ACCU-CHEK combo pump

[weeezer]

i'm very excited, i've been approved for a pump. having a trial using saline on 15th aug. i had a choice of two pumps, the combo looked good, i like the way the tester talks to the pump. THINK the other was medtronic, but can't remember!

anyone using the combo? any opinions on it? are there any better pumps out there? if so, why?

i'm very excited, i'm looking forward to a new era of being diabetic, one of more accuracy & control and less hypo's. and more choice of what & when to eat.

cheers

weezer

 

[kellyrae]

Hi, I have been on the combo for 1 month now.....to be honest I found it quite hard to adjust from injections but this is probably because you get used to doing it all a certain way over lots of years.
But saying that I think I have finally got to grips with it and started to understand all the different changes, like your sensitivity to the way the insulin is administerd, my basal(background rates) rates took a while to get right and they still need tweeking before they will be perfect.

It takes time and sometimes a little frustrating (for me anyway) if it doesnt seem to be working right away.
But saying all that everyones different, the pump itself is great, the way it delivers, what you can progarm it to do, like eating pasta and being able to pick and choose the rate and times of insulin thats best for your body.
Not having to find somewhere to do your injection when your out, simply testing your blood and bluetoothing the pump to deliver is great and much easier.

Its a learning curve at the beginning specially when getting used to a different way of doing thing but once you are on it and using it you cant do without it.
For example this weekend I had a problem with my canulas and had to disconnect the pump and use my pens overnight, there was such a big difference in my bloood sugars when i had stopped using it, I couldnt wait to get it back on again.

As for wearing it all the time isnt so bad after you have found somewhwere suitable and what your comfy with.

Good Luck and I'm sure you will love it!!!!

 

[iHs]

Hi

I too have the Combo as I wanted a pump that I could conceal under my clothing in my bra and one that would work by using a bluetooth remote.

Although I like using a pump, I only like it when it behaves as it should. There are many times when I find that my basal rates (even with fasting) need to change... because my bg levels change. Sometimes there's a valid reason but sometimes there doesn't appear to be a cause and it's just the way things are. I'm not the only one like this, there are others who also have the same problem.

At first I think everyone loves a pump as it is new technology etc etc but as time goes on they then start to realise that there's more to using one than they thought. As Jopar and others have stated..... a pump will only deliver the insulin according to the settings you have entered.... so no, it doesn't work magic.

With regards to bg testing....... the only way you will know whether the pump is working all ok is from doing bg tests so these need to be done about 10-12 times a day just for peace of mind (at least that's the way I feel anyway).

So good luck when you get it but do be prepared to do a lot of bg testing in order to try and get the best from it.

 

[weeezer]

thanks for that ladies. so you're new to pump kelly-rae? hope to pick your brains soon then! i see you have a little one, i've got a 2 and half yr old lil lady (sure keeps me on me toes) - do you find your diabetes can take a back seat when stressed/busy/knackered/dealing with kid stuff? mine certainly does. yeh, must be funny to not inject after doing it for years. this basal rate malarkey is intriguing/worrying me! i realise it must be better than long acting insulin but sounds tricky to get right.

thanks ihs...i intend to be a bra pump wearer too, not so long ago i would've hated the idea of something interfering with the streamline of my clothes! but i don't care anymore, my clothing is more loose these days (bit 'chubby'!). i'm a bit concerned about the basal rates and how & why they need to be different through the day. worried that there will be no background insulin to 'cover' me, but i realise the constant supply of small amounts must be better, just that you wouldn't know if this was failing unless you test allll the time. i know that whenever i am testing intensely (in pregnancy for example), my control always benefits, but i can't keep that up constantly, i just can't. but, maybe i have to look at it in a different way - it HAS to be done to avoid future probs. i sure hope CGMs become more common in the future, i love the idea of a CGM talking to a pump, but know they are v expensive and no chance of getting on NHS, in my area anyway.

hope to be talking to you again soon about pumpy things!

 

[iHs]

The wheels are turning regarding cgm. The sensors that go under the skin will eventually become more or less comparable with bg tests and be fairly acurate. In the wings though is the C8 medisensor offering which will hopefully be approved for European sale later this year and there seems to be some movement going on now regarding The Glucoband.

The closed loop pancreas is now going through trials.......... google... Bionic Pancreas for details :thumbup:

 

[Trina]

Hello people. Don't laugh but I have a couple of silly questions. Does anyone have ideas about where to put the pump at night. I did read that it can be placed under the pillow? Where do you get the covers, carrying cases etc from, apart from Roche of course.mi suspect Roche prices are quite high. Thanks people.

 

[iHs]

Hello people. Don't laugh but I have a couple of silly questions. Does anyone have ideas about where to put the pump at night. I did read that it can be placed under the pillow? Where do you get the covers, carrying cases etc from, apart from Roche of course.mi suspect Roche prices are quite high. Thanks people.

Firstly Trina

Hi from me... I'm 2yrs behind you regarding the 50yrs lol.... I often wish I could g..o back to just injecting insulin once a day and use Clinistix strips to test my urine instead of all this multiple jabs malarky......and worrying all the time about how bolus insulin affects bg levels...

