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Insulin pumps

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yingtong

Well-Known Member
Messages
487
Location
Swindon uk
Type of diabetes
Type 1
Treatment type
Insulin
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People who.kock diabetes
Got approval for a pump yesterday,after over 50 years of injections,any advice would appreciated on pump types and what to expect.
 
If you want a good pump with the option to use it as a self-funded CGM, get an Animas Vibe.

If you really want to hide your pump and operate it with a remote control get Roche or Medtronic. Not sure which has the best remote.

If you think you really really can't handle dangly tubes attached to you then try to get the Omnipod tubeless pump.

What pump types are you being offered?
 
yingtong said:
Got approval for a pump yesterday,after over 50 years of injections,any advice would appreciated on pump types and what to expect.
Click to expand...
What ever pump you choose or told you are having will be the be all and end all of all pumps as you have no comparison
What to expect...... plenty of hard work sleepless nights, frustration are high on the list when you start pumping. Good side is a fantastic quality of life
Please make life easier for yourself by buying the book pumping insulin by John Walsh (Amazon)
 
I second all of the above but would say to remove frustration and sleepless nights get the CGM at least for start up. yes its £500 for about 8 weeks(cheaper the longer you run it) but setting basal becomes soooo much easier for that you need Animas vibe but as spiker said, its your preference
 
Congratulations on being approved.

Can't get you much advice on pump choice or being on a pump as I'm still awaiting mine.
 
I very much agree with carbsrok. Dont give up yr insulin pen though as there will be times when you'll find it will save yr bacon esp if bg goes very high and yr not sure why. Re cgm........difficult one atm as Abbott will be launching their Libre flash glucose monitor.
 
I have do a great deal of online research on insulin pumps since my DSN recommend me for a pump,I would be appreciate other users experience with the various pumps I.e for and against with each pump,at the moment I am leaning towards the Roche.i am seriously looking at CGMs which I will self fund.i have at the moment the loan of a CGM because I have lost the signs of a hypo.
 
Congratulations on getting pump approval yingtong, that will be quite a change after 50 years of injecting.

I wish you well with choosing and starting to use a pump.
 
If you are looking to send fund CGM, it would probably make sense to go with Animas or Medtronic, which are CGM compatible. Dexcom seem to have the best reputation regarding CGM accuracy, which would point to the Animas.

Also Roche are bringing out a new pump beginning of next year so make sure you look in to that, ie. will you get an upgrade etc, if you decide to go with them.
 
I would agree with those above, if you do think your going to go down the CGM route then choose Animas, the cost of the Dexcom CMG's is much cheaper and you do not need the Dexcom receiver as its part of your pump.

But I would look at other pumps too, I've tried the Omnipod and its a good pump, I'm on the Accu Check which is also good, both these pumps have remote controls which I find very handy (not needing to dig out the pump to make adjustments). But 99% of pump users will tell you their pump is the best because its what they are used too, which kind of indicates they are all good and you just need to choose the one that fits your lifestyle.
 
you forgot the cellnovo, titchy tube and rechargeable
 
My Animas Vibe is due for replacement in November (warranty issue) and I've been offered four options:

Medtronic Veo
Accu-Chek Combo
Animas Vibe
Omnipod

In spite of long-term pump usage, I've not been able to sustain good glycaemic control for more than 1 or 2 days on the trot; after consultation with my GP yesterday (at which I pretty much broke down with exhaustion from the constant variations and inability to run successful basal tests owing to frequency of cannula changes - once every 2 days - and hypos - nigh on daily), he has agreed to support my application for a CGM.

I'm also being transferred to another hospital owing to insufficient capability at my current one to provide me with the integrated support my GP and I concluded that I need (and have probably needed for over a decade) to get me back on track.

I think in reality I need a pump that integrates with a CGM and only two models seem to do that presently: the Animas Vibe and the Medtronic Veo.

The other, less costly alternative (in the immediate term that is), is to go for a different pump and access to a standalone CGM (or the Abbott Freestyle Libre). The Accu-Chek Combo, Omnipod and the Dana-R also have integrated BG meters that communicate with the pump.

I've had several issues with pump uage over the years:

1) Cannulas - I found the nylon ones tended to aggravate and have since moved onto 6mm steel. HOWEVER, owing to the fact that I do a lot of walking with my 9 month old daughter slung in a carrier that tends to push the cannula into muscle walls, I'm a tad at a loss about which way to turn. That said, from December (when she turns one), I'm planning to buy a cycle trailer so that I can commute her and her 3-year sister to pre-school and back in less time, which should lessen the carrier use somewhat;

2) I have an ape-like hairy stomach: I would shave it in order to apply cannulas in the past, but have since tended to place the cannula around the sides of my waist (which then results in the aforementioned issue with the carrier) as it looked ridiculous when going swimming / sunbathing;

3) I have found that the slow/extended bolus release on the Vibe does not seem to work as they state - in the past, my insertion sites would become excruciatingly painful owing to the flooding of the site with large boluses... this has been lessened by my ongoing carb reduction strategy;

4) I do not currently have a fixed daily routine that has enabled me to undertake a methodical review of my control (this is the childcare issues), but this is changing as my eldest is settling into pre-school. However, this half-routine is at risk owing to the rapid development of our youngest, who seems intent on walking before she reaches 10 months.

