Thanks for Janet Lafler's informative article about insulin pumps. I've been a Type 1 diabetic for almost 40 years and am intimately familiar with the complications of ordinary daily life choices for insulin-dependent diabetics. I was introduced to the concept of the insulin pump almost 20 years ago. At that time, I flatly rejected it for myself. Pumps at that time were extremely expensive and weighed about 2 pounds. I couldn't face the prospect of lugging around a device like that attached to my body constantly.
Lafler has made me rethink the topic. Even though I'm extremely disciplined with my diabetes, and have not suffered any serious long-term consequences, I'm not very satisfied with the sine waves of my blood sugar levels. Perhaps an insulin pump would help smooth them out.
-- Toni Michael
While I applaud the author's sentiments, her article unfortunately adds to a dangerous popular myth concerning the insulin pump.
I have been a Type 1 diabetic for the past 17 years. I have also worked at a diabetic camp in Ohio serving children from ages 5 to 15. The pump can offer increased freedom and control to a small segment of the diabetic population, but it's not for everyone. It can, in fact, be dangerous, especially to younger patients. Use of the pump requires intensive blood sugar monitoring in order to program the correct dosages, as well as a knowledge of the user's own sensitivities to insulin and various kinds of food. Young people, particularly teenagers, often cannot use the pump safely because of the constant changes their bodies undergo. A careless user who is unwilling to undergo blood sugar self-monitoring to a much higher degree than injectors also runs the risk of hospitalization from incorrect pump programming.
The pump is indeed a boon, but several doctors and registered nurses I have worked with consider it much more work; one former pump user I know found that he can control his blood sugar just as well without it. My own blood sugar levels, on three to four injections daily, are just as well controlled as any pump user's, and I don't have to worry about the danger of pump overdose. I urge people considering the pump, and particularly those under the age of 20, to seriously evaluate their ability to engage in the work necessary to use it safely.
-- Mary Campbell
I am so gratified to see an article like this in a publication like Salon. I've had insulin-dependent diabetes for almost 40 years, take four insulin injections per day and started on insulin infusion pump therapy with a MiniMed 507C about 18 months ago. For years, I've only been able to find articles in publications like "ADA Forecast" and "Diabetes Self-Management" -- good, helpful, informative, often even well-written articles, to be sure, but somehow lacking in the creative or individualized touch.
Unlike the author, I never felt like a cyborg when I started using my pump. It actually feels more natural to me -- because of the increased level of control, perhaps, and the consequent improvement in the way I feel -- than taking injections ever did. There's the portability of it, as well as the ability to "be discreet" (which is important to a lot of people, though not particularly to me, as I love showing and talking about my pump and how it works), not to mention the flexibility (I can actually not eat if I don't feel like it, although this is of course not something to make a habit of; I can easily disconnect from the pump, for everything from taking a shower to making whoopee) -- I am astonished at what an amazing tool the pump can be. Making this marvelous technology available to more people is definitely an important next step.
-- Carol Emmet
Janet Lafler's thoughtful article about her insulin pump neglected to mention that the insulin most of us Type 1 diabetics inject one way or another is likely made by recombinant DNA technology. This human-type insulin is a significant advance over the earlier insulins extracted from pig and cattle pancreases, to which the human body could eventually develop resistance. Opponents of biotechnology need to explore these issues more carefully. Many of us concerned about the ecological and technological implications of biotech nevertheless may join feminist biologist Donna Haraway, who concluded in her "Cyborg Manifesto": "Though both are bound in the spiral dance, I would rather be a cyborg than a goddess."
-- David Walls