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Pump Advice

Louisek93

Louisek93

Member
Messages
9
Type of diabetes
Type 1
Treatment type
Insulin
Hi , new to this forum thing so bare with me .. I have been type 1 for 21 years (injections) & last week I got offered to go on the pump, ofcourse I'm feeling apprehensive and a bit scared about the change but I think it would completely change my life. What's your thoughts on them? Best pump out there ? And any other advice you could give me .. Thanks
 
Hi @Louisek93,
I was advised to move to a pump at around the 45 years on insulin mark. My need to do so was because of debilitating night hypos despite up to 8 injections per day.
Being stubborn and fiercely independent I had resisted the thought of using a pump for years before. But the hypos and my endocrinologist convinced me and I have not looked back. I am now at the 51 + on insulin and have never regretted the decision.
Very few hypos, brilliant HBA1Cs, very occasional grumbles about the the needle insert going in bent and that affecting BSLs.
I have an Animas pump which is being phased out, sadly. It is a pump with a tube as supposed to a tubeless pump like the Omnipod.
Living in Australia I have the choice going forward (after my pump's warranty expires, usually a 4 year process so = 2019 for me) of Medtronic, Tandem or Roche.
If you live in the UK you might only be offered one pump brand, others on the site here will be able to inform you better than I about that and about the other brands.
I get the impression that some on the Omnipod (the tubeless) find it tricky to position it but like the lack of a tube that might get tangled or hooked on something. My comment on that is whether activity such as sport, sailing etc would be possible with a fixed pump that could be dislodged during such activities.? And a pump with tubing can be detached temporarily leaving the needle port in situ where as the Omnipod would need to be removed and repositioned/re-attached. (pumps may be temporarily removed say when showering, but the omnipod can be left on for that, during sexual activity, to read off data.
The varieties with tubes do have their issues but you get used to preventing tangles. There are accessories to help attach and hold pumps and discussion on this on forums like Pumps, Type 1). I like the soft toy lion in the Medtronic accessories but am too big a kid to actually use it in public!!!
Do look at the device (insulin pump) companies sites to familiarise your self with them and then at the discussions/pros/cons about them on the Pump forum.
Of course some pumps accomodate Continuous Glucose Monitoring (CGM) and there are discussions on this vs use of devices like the Libre. Medtronic's CGM has a dose reduction feature for when BSLS get low. It is expected that Dexcom, the CGM used by Animas, and to be used with Tandem, will have this feature in 2019. Some members have details on hooking up pump CGM read outs to mobile phoned and rigging up 'closed loop' systems where the pump automatically puts in extra insulin when the CGM readings gets above a certain BSL - but these are not under warranty and are complicated.
My 'biased' vote is to take the insulin pump rather than staying with multiple injections. There is an tourism slogan in Australia about one of our States: "If you never never go, you will never never know".
If you decide on the pump, there can be more discussion about the ins and outs of the brand in question etc.
Best Wishes on the next step on your journey and please read and keep posting !!
 
Hi @Louisek93 What your feeling is perfectly normal, when you’ve relied on injections and this has been your way of life for so long then changing to a new insulin delivery system can cause feelings of anxiety.

I moved to a pump 2.5 years ago, on injections I was struggling to get good control, my HbA1cs were up and down and I felt like I was putting so much effort in and not getting decent results. It was a huge relief to get approval and at the point I got my pump I was over the moon, it took a while to adjust ratios but it’s been such a positive move, it reduced my anxiety with injections, I can adjust for exercise or other events and making adjustments to manage my control is so much easier now, my HbA1c is at its lowest.

Pumps are all pretty similar it just depends if you are ok with cannula sets or pods, if you know what pumps are on offer then YouTube them to see what other pump users make of them.

Good luck and let us know how you get on :)
 
I can't offer any advice on the best pump as I was given no choice and the one I have (Animas Vibe) is no longer available.

