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Please help me choose my pump

Bluemarinejosephine

Bluemarinejosephine

Active Member
Messages
42
Type of diabetes
Type 1
Hello everyone,
I hope you are very well.

I am a type 1 and I have been offered the option to switch from injections to a pump.
My hospital offers me the following 3 options for me to choose:
  • Medtronic 780G
  • Tandem T-Slim (Air Liquide)
  • Omnipod DASH (insulet)
Because I don’t know the pros and cons of having a pump, and I also don’t know what would be the best option for me, may I ask for your guidance and advice based on your experience?

Thank you
 
I know this may not appear helpful but our requirements are all different. If our clinic has selected a pump, it is rare for it not to be any good.
The usual advice is to make a list of what is important to you and then read and watch videos about the pumps on offer.
This is not an exhaustive list but here's a start
- do you want a tubed or patch pump?
- how much insulin (basal and bolus) do you use over 3 days? Pumps need to be changed every 3 days. Typically, each pump takes up to 200 units. There are some pumps that take more. So, it is useful to know what you need as it may limit your choice.
- how important is it for you to have the option for closed looping. Given your choice, I assume the hospital is not offering to fund the appropriate CGM to achieve this today but may do in the future or you may chose to self fund.
- are you concerned about having your pump "on show"? Some pumps allow you to do a bolus from a phone app or PDM (remote control) whereas others require you to take it out (with its tubing). Do you mind?
- is size important? If you have a "smaller frame" you may find some pumps rather obvious regardless where you place it.
...

Personally, I came up with a list of requirements, considered whether they were nice to haves to mandatory and then scored the options available to me.
 
In Response said:
I know this may not appear helpful but our requirements are all different. If our clinic has selected a pump, it is rare for it not to be any good.
The usual advice is to make a list of what is important to you and then read and watch videos about the pumps on offer.
This is not an exhaustive list but here's a start
- do you want a tubed or patch pump?
- how much insulin (basal and bolus) do you use over 3 days? Pumps need to be changed every 3 days. Typically, each pump takes up to 200 units. There are some pumps that take more. So, it is useful to know what you need as it may limit your choice.
- how important is it for you to have the option for closed looping. Given your choice, I assume the hospital is not offering to fund the appropriate CGM to achieve this today but may do in the future or you may chose to self fund.
- are you concerned about having your pump "on show"? Some pumps allow you to do a bolus from a phone app or PDM (remote control) whereas others require you to take it out (with its tubing). Do you mind?
- is size important? If you have a "smaller frame" you may find some pumps rather obvious regardless where you place it.
...

Personally, I came up with a list of requirements, considered whether they were nice to haves to mandatory and then scored the options available to me.
Click to expand...
Thank you. Particularly for the list. It is very helpful.
 
Hi Bluemarinejosephine

I use the Omnipod Dash. I had the Medtronic 670 for a short while before this but due to arthritis in my hands I found the filling and changing the reservoir very difficult to do. I must stress that this was due my arthritis and not the pump.

The questions from In Response are a really good place to start in your decision making. I would suggest having a look
On-line as there are numerous videos on doing a set / pod change for each of these pumps. That will give you an idea of what is entailed

Good luck in your decision making
 
h884 said:
Hi Bluemarinejosephine

I use the Omnipod Dash. I had the Medtronic 670 for a short while before this but due to arthritis in my hands I found the filling and changing the reservoir very difficult to do. I must stress that this was due my arthritis and not the pump.

The questions from In Response are a really good place to start in your decision making. I would suggest having a look
On-line as there are numerous videos on doing a set / pod change for each of these pumps. That will give you an idea of what is entailed

Good luck in your decision making
Click to expand...
Hello, thank you very much for your reply and for your guidance.

Please, may I ask you? I read on other threads that there are costs involved but, from the hospital they have not informed me about any incurring costs. Could you enlighten me about the costs involved, if any, when using a pump?
 
