The insulin pump was the right choice for me

Photo of a woman (PantherMedia / Jens Schade)

Martha, 25 years old

“When I realized that I was really far more independent with the pump, that I no longer had to carry around any needles and pens with me, just the pump, I knew I had made the right decision.”

I was diagnosed with type 1 diabetes in 1999. It was actually more by chance. I was 18 years old and in the second year of training.  My mom was really pressuring me to go to the doctor. I probably wouldn’t have gone otherwise. I had blamed the symptoms I had – like having to go to the toilet a lot and blurred vision – on the hot summer. I was tired and lethargic the whole time, had lost a bit of weight and also had an infection in my genital area. One day I felt completely exhausted and had drunk seven liters. I was generally a very active person, but that day I stayed at home despite the good weather because I was so worn out. My mom was worried about me and made me have a blood test done. I was then sent to the hospital, where I was treated very well. They gave me insulin and my blood sugar levels went down straight away.

I started injecting myself after two weeks

The first time I tried to inject myself I threw the insulin syringe away, almost as a reflex. Although I’m a nurse, I only felt comfortable being injected by others. I didn’t want to do it myself but I knew I had to learn. It took a surprisingly short amount of time – after about one to two weeks I was injecting myself.

After two weeks in hospital I was sent to a health resort for further treatment, where I had a very good doctor. She placed a lot of emphasis on mental wellbeing and had a holistic approach to diabetes. She made it clear that it’s all right to eat ice cream or drink wine every now and again. And that you shouldn’t be afraid to do sports, exercise and really try out everything that you want to do. That was really important to me – it made me think about things and made me feel better about my situation.

I started off with the intensive insulin therapy approach, using longer-acting and regular short-acting insulin. I often had low blood sugar from doing exercise. It was difficult to predict how much long-acting insulin I needed because I often ended up doing sports pretty spontaneously. That was a real downside for me because I couldn’t control it.

Quality of life was important to me

One year after being diagnosed, I switched to using longer-acting insulin and an insulin analogue. The fluctuations didn’t stop completely but it was easier to predict the effect of the insulin. I still had low blood sugar sometimes. That's why I then decided to use a pump. That was 6 years ago. It was an important step in terms of my quality of life because I had read that the pump keeps blood sugar levels more stable and hoped that would give me more independence. It turned out to be the right decision, but it was difficult at first. I thought “Oh God, now I have to carry this thing around with me all the time!” I wasn't exactly over the moon about that. But when I realized that I really was far more independent with the pump, that I no longer had to carry around any needles and pens with me, just the pump, I knew I had made the right decision.

There was a lot to learn about the pump at first. You get to know the pump better over time. I tried out different settings and could adjust the insulin according to how much physical activity I did. But it was also easier to take into account hormonal changes or special meals. I first got the pump when I was at the health resort and just wanted to try it out at first, but I was so impressed that I ended up wanting to keep it.

In the winter you get used to the pump but in the summer you sometimes think: "This damn thing!" When it’s warm I want to wear tight clothes and always first have to try and remember where I wore the pump the year before. You either have to have a pouch with you, or when you buy bras and pants you have to make sure that the pump fits into them. That can be annoying, but you get used to it faster than you expect.

I can still do things like sports and going to the sauna

Sometimes I switch to intensive insulin therapy using an insulin pen. For example, I was going to a wedding and wanted to wear a close-fitting dress, so I used the pen instead. I can always be flexible and remove the pump if I want to. I take it off for an hour or so when I'm doing sports or in the sauna. It’s really not a problem.

I think it's crucial that you keep on looking for a good doctor if you’re unhappy with yours. My doctor really helped motivate me, which was very important. After all, over time your diabetes changes, the effect of the insulin changes and your hormones change, and that can be difficult to cope with. It’s a constant learning process. Sometimes when you’re tired of following the rules, or simply have cravings like anyone else does, you eat without thinking. It isn’t always easy to motivate yourself. You have to accept that there will be “bad” days too. That's really important for my quality of life.

Diabetes sometimes gets me down

When I first found out I had diabetes I thought of it as a normal illness. I only really looked into it quite a bit later. Fortunately I was 18 and had already gone through puberty by the time I was diagnosed. I understood that I was responsible for my own health. Getting to know my body better was actually quite a slow process. Looking back, I think it’s really the most important thing that you have to do. I have to know my body well and know how it reacts. It's important to realize that. Only then can you manage diabetes well. If you don’t accept this fact it’s almost like not accepting yourself.

Despite generally being a very positive person who enjoys life, my diabetes does sometimes get me down. There are some days when I just think, "For God's sake!" Like if I forget my blood glucose meter or muesli bar. My partner knows what these days are like. On perhaps two days a year it ends in tears. Sometimes I worry that it’s annoying for other people. But I get a lot of support. I can fully rely on my partner. And I am very lucky that my family have no problem with it. That really helps me.

Having diabetes isn’t the worst thing that's happened to me. Since the diagnosis, I have been much more aware of my health. I’m familiar with my pulse, my blood sugar levels, my body and I always know straight away if something is wrong, which is a good thing. I don’t always feel like my diabetes is dragging me down. I don't shy away from it, but try and deal with it. I do have a good quality of life. Other people have other problems – we all have our cross to bear.

I’ve read a lot about diabetes and have realized that the best thing for me to do is write down my blood sugar readings, what I eat and what activities I do. That way I can learn to improve my sugar levels. It can be tedious at times but it is worth doing, at least for one month a year. Then you can find out how going for a walk or eating a plate of pasta affects you. You can find out your own personal basal rate and insulin-to-carbohydrate ratio.

It has taken me years to get to this point. I think diabetes should be approached holistically. You need to find out what is best for you personally.


Acknowledgment

Our real-life stories summarize interviews with people who are affected by the medical condition. Our interview partners have given us permission to publish their stories. We would like to express our sincere thanks to them.

The real-life stories give an insight into how other people cope and live with a medical condition. Their opinions and comments are not recommendations by IQWiG.

Please note: The names of our interview partners have been changed to protect their identity. The photos are of models.