However, I can share my pumping experience.
After 12 years of reasonable control with MDI, I wasn't sure what the point was of having something attached to me all the time.
That was until I learnt about the way pumps control basal - they pump fast acting insulin every 5 minutes. The fantastic advantage of this is that you can alter your basal
- you can set up a daily schedule to account for your different basal needs at different times of the day (e.g. to handle dawn phenomenon)
- you can temporarily adjust your basal when you exercise to avoid hypos (this is huge for me)
- if you are feeling unwell resulting in high BG, you can increase your basal immediately and tweak it a couple of hours later if it is wrong rather than waiting for your daily basal dose, increase it a bit, increase a bit the next day, increase it the next day ... and before you have worked out the correct increase, you are feeling better.

Another advantage is the ability to administer tiny amounts of bolus. For get half a unit. What about 0.05 units? This allows great control with corrections and meals (if you can count your carbs that accurately).

Of course, there is the advantage of not realising you left your pens at home so can't eat. However, you do need to think of some sort of backup plan in case your pump fails.

And whilst we're on the negatives, all this fun doesn't come for free. You still need to carb count. In fact, you need to carb count more accurately - no rounding up to the nearest 10g carbs (although I still guestimate a lot of the time). As you no longer have "spare" basal running around your body mopping up any carbs you miscounted, you are more likely to go high.
Talking of going high, this more of a risk - if your pump fails, you have no basal in your body so you could go high quickly. Before you panic on that one - I have been pumping for two and a half years and never experience this ... I just have to be aware.
It's wonderful that you don't have to prime your pen every time you eat, but every 2 to 4 days, you have to change your pump sets which is more faffy. You get used to it but I was very nervous I would make a mistake when I first started.

All these different basal rates and bolus ratios and ... can take some time to get sorted. So just when you are not sure if you really want to be attached, you may experience more hypos are hypers as the settings are tweaked, tweaked again and tweaked again until they are right. And this is the time when you are nervous with the set changes. Don't expect the first few weeks to be run - expect a bit of a roller coaster. But it will sort itself out and you will be gliding along at the peaceful end of the log flume for a long time afterwards

As I mentioned, I had no choice which pump to get. So I have one with a tube. Most of the time this doesn't get in the way. I know some people express concerns what to do with it when they sleep (I put it in a garter belt type thing attached to my leg) or when they shower (I take it off) or when they swim (I take it off ... but remember to reattach and give myself a basal top up if I am disconnected for a while) or during ... ummm ... intimate moments (I take it off).

My biggest problem with the tubiness is that I find it difficult to hide and be easily accessible to give myself a dose without fumbling in my bra, hitching up my dress or running off to the bathroom. Many people cope well with this and find they can can put it in their trouser pocket (lucky guys with their large pockets and no hips) or clip it to their bra strap (lucky women with "enough" to hide the pump bulge). But, most of the time I clip it to my belt and be aware that others are wondering why I have a pager from the 90s.

Sorry for the essay - I hope I have not put you off. Whilst there are annoying things with a pump, given the choice I would not go back to injections.
However, one thing which made me take the plunge was, when I was told if I didn't like it I could go back to injections, I decided I had nothing to lose.

Tell us what you decide @Louisek93
 
Last edited by a moderator:
helensaramay said:
I can't offer any advice on the best pump as I was given no choice and the one I have (Animas Vibe) is longer available.

However, I can share my pumping experience.
After 12 years of reasonable control with MDI, I wasn't sure what the point was of having something attached to me all the time.
That was until I learnt about the way pumps control basal - they pump fast acting insulin every 5 minutes. The fantastic advantage of this is that you can alter your basal
- you can set up a daily schedule to account for your different basal needs at different times of the day (e.g. to handle dawn phenomenon)
- you can temporarily adjust your basal when you exercise to avoid hypos (this is huge for me)
- if you are feeling unwell resulting in high BG, you can increase your basal immediately and tweak it a couple of hours later if it is wrong rather than waiting for your daily basal dose, increase it a bit, increase a bit the next day, increase it the next day ... and before you have worked out the correct increase, you are feeling better.

