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From Florida, USA:

I am 34 years old and have had Type 1 diabetes since I was six years old. I have had very few complications, however, I am extremely brittle and this has made it difficult to maintain tight control. In the past six months, I have been under a tremendous amount of stress (death in the family, loss of job, stepchild, etc.). This has caused my control to be even more difficult. My physician is considering changing me to either 70/30 or an insulin pump to try and get better control. Is it more difficult for a brittle diabetic to use a pump? I'm concerned about how dangerous it may be because my sugar drops so rapidly when I take insulin. Would 70/30 be a more moderate step to take first?


First of all, let me state my very firm opinion that if you're under a lot of stress, and there's a reasonable likelihood that it may settle down relatively soon, it's the wrong time to start changing your diabetes program. I'd advise sticking to what you know, and maintaining your composure, rather than experimenting with new programs that might cause more stress, and throw things out-of-whack worse than they already are!

The choices that you imply that you were offered (either using 70/30 or an insulin pump) are not equivalent choices. If you were to change to a program using 70/30, you'd inevitably be giving up flexibility in exchange for simplicity (since most people using 70/30 take two injections daily: which works well for some folks with Type 2 diabetes, but is rarely workable for people with total insulin deficiency). On the other hand, if you start an insulin pump, you'd gain flexibility, but would have a new and complex program to learn. It's difficult for me to conceive of what your doctor was thinking of, when offering such vastly different alternative programs for you to consider! If your doctor is part of a diabetes team, ask the doc to explain the rationale behind these choices. If the doc is not, ask for a referral to a diabetes team for evaluation of your options.

By the way, "brittle" is such an ill-defined term that I wouldn't want to comment upon the impact that a pump program might have, without reviewing your entire diabetes program in detail with you: obviously a job for a diabetes team!


Original posting 24 Aug 1998
Posted to Daily Care and Stress


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Last Updated: Tuesday April 06, 2010 15:08:58
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