I appreciate that we all have preferences of pumps, etc., but I thought I should air my predicament with you all in the hope that someone's comments / experiences may help me shed new light on the variables...

I've looked through the websites about each pump, but what I'm now looking for is personal insights not corporate speel.
 
Hey @ConradJ - tough challenges :-(

I am generally very excited by the idea of a pump + Libre combo because it allows a choice of pump, whatever suits the person best. But in your case with the frequent hypos it sounds like you need a full function CGM with alarms, not the Libre.

Though is there any chance the infusion problems you are having with the pump are causing the hypos?

Just as a thought have you also considered going back to MDI (pens)?
 

I have experienced this only very rarely on the Vibe and in every case it resolved with a cannula change. So this I believe is an infusion set problem rather than a Vibe problem as such. I think the pain comes when the needle is too shallow. Have you tried using longer steel needles than 6mm? You may just have thicker skin.

If the insulin is pooling (painfully) between the skin layers rather than delivering properly this could explain your frequent hypos and might also suggest your carb:insulin ratio could be incorrect, as injecting into skin would give the false impression of increased insulin resistance.

However if your problems with the Vibe are intractable then go with the Medtronic Veo and the option of the Enlite CGM sensors. I'm not convinced Enlite is less accurate than the Dexcom G4 (for the Vibe). Enlite is more expensive if you self fund. If you are confident of NHS funding for CGM then the Veo + Enlite could be your best bet.
 
@ConradJ I'm on the Animas and used to find bolusing painful sometimes. Have you changed the delivery setting to slow? I only ever bolus 2.5u in one go which solved the issue for me. So if I need 6u I do 2.5u, pause, another 2.5u, pause again and then a final 1u.

I tried the steel sets for while and found the bolus more painful due to the steel being thinner than Teflon. In fact the pump delivery was so powerful it was pushing the cannulas out slightly so I needed to use 8mm steel instead. The animas has the most powerful delivery so other pumps might suit you better from that point of view.
 


Hi @Spiker and thanks for the replies,

Yes, it's been tough and ongoing for so long as to be ...well... let's just say I can't really recall having a period of stability since 2003.

I reached a point of absolute desperately frustrated pointlessness with it all - looking at repeated meter result printouts and diasend reports and just thinking "wtfp". The stress of trying to attempt basal rate testing whilst succumbing to the frequency of cannula changes and such wild swings from low to high and vice-versa was just the final straw.

I've made so many alterations to my lifestyle over the last few years: I've cut the carbs by 2/3, I've vastly increased the quantity and variety of leafy greens, nuts, berries, lost about 5kg (I'm down to 150lbs / 10st 7 / 68.5kg - and I'm 180cm / 5'10") so my BMI is erring towards the lower end. No, I haven't gone completely LCHF, but that is a possible next step. My physical activity is up (I fast walk around 4.5miles five days a week), etc., etc.

Yet, in spite of all that th results were still (average): 5-10% below target (i.e. hypo), 30% in range, and 60-65% above target (8mmol+).

I will try out a couple of longer (nylon) cannulas again, although I tended to have worse problems owing to the scarring.

As for MDI, yes it's been on my mind; however, my current basal insulin prescription is still Lantus - I was put onto Lantus in 2003 and that's when the roller coaster turned into the Himalayan mountains. The pump has brought me down to 8% HbA1c, whereas I was 11% and above on Lantus, so I will need to see a diabetologist to discuss alternatives. (Hence the transfer to another hospital - my current one has turned over three consultants in less than 18 months and they were unable to recruit anyone until earlier this year, but the backlog is well...)

Anyway, thanks again for these insights and suggestions - very much appreciated.
 
Bum is a lovely place fot steel sets if you are muscly. I am and have used my bum cheeks for nigh on all jabs n cannulas for 30 years. Not a mark on my bum. Still beautiful and j lo...

Teflon never worked properly with me. Steel in stomach and lack of love handles still hurt and occluded.

I'm on 6mm steels but would love 4mm, can't get accuchek. 8mm are way too long for me.

Everyone different.

So good to hear that after 50 years jabbing you will have a pump.
 

Hi @MushyPeaBrain ,

Yes, I've always had mine set to slow delivery; but around 8 months ago I also reduced the delivery step down to 0.1u from 0.5 and that has also made a huge difference in that respect. Mind you, I don't think I knew that about the Vibe's power, so maybe another pump is the option.

Actually, the main cannula issue I have at the moment is being caused by the baby carrier - it has a waist strap that needs to be tight. The trouble is, it sits in a position that generally covers the areas I tend to use sometimes catching and pulling at the wings or pushing the cannula in / against other tissue/muscle if the strap is covering it.

I shall try out both your and Spikers suggestion about longer cannulas, although I suspect that I may have quite thin skin - especially now with the flab loss that's occurred over the past 8-9 months.

Thanks for your help as well - very much appreciated.
 
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