Another advantage is the ability to administer tiny amounts of bolus. For get half a unit. What about 0.05 units? This allows great control with corrections and meals (if you can count your carbs that accurately).

Of course, there is the advantage of not realising you left your pens at home so can't eat. However, you do need to think of some sort of backup plan in case your pump fails.

And whilst we're on the negatives, all this fun doesn't come for free. You still need to carb count. In fact, you need to carb count more accurately - no rounding up to the nearest 10g carbs (although I still guestimate a lot of the time). As you no longer have "spare" basal running around your body mopping up any carbs you miscounted, you are more likely to go high.
Talking of going high, this more of a risk - if your pump fails, you have no basal in your body so you could go high quickly. Before you panic on that one - I have been pumping for two and a half years and never experience this ... I just have to be aware.
It's wonderful that you don't have to prime your pen every time you eat, but every 2 to 4 days, you have to change your pump sets which is more faffy. You get used to it but I was very nervous I would make a mistake when I first started.

All these different basal rates and bolus ratios and ... can take some time to get sorted. So just when you are not sure if you really want to be attached, you may experience more hypos are hypers as the settings are tweaked, tweaked again and tweaked again until they are right. And this is the time when you are nervous with the set changes. Don't expect the first few weeks to be run - expect a bit of a roller coaster. But it will sort itself out and you will be gliding along at the peaceful end of the log flume for a long time afterwards

As I mentioned, I had no choice which pump to get. So I have one with a tube. Most of the time this doesn't get in the way. I know some people express concerns what to do with it when they sleep (I put it in a garter belt type thing attached to my leg) or when they shower (I take it off) or when they swim (I take it off ... but remember to reattach and give myself a basal top up if I am disconnected for a while) or during ... ummm ... intimate moments (I take it off).

My biggest problem with the tubiness is that I find it difficult to hide and be easily accessible to give myself a dose without fumbling in my bra, hitching up my dress or running off to the bathroom. Many people cope well with this and find they can can put it in their trouser pocket (lucky guys with their large pockets and no hips) or clip it to their bra strap (lucky women with "enough" to hide the pump bulge). But, most of the time I clip it to my belt and be aware that others are wondering why I have a pager from the 90s.

Sorry for the essay - I hope I have not put you off. Whilst there are annoying things with a pump, given the choice I would not go back to injections.
However, one thing which made me take the plunge was, when I was told if I didn't like it I could go back to injections, I decided I had nothing to lose.

Tell us what you decide @Louisek93
Click to expand...
Ah! If only they looked more like an IPod or something and played all sorts of tunes as well!!
 
kitedoc said:
Ah! If only they looked more like an IPod or something and played all sorts of tunes as well!!
Click to expand...
I am not like others ... I have a thing about being different. At school, I was the only girl who didn't have their ears pierced and the only reason was because everyone else had them done.
As, for having my pump on show, it is a feeling I can't hide my diabetes. Although I know very few people notice it, I feel it is a big label/arrow on my belt saying "this person has DIABETES!"
 
helensaramay said:
I am not like others ... I have a thing about being different. At school, I was the only girl who didn't have their ears pierced and the only reason was because everyone else had them done.
As, for having my pump on show, it is a feeling I can't hide my diabetes. Although I know very few people notice it, I feel it is a big label/arrow on my belt saying "this person has DIABETES!"
Click to expand...
I suffered from a bit of a 'I am Different' complex at school and thereafter. I wore that 'badge of difference' even though most of the time few people really knew. I think in retrospect it was a protest against being dependent on insulin, testing etc. But I also could not fully 'copy' my peers anyway, because of dietary issues, caution about exercise, daredevil type activities and so on.
It make me a bit of a loner at times. But I survived, despite doing some crazy things like week long canoe trips thru wilderness. And part of that was about planning and preparation and succeeding.
 