..Regarding where to put pump at night...... dont worry you can shove it in yr knickers if you want or in your bra or buy a cheap mobile phone/camera case with a neck band to it and just hang the pump over your neck.. Pumps come with a choice of tube lengths so you will have at least 2ft tube between the pump and the infusion set so you can if you want, leave the pump beside you in bed.. The only problem will be if you get up in the night and forget that the pump is attached to you... If you have a long tube, the pump will just fall to the floor but if the tube is shorter, then it will just hang down your leg and maybe pull the infusion set out. I tend to use a mobile phone wallet thing with neckband to stop the pump from falling....

Make sure that you get your GP to prescribe plenty of Aviva teststrips (about 300 per month) and take some with you when you get the pump as the rep might not have any and neither will your DSN. Also, get GP to prescribe you your insulin in a vial and take the vial with you to hospital (get it to warm room temp). The pump rep will go over the technique of filling the cartridges with you so make sure that the air bubble problem is discussed and that you'll know how to deal with it......

When you get the pump, the dsn will start you off on one basal rate for each of the 24hrs. You will also be started on a insulin to carb ratio that you might ???????. Very seldom is the carb ratio correct so you will need to test your bg levels every 2-3hrs and log all bg levels down so that you'll be able to see if the carb ratio is correct or whether you'll need to adjust it.... For sure, you will need to get up every 2hrs when you go to bed as the basal rate overnight will probably not be correct and need adjusting....

All in all, you'll find using the pump really different from what you are used to... but dont panick... take it all in your stride and remember the pump is just a battery operated insulin delivery device.....

 

[Trina]

Thanks very much. I've been using the accuchek mobile for testing blood that uses a cassette and that's being queried by my local surgery. It's going to be fun asking them to change the prescription yet again. However am grateful for the warning about the strips and different insulin phials :crazy: the carb counting I've been doing so hopefully that won't be too much of an issue. Like some of you been on injections for sooooooo looooong that its going to be exciting times ahead I think. Thanks everyone :thumbup:

 

[jopar]

Trina

If you get any problems with your surgery, changing your prescriptions or refusing to prescribe a suitable amount of test strips, go back to your pump team, they will be more than willing to set your surgery straight to what you need etc! Do ensure that if you do need to ask your pump team to intervene, ask them to copy you in as well...

Just in case your surgery has similar habit to my surgery! Reducing your test strips, then when you point out the consultants letter, they haven't got one on file! A lot easier to produce your copy of said letter than going back to your team! Oh if they ask to keep you copy for your file, tell them to photocopy it!

Also if your consultant is anything like mine, the 'You will issue my Patient' blah blah put GP in their place, are normally quite good!

 

[Trina]

Hi Jopar
Thanks for your advice. I must confess my surgery has been ok up til recent as I have been testing more often because of the hypo situation, which is why I am finding this a wee bit odd. However, I feel I will be armed with enough info in order to turn on the guilt. I am sure they will be rubbing their hands when they learn that hopefully I won't be requiring too many more needles. People you have all been great and I am feeling really positive about the pump as I feel it's the way forward. Thanks once again

 

[Trina]

Well people first day on the pump with actual insulin on board. Had two days of being pumped with water. All ok apart from when I changed the canunula. Oh my what a mess I made of that. I was given an insertion device in order to shoot the cannula in and I completely lost the plot, destroyed the cannula and in the end it jumped into the sharps bin all by itself. However did go on the web to see if there were any better instructions and managed to get into Accuchek in Australia where I found a video which was so helpful all about not only the insertion device but other elements. I'm copy it across just in case it's of use to anyone else.

I know it's my honeymoon period on the pump but so far in my life as a diabetic this is just the best thing that's happened.

The diabetes nurses have written to my surgery and emphasised that I do require generous amounts of testing strips so hopefully there won't be too much of an issue there any more.

Thanks everyone once again

 

[iHs]

Well people first day on the pump with actual insulin on board. Had two days of being pumped with water. All ok apart from when I changed the canunula. Oh my what a mess I made of that. I was given an insertion device in order to shoot the cannula in and I completely lost the plot, destroyed the cannula and in the end it jumped into the sharps bin all by itself. However did go on the web to see if there were any better instructions and managed to get into Accuchek in Australia where I found a video which was so helpful all about not only the insertion device but other elements. I'm copy it across just in case it's of use to anyone else.

I know it's my honeymoon period on the pump but so far in my life as a diabetic this is just the best thing that's happened.

The diabetes nurses have written to my surgery and emphasised that I do require generous amounts of testing strips so hopefully there won't be too much of an issue there any more.

Thanks everyone once again

Hi Trina

I take it that you are using the Flexlink with the inserter device...... A word to the wise..... when using these inserters always move the spring back and release it a few times before you put the set in.... A few times... I've had sets fire out into my bedroom curtains as I've pulled back the spring. Its just been luck that I've not had the inserter pointed upwards as a set fired into a face is not good..... But most of the time... the inserter is ok and fires the set in very quickly and with very little discomfort so is worthwhile using... but just keep safe and **** the spring away from your face.....

