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Choosing a pump

S

SKB_9

Member
I have just been recommended an insulin pump by my consultant however the information from my clinic was very sparse. I have been sent a list of about 5 pumps to choose from, and told that the nurse cannot advise me on which to choose and whichever I go for I will be tied into for four years and unable to change until then.

This is all fine but I feel like I’m making a really important decision completely blind. I have looked at the pump websites and I don’t feel like I understand what I’m looking at. Ideally I want to compare features to make a choice it I know nothing about pumps and what I should be looking for, so I’m finding it overwhelming. For example I see zero basal rate function but no idea what it is, if I want or need it, if this is a standard feature etc etc.

Does anyone have any tips for what to look for in choosing a pump, or can point me to somewhere online that I could get some information that’s a bit more clear? I know I should ask for more info but my clinic isn’t very forthcoming and all contact at the minute is by telephone with really appalling signal at the hospital so it’s very difficult to make that work.

for what it’s worth I’m leaning towards omnipod (no idea if it’s the new or old one) because wire free seems a good option for me and my small children, but no idea what features I might be compromising for the sake of no wire. By the way I’ve been diagnosed 3 years (at 29) and find I can get good control on MDI but multiple daily hypos since having children hence the pump.

Any advice greatly appreciated
 
Hi @SKB_9, I’m a new pumper myself. I started on the 7th of January this year. I was granted funding for a pump & a Cgm for a closed loop system so I went with the Medtronic 780G with there Guardian 3 CGM. For me having a closed loop system was a no brainer. I’m quite active, go to the gym 6 days a week & go for long walks or do cardio probably 4/5 times a week. My basal requirements can be different daily.

The Medtronic 780 is basically an artificial pancreas. It adjusts my basal needs every 5 minutes automatically & can also give automatic correction doses. If the pump senses im going low it’ll shut off all insulin & vice versa when the sensor picks up my bloods going high it’ll give me a correction dose to stop it.
 
Hi,
Can you tell us what pumps are on the list? You are extremely lucky to be able to choose from 5 options. A lot of areas only give one or two options.

I chose the Tandem t:slim X2 because I needed a lot of insulin and it holds 300u in the cartridge. Unfortunately it does have a tube and cannula. I have gotten used to the tube, but I wish I could have a patch pump.

Almost ALL of the other people in my area chose the Omnipod. It is a very good pump and is cordless.
There are other patch pumps, but I think that the Omnipod is pretty much the most popular choice.
You can now control it from your phone, instead of having to carry a separate controller, which is a good thing.

Patch pumps are probably the way ahead, provided 200u is enough insulin for you for 3 days.

Also, I think I am right in saying that Patch pumps do not require you to have insurance because you are changing the whole thing.

Because I keep my pump and change the cartridge, I have to insure my pump for £4000.00 myself.

There are lots of other things that people use to make their choice, but most people are not qualified to evaluate the pumps themselves, which I think is the crux of your dillema.

You will probably take part in group training for your pump.
I was the ONLY person in my group who did not have an Omnipod.
The others in my group were keeping in touch and that effectively gave them a great local support group.
You may want to factor that into your choice too.

I hope that this helps you a little.

Regards Chris
 
I would start by listing what is important to you. What is important to me and my lifestyle probably doesn’t bother you.
Then read, watch YouTube videos and learn about the pumps on offer.

Also consider the criteria that qualify you for a pump and check which is the best to satisfy that criteria.
Then check what you have qualified for. Is it just a pump or also a CGM which can talk to the pump? There is no pint looking at closed loop unless you have a CGM. Are you willing to fund a CGM yourself? (Libre does not count as it is not integrated to any pumps today).

I have experience of two different pumps and see the value in both ... for me. I know others do not like the ones I have used. I had no choice but happy with both.
 
Capt-Slog said:
Also, I think I am right in saying that Patch pumps do not require you to have insurance because you are changing the whole thing.
Click to expand...
This is not the case.
Patch pumps still need to be insured as you do not change the whole thing. Only the patch, not the part with the brains.
 
Last edited by a moderator:
Hi @SKB_9, I'm a Medtronic 640g pump user. It would be good to know what options you have been given.
I think a crucial point when considering an Omnipod is as @Capt-Slog says - is 200 units of insulin enough for you for 3 days. I've seen posts on here where people are running out of insulin before the 3 days is up and there is no way to add more to the pod. At my clinic they told you whether you could have an Omnipod or not based on whether your insulin requirements were low enough, but I guess some clinics fail to do that something to consider though is your insulin requirements may change once you start on the pump, previously I was on a carb ratio of 1 unit per 5g, when I started my pump I changed to 1 unit per 10g, it has changed since then but I think (somebody correct me if I'm wrong please!) it's quite normal to need less insulin on a pump.
 
People that have pumps that integrate with CGM and work closed loop. So tandem/Medtronic seem to have better overall control. But the cgm in most cases will not be supplied by the nhs so would need to be self funded However they will work without cgm but just be a basic pump

So for me I choose tandem as I wanted closed loop even if I had to self fund…

The next consideration is tube or not.. I got used to the tube in 3 days

With omnipod/non cgm. you’ll still need regular bg tests to know what’s happening and for dosing etc

Whatever you choose it will be better than what you currently have
 
Hi @SKB_9

When I started nearly 10 years ago it was not so hard a choice as all were piped pumps.

I made a list of what I wanted to do and my life style, then did my best to match the pumps to these questions and see which one fitted best.

