| Items | CSII | MDI |
Device Operability Aspect | Device Operability | The device is difficult to operate. The pump was difficult to use and it takes time to get used to it. | It’s easy. Although I sometimes forget to inject myself. |
Trouble | There is no injection. The tube gets jammed. | I’ve never experienced any trouble with it. |
Physical Aspect | Insertion area | You can only insert the device in the abdominal area. It leaves a greater mark as compared to insulin injections. It sometimes gives me a rash. The needle is longer compared to the insulin injections, which makes me nervous. | The injection area turns blue. Sometimes I hit a blood vessel. |
Injection pain | I wouldn’t say it’s extremely painful, but it is uncomfortable. | I’m right-handed, so when I inject the insulin into the left side of my abdomen, the angle of the needle slants, creating pain. |
HbA1c(NGSP) | Once I started using the insulin pump, my HbA1c level stabilized and I could get better control over the blood glucose level. | My HbA1c levels were high. I can’t eat during work, and so sometimes I couldn’t inject myself. I didn’t want to inject myself in the toilet, so sometimes I missed injections. That’s why I would get high HbA1c levels.HbA1c. |
HbA1c and blood glucose levels | After I started using the insulin pump, my HbA1c levels stabilized. However, even with the insulin pump, I keep a careful watch on the amount I eat, as carbohydrates raise the blood glucose level. | My blood glucose levels fluctuated considerably. During work, there were many situations where I could not measure my blood glucose levels even though I wanted to. Therefore, I knew when I got hypoglycemia, but when I got hyperglycemia, I would leave it untreated. |
Hypoglycemia | In the case of the insulin pump, I can insert it slightly and see the situation then work out whether I need more insulin. Regulating levels in this way means that I don’t get as much hypoglycemia. | My HbA1c levels were high. I can’t eat during work, and so sometimes I couldn’t inject myself. I didn’t want to inject myself in the toilet, so sometimes I missed injections. That’s why I would get high HbA1c levels.HbA1c. |
Daily Living Aspect | Cooking | It hurts when I press against the cooking table. | Not particular. |
Cleaning | I don’t seem to get tired so easily. I can’t do cleaning in a crouched down position. | I get tired easily and I don’t have enough stamina, so I can’t do cleaning without taking breaks. |
Child-rearing | When I’m carrying my child, his feet sometimes press against the pump, depending on where it is positioned, which makes the pump seem like it is coming loose. | Not particular. |
Bathing | When I bathe, I remove the insulin pump part only. | Not particular. |
Sleeping | The device is an inconvenience, so I move it about unconsciously (move the device while sleeping). | Not particular. |
Dressing | If I don’t wear loose clothing, the insulin pump protrudes. One dresses more lightly in the summer, so my clothing options are especially limited then. | Not particular. |
Out or Dining in a restaurant | CSII does not have the following drawback associated with the MDI. | It’s awkward to inject in the presence of people. It’s bothersome to hunt for a suitable place to inject. Sometimes I forget to take my injection kit with me when I go out. |
Social Aspect | Feel a sense of restriction | The presence of the insulin pump bugged me until I got used to it. | You have to carry the injection kit with you wherever you go. |
Regarding work | After switching to the insulin pump, I’ve been able to make progress at work. | When at work, I inject myself in the lavatory. If I get hypoglycemia, I wouldn’t be able to work anymore. |
Medical cost | CSII therapy costs around 15,000 yen a month(the CSII pay medical fees of around 5,000 yen more as compared to those under the MDI). | MDI therapy costs around 10,000 yen a month. |
Psychological Aspect | Body image | I have to take certain measures with my clothing so that the insulin pump can’t be seen. | I can’t inject myself in the presence of others. I’ve also told my kids never to mention that I use injection. |
Sense of burden | I don’t have to worry so much about getting hypoglycemia, and the fact that I don’t have to inject myself four or five times a day is a weight off my mind. | It was really psychologically stressful knowing you had to inject yourself four or five times a day. My blood glucose levels were unstable, so I sometimes wanted to give up visiting the hospital. My blood glucose levels would fluctuate a lot, and my HbA1c level was high, so I was constantly anxious about controlling them. |