Afternoon, thanks for the tag - following this with great interest, as after injecting for 20 years, I’m starting pumping next week! Am excited and mildly terrified in equal measure, but if it deals with dawn phenomenon without me having to wake up at 3 and 5am to correct every day, and the resistance of shark week, then bring it on!

:borg::borg::borg:
 
I have been on pump therapy as they call it for 3 years now. I started off with the Accu-Chek combo pump system which was a good change to having to inject 5+ times a day. You have to change the infusion sets once every 3 days instead and it comes with an insertion device so all you have to do is load it up, put it over where you want it and press a button and it's all set up. The thing I didn't enjoy about this set is that you had to load up all the insulin yourself, as in, take the syringe and extract the insulin from the vial (I am on Novorapid for reference) and then wait for the infusion set to be primed. Depending on what length of tubing you decide on the longer this process takes.

Then I was on the Accu-Chek Insight pump system which was a lot more slimline and the handset was great as you could control the whole thing from that, meaning the pump never had to leave my pocket all I had to do was test my glucose levels and I could input my carbs I was eating and it would tell me how much insulin to take.

I am now on the Omnipod system and it's my favourite so far. There's a small plastic pod attached to me that I change every 3 days that is filled with a minimum of 100 units and a maximum of 250 units. That handset it comes with does everything. Input your carbs after testing and it will suggest your bolus for you so there's less working out to do when it comes to meal times (if you carb count that is).

As for pumps in general, I was apprehensive at first and turned it down the first time I was offered one. I was bothered by the fact that I would have something attached to me 24/7 but once I started it I realised I preferred not having to inject with pens, I could just whip out my handset and press a couple of buttons and boom. Sorted.

It is all personal preference of course and they aren't for everyone but personally I find it much easier to manage now that I'm not having to remember to inject. If you want to know any more details about the three systems I mentioned hit me up, I don't mind going through my experiences with them :)
 
Hello @Louisek93, like you I have had diabetes for 21 years but have been using a pump for nearly 6 of those. I was given a choice of a few different pumps and went to a session at the hospital where they had all the types available and could have a feel of them, see what they looked like and could ask questions. I went for a medtronic one as that was the one my doctor had recommended for me.
I now have a medtronic 640g and I really like it.
I'm tired at the moment so my brain is not working very well, but just wanted to reply as I don't think anyone else who has, has a medtronic pump. I will have a think about what useful information I have to share but in the mean time let me know if you have any questions about the medtronic pumps :)
 
“Best pump”is An opinion. And there’s always a lot of different opinions.
 
Thankyou so much everyone for your comments and advice, much appreciated. I have done some research and there is one or two pumps I'd consider. Due to personal preference id most likely go for a cannula one rather than the needle under the skin cause needle under the skin terrifies me(lol). I'm looking forward to my appt in october to find out even more about them X
 
@sleepster the medtronic 640g is the one ive been looking at for the past few days and it looks like it's the one that would be most suitable for me. I wear the freestyle libra aswell but was wondering with that pump do you wear a different CGM device? X
 
Louisek93 said:
@sleepster the medtronic 640g is the one ive been looking at for the past few days and it looks like it's the one that would be most suitable for me. I wear the freestyle libra aswell but was wondering with that pump do you wear a different CGM device? X
Click to expand...
Hi. It's the enlite sensor that is worn with the 640G.
 
I'm afraid I have no experience with CGMs (not through choice!) so I don't know much about them. Medtronic do have a CGM which connects to the pump, but I'm afraid that's the extent of my knowledge, sorry!
Medtronic are super helpful if you phone them and I'm sure they could give you any information you need.

Edited to say: funding for CGMs is different to pump funding, at least where I live, so you would have to find out if you can get funding for the medtronic ones
 
It all seems very confusing, thankfully I'm glad i have an appointment with my dsn to discus things further X
 
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