As for operation questions.
Zero basal - is when the pump see's via a CGM that your BG is going to be low and stops your background basal to help bring your BG back up - you need a CGM for this.
Loop Pumps (Medtronic/t:slim), act like a dimmer switch turning down or up or off your insulin based upon your BG read via a CMG to manage your levels. Without a CGM these Loop pumps act like normal pumps.
Remote control - I see your looking for maybe a patch pump due to your children, I personally would agree with @searley and choose one that will allow your phone to be the controller, if not then look at the size of the controller and remember you need that with you at all times.

I waited around 10 years after first being offered a pump because I thought I could not manage with something attached via a pipe and it was 10 yrs wasted.
 
Hi @SKB_9
I am very happy with my Tandem t:slim.
I fund a Dexcom CGM to enable the closed loop capabilities.
Even if you can't afford the CGM now, this may change in the next 4 years or the NHS might fund them - you never know!
Usually you get a pump for 4 years. One positive advantage of the t:slim (and the Medtronic 780G?) is that the software may be updated. I've had 2 updates so far in 2 years.
 
Wow everyone this is all so helpful, thank you all so much. Some really good suggestions on how to consider what might work for me.
I have learned that I am lucky to get so much choice but I really felt I needed a bit more guidance. For those interested, (@Capt-Slog @sleepster the ones I have been told to look at are Medtronic 640G, Roche Accucheck Insight, Omnipad dash, A6 Touchcare, Tandem slim, mylife ypsopump.


DunePlodder said:
I fund a Dexcom CGM to enable the closed loop capabilities.
Even if you can't afford the CGM now, this may change in the next 4 years or the NHS might fund them - you never know!.
Click to expand...

I’d love a closed loop but unfortunately I wouldn’t be able to afford it now I have my baby and nursery fees, I use the libre with good success which I self funded until it was offered by nhs. That will have to do for at least the next four years and then I might be able to reconsider!

sleepster said:
I think a crucial point when considering an Omnipod is as @Capt-Slog says - is 200 units of insulin enough for you for 3 days..
Click to expand...

thanks, no one has mentioned this to me but I was told to consider the omnipod, not sure if they’ve checked this already or not but I will make sure to ask. Just made a note in my phone of what I’ve had so far today and will do for the next couple of days! I do keep getting told I’m very sensitive to insulin...



I have read that in a couple of threads on here actually, I’m 1:10 or 1:12 at the moment so if I do find I need less then even better!

searley said:
Whatever you choose it will be better than what you currently have
Click to expand...

Agreed!!

Chas C said:
I waited around 10 years after first being offered a pump because I thought I could not manage with something attached via a pipe and it was 10 yrs wasted.
Click to expand...

I felt the same when I was first diagnosed it was mentioned and I wrote it off, I think it was all a bit overwhelming for me at the time but now I feel ready to give it a go! I’m actually looking forward to it especially now I’ve had such useful insights here.


Capt-Slog said:
Because I keep my pump and change the cartridge, I have to insure my pump for £4000.00 myself.
Click to expand...
Insurance hasn’t even been mentioned so thanks to both of you who did here, I will ask about this too.

I’m definitely leaning towards omnipod and have a few useful questions to ask the nurse now, but I’ll go and look at the others now I have a bit of direction! I have to choose by next week. I used loads of ‘reply’ functions in this which I’ve not done before so apologies if it’s all gone awry, I’ll have another go if it did!
 

Just a quick note - I do closed loop and use Freestyle Libre that I get on the nhs as my cgm - this means it’s all completely free no extra costs.
 
 
Did you end up going with the Omnipod? I took part in an online group chat run by Omnipod with 4 others that were also thinking of switching to pump therapy. I been on injections for 38 years so it feels like a big change. What's been your initial feelings about the change and has it helped?
 

Once you are past the first few weeks/month of working out your basal settings and stabilise the change is amazing - I was around 38 years before pumping just like you too and I'm pretty sure you won't look back.....
 
Hey all, thanks for the great insights. I've been dormant on the forums for a while but I've now been given the option to choose a pump. My choices are Medtronic 780G, Omnipod Dash, Tandem T:Slim.

I've had T1D for almost 27 years now and I too felt it all overwhelming with these new technologies etc. I've only recently switched from finger prick testing to the freestyle libre and these 5 months have been a total revelation!

I hope it's the same for the insulin pump too. I'm leaning towards the Omnipod simply because it feels the least invasive ie no cannulas or visible sites of entry, and also because I play sports so I'm not keen on having the bulky machinery attached to me. When I do play sports, I've found that wearing body armour or skin-tight underlayers, help absorb any sweat whilst also keeping the sensor in place. Fingers crossed it might support the omnipod too.

My insulin sensitivity has also been an issue - on average I inject 2.5-3 units novorapid for every 10g carbs so I'm thinking the 200 units of insulin might get eaten up pretty quickly. I read above that the insulin requirements drop for pumps vs MDI so I might be ok?

Does anyone have experience or any other insights into the trade offs between the three choices?
 
You do need insurance for Omnipod PDM or Dash which programmes the pumps. (I have had to make a claim due to screen breaking)
 
I use the Omnipod as I find it simpler to use. Can also swim / shower with it on. I do/ did not wish for attachment for pump worn attached to / near body day and night. However not as sophisticated and cannot automatically make adjustments. However easier to read manage with Libre. If you are entitled to this. Can set up settings for alternative Basel ratio eg if doing exercise / in hot climate / casual day. Also temporary Basel’s reduce increase depending on activity. Hope this helps.
 
 
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