Freedom at the End of a Leash

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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  • tralea

    I couldn’t agree with you more about a pump. It’s made things so much better for me since I got it. I am a type 1 and had very erratic sugars on MDI. I took up to 6 shots a day and things when weren’t getting any better, I decided to get a pump. I totally agree with you about the advantage of pinpointing and changing basal settings. Being able to set a temp basal is coolest. I think it’s the closest thing to working like a pancreas should work. I engourage anyone that is thinking about a pump to go ahead and try it. At least you will know if it’s something for you.

  • Ann

    I’m another long-term type 2 pumper. Jan, I think I got my first pump around the same time you did.

    When I got my pump, I had a highly irregular work schedule. I never knew when I was going to get a chance to eat, so I did not want any peaky intermediate-acting insulin on board. I was using H at meals, with a small amount of R at bedtime, and a little bit of H in the middle of the night if I woke up — which was most nights — to cover my dawn effect. I decided to get a pump when I started needing a bit of H in the mid-afternoon, after the lunch insulin wore off and while dinner was still a few hours away. Somehow that 1 more injection convinced me I needed a pump.

    What surprised me with the pump was how much more energetic I felt. I had really good A1Cs before I got a pump, so the improved energy levels cannot be from that. I think the body just feels better when the metabolism is closer to the way a healthy body is.

  • Mary

    I couldn’t agree more to what you said about using a pump. I was diagonisis on July 25, 2003. My endo said I was a type 2 and he immediately started me on insulin shots. With the shot my blood suguar level have been up, down and all around. In January of this year 2006, he stated I was more of a type 1 than a 2. So on May 22, 2206 I started on the pump. Yes it has made a diffenence. So I am new to pumping but the experience has well worth. I had no problem with my insurance. I still learning around pumping, but I would telling everyone it will make a diffeent in your life. Eats when you want, sleep in,it is like taking a vacation. I need relazie how much my life was set around the shots

  • Florian (T1, dx1967)

    How do you decide what pump to use?

  • Jan

    Good question, Florian. One place you can go for a side-by-side comparison is

    Two things you might want to look at are reservoir size and dosing amounts. If you need a lot of insulin, you may not want a pump with a 200-unit reservoir. If you’re very insulin-sensitive, a pump that doses in increments of 1/4 unit might be important to you.

    Then there are personal issues. One company’s pumps have proprietary sets: the others have sets that are interchangeable, which gives you a wider choice. Are you around water a lot? You might want a pump that is waterproof.

    Look at the comparisons and choose a couple you think you might like. Then ask for a trial run on each of your choices. Your CDE may be able to arrange for that, or talk to the sales representatives.

    Most pumpers believe, however, that any pump is better than none, so you really can’t go wrong with any choice.

  • christine

    I’ve been a pumper for 14 years. I’ve had type 1 dm for 33 years. The reason I went on the pump was to have more freedom and less hypoglycemia. 14 years later and many cities later (read,change of doctors), I am still experiencing daily lows. In fact, I should own stock in the glucose tablet company, as I go through them like crazy!!!!
    I test 4 – 8 times daily. I’m not real skilled at figuring out what to do with my blood sugars except to chase highs and lows, of which there are plenty.
    I am under military health care, and do not have walk-in or phone-in access to my physician. I don’t have a “diabetes team.” Can any of you steer me in the right direction of using my bg results and my pump to obtain more “in the zone” results????? Thanks so much ūüôā

  • Jan Chait

    Christine, there is a book called “Pumping Insulin” that is very useful. It can be ordered from any bookstore, or via the Diabetes Mall or It’s currently in its 4th edition. The best place for on-line help and support for pumpers is With more than 5,000 members, the mail load can get a bit heavy, but you can get feedback on just about any question you can think of. It also has Digest and Browser versions of the mail list.