 

[magelizh]

Hi, I have been using the Accu Check Combo pump for just over 1 year now. I like the idea of only having the equivalent of one injection every 2 - 3 days (depending on which cannula set is used) and it has reduced my HBA's to 7% but I can't honestly say that I don't have as many high or low blood sugars as I did previously on injection. However, my awareness has returned and I now know by how I feel if my blood sugars are high or low. Being an older person 'over 50 - the age when new technology suddenly becomes a bit confusing' I have found it difficult to programme the pump to change the different basal and bolus rates for the different times of day - to be honest I have been a little lax with it, but I am persevering and I am sure that eventually I will come to terms with it all. A bit scared of messing it all up. I don't think that it is an easy option and I am still not sure whether I prefer the pump to injections. I am going to Australia and NZ in Feb for a couple of weddings when it will be back to pens so this will be a better comparison test - I will see whether I decide to stay with the pens or go back to using the pump.

 

[Trina]

Well people over 2 weeks on the pump now. Gees it's a steep learning curve but where I find it comes into its own is not having to be so rigid with meal times and testing. I am out and about driving every day and some places I go to are not exactly the place where you can just do blood tests willy billy let alone inject, so being able to just program the carbs and whoopee bolus is such a treat, I feel spoilt.

One question after my total wrecking experience with the insulin change, has anyone drawn up insulin into the syringe and then popped it in the fridge until required which might be later in the day. In my pea-like brain I am thinking this might save a lot of time.

 

[Trina]

Well people over 2 weeks on the pump now. Gees it's a steep learning curve but where I find it comes into its own is not having to be so rigid with meal times and testing. I am out and about driving every day and some places I go to are not exactly the place where you can just do blood tests willy billy let alone inject, so being able to just program the carbs and whoopee bolus is such a treat, I feel spoilt.

One question after my total wrecking experience with the insulin change, has anyone drawn up insulin into the syringe and then popped it in the fridge until required which might be later in the day. In my pea-like brain I am thinking this might save a lot of time.

 

[Trina]

Hi People. Happy Nre Year although I suspect this is the wrong Forum for this. However, forward moving on the pump. To bore everyone to death. I am using the Accychek pump and moving to this pump has been life changing. I still think its a bit Jurassic at the way I have to fill the cartridge as I am still getting bubbles. Suggestions welcome peeps. I seem to still get bubbles when I draw up insulin. However when I did use my pen insulin cartridges did find that easier. Strange. Any comments from those more knowledgeable would be welcome. Happy New Year fellow pumpers

 

[iHs]

Hi

Happy new year to you too Trina....

How are you filling the pump cartridge..... are you injecting air upwards into the vial (like the old way ) or injecting air downwards into it (the new way) ?

Also, how are wearing the pump...... close to your body (in yr pocket or in yr bra) or have you got it clipped to your waistband. Insulin inside a pump tends to get warm especially when also close to the body.....

 

[Trina]

Hello
I usually draw the insulin in with the vial upside down and usually there doesn't seem to be any bubbles. It's when I disconnect the vial from the plunger that the trouble seems to start. I wear the pump usually attached to a waistband, if not then dangling round my neck. I found the inside the bra regime a bit uncomfortable.

 

[iHs]

Hello
I usually draw the insulin in with the vial upside down and usually there doesn't seem to be any bubbles. It's when I disconnect the vial from the plunger that the trouble seems to start. I wear the pump usually attached to a waistband, if not then dangling round my neck. I found the inside the bra regime a bit uncomfortable.

Hi

You remind me of myself when I first started using the Combo... I also had the problems with air bubbles when I tried to remove the vial from the blue vial adaptor thing. It was too tight... so using a pair of sharp scissors, I cut a small 'V' nick in the vial collar to enable me to pull the vial of insulin off the adaptor without any agro. I always use insulin straight from the fridge as its easier to fill syringes, cartridges etc with cold insulin than room temp. Once cartridge is filled (24hrs before you need to put it in pump) I get the cartridge up to body temp and then the warmth of my body enables air bubbles to rise to the top. I then tilt the cartridge slightly diagonal and using my thumb nail I flick the bubble to the centre of the cartridge below the neck (luer bit) and using my thumb nail again, sharp flick to get the bubble in the neck and then screw in the blue plunger and push the bubble up the neck and remove the cap. I also get a piece of tissue paper to catch the insulin with air bubble coming out the top of the luer neck so that it doesnt go down the cartridge.... I then push on another black cartridge adaptor with a new tube already screwed into it. Once that is done... I then get the pump and advance the piston upto the level of insulin in the cartridge and then I'm good to go and let the pump go through its procedure to prime the tube etc......

Unfortunately, the Combo cartridges are prone to air bubbles and loads of people have different ways of getting rid of them.

viewtopic.php?f=14&t=26176&p=240320&hilit=accu+chek+combo+air+bubbles#p240320

In tiime probably later this year I think... glass cartridges will be produced already filled with insulin.

 

[Trina]

Thanks for that. It's just good to know I'm not a complete numptyhead. I think I'll try to fill cartridge with insulin straight out of the fridge as you recommend and see what happens. Lots of great suggestions, thanks once again.