The only costs I am aware of are
- insurance. I was expected to pay for insurance if I lose or damage my pump. I have covered this on my house insurance
- CGM for closed loop if your clinic do not fund it and you decided you want it. I know for T-Slim this is the Dexcom
- pump belt for a tubed belt
 
In Response said:
The only costs I am aware of are
- insurance. I was expected to pay for insurance if I lose or damage my pump. I have covered this on my house insurance
- CGM for closed loop if your clinic do not fund it and you decided you want it. I know for T-Slim this is the Dexcom
- pump belt for a tubed belt
Click to expand...
Hello, thank you very much for you quick reply and for your explanation.
I am so sorry for the embarrassing question… what is a closed loop?
 
Bluemarinejosephine said:
Hello, thank you very much for you quick reply and for your explanation.
I am so sorry for the embarrassing question… what is a closed loop?
Click to expand...
There is nothing embarrassing about your question. The forum members are here to answer.
Without a connected CGM, when your blood levels go high or low, you have to manually treat them. When high, you need to give yourself a correction bolus and when low, you need to treat with fast acting sugars. With a pump you could also manually increase your basal when going high or decrease it when going low.

With closed loop, the pump is connected to the CGM so it knows when your levels are rising or falling and can react automatically, For example, when your levels are falling, your CGM will tell the pump and the pump will suspend basal and, when high, your CGM can tell your pump and it can give you more insulin.

So, Closed loop is when a human does not have to get involved with corrections (but you still need to carb count and bolus when eating).
I think of me reacting to highs and low alerts by "fiddling with my pump" as Open loop - the connection between pump and CGM is broken and needs me to fill in.
 
In Response said:
There is nothing embarrassing about your question. The forum members are here to answer.
Without a connected CGM, when your blood levels go high or low, you have to manually treat them. When high, you need to give yourself a correction bolus and when low, you need to treat with fast acting sugars. With a pump you could also manually increase your basal when going high or decrease it when going low.

With closed loop, the pump is connected to the CGM so it knows when your levels are rising or falling and can react automatically, For example, when your levels are falling, your CGM will tell the pump and the pump will suspend basal and, when high, your CGM can tell your pump and it can give you more insulin.

So, Closed loop is when a human does not have to get involved with corrections (but you still need to carb count and bolus when eating).
I think of me reacting to highs and low alerts by "fiddling with my pump" as Open loop - the connection between pump and CGM is broken and needs me to fill in.
Click to expand...
I cannot imagine how uncomplicated it would be having an automated system handling the calculations… I am amazed. I did not know that this type of help existed… thank you for telling me.
 
Bluemarinejosephine said:
Hello, thank you very much for your reply and for your guidance.

Please, may I ask you? I read on other threads that there are costs involved but, from the hospital they have not informed me about any incurring costs. Could you enlighten me about the costs involved, if any, when using a pump?
Click to expand...
Like In response, I have included my pump on my house insurance. No other costs I can think of
 
h884 said:
Like In response, I have included my pump on my house insurance. No other costs I can think of
Click to expand...
Thank you very much. Please, may I ask you one more thing? I currently use Freestyle Libre to monitor my levels. When I started using it, the glue on the sensor gave me a terrible skin reaction. I had to come up with ways to create a barrier between the adhesive and my skin to continue using the system (the best I could find was Compeed pads). In case you use a pump that has a pod with adhesive, have you had a skin reaction, and do you know how this can be prevented?
 
Bluemarinejosephine said:
Thank you very much. Please, may I ask you one more thing? I currently use Freestyle Libre to monitor my levels. When I started using it, the glue on the sensor gave me a terrible skin reaction. I had to come up with ways to create a barrier between the adhesive and my skin to continue using the system (the best I could find was Compeed pads). In case you use a pump that has a pod with adhesive, have you had a skin reaction, and do you know how this can be prevented?
Click to expand...
There are a number of options depending upon your sensitivity.
I have used SkinTac before applying my cannula. I have used Cavilon, again before applying y sensor. And I currently use HyperFix tape under my patch pump.
 
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