs. For instance, I need about twice as much insulin overnight as I do during the daytime. If I took one of today’s long-acting insulins, I’d either be correcting for the overnight highs or feeding the daytime lows.

Getting a pump was easy. Getting to the point where I could get a pump was not.

As I recall (it’s been awhile—my eighth anniversary of pumping will be December 1), I called the pump company first. After going through a long list of questions and answers with the sales rep, I said, “By the way, I’m Type 2.”

Pause. “You don’t want to make things easy, do you?” she asked.

On my next visit to the endo, I told him I wanted an insulin pump. “But you’re a Type 2,” he said.

On the next visit, I told my endo I wanted a pump. Again, I was waved off.

On the next visit, he came into the examining room and asked, “Do you want an insulin pump?”

What changed his mind? I don’t know, but I have my suspicions, which are that he figured I was going to bug him about it at every visit, so he decided he’d recommend one and put the onus on my insurance company to turn the request down.

I got approval from my insurance company in less than one week. Soon, I became the first Type 2 pumper the medical center my endo is affiliated with had ever had.

If you have Type 2 diabetes and are interested in using an insulin pump, don’t be discouraged by my experience: I started pumping when pumps for Type 2’s were very rare. In fact, I believed they were only for Type 1’s until I “met” a Type 2 pumper online. Turns out that neither he nor his doctor were aware that pumps were supposedly only for Type 1’s, so they went for it.

Today, Type 2 pumpers are much more common. In fact, about 6% of the pumpers on the e-mail list at are Type 2.

Some insurance companies don’t make it easy for anyone to get an insulin pump, using various excuses: If your blood glucose is running too high, you have to get it down. If you’re in good control, you don’t need a pump.

However, the fact is that if your insurance policy doesn’t specifically say that it doesn’t cover an insulin pump, it probably does. I would suggest researching the different pumps on the market and calling the company that makes the one you choose. Pump companies are very good at maneuvering their way through insurance issues. Also, see if you can “test drive” a pump or two—using saline solution instead of insulin, of course. By doing that before getting my second pump, I found out that the karma just wasn’t there between me and the model I thought I wanted, but that the model I tested because I thought I should at least look at one other pump was in fact a perfect match.

Whether you have Type 1 or Type 2 diabetes, if you’re thinking about pumping, read up on the topic. There are a couple of articles in the “Magazine Archives” section of (including one that I wrote for the January/February 2005 issue of Diabetes Self-Management)—you can find them on the “Insulin” page.

If it sounds like an insulin pump is for you, get your facts together, approach your doctor, and go for it. Happy pumping.

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