Pump Upgrade – Decision Time/ Advice Appreciated

Hello all,

Hope you're well!

First of all, appreciate how many threads there are on this already and the wealth of info available.
However, starting a new thread with the hope I might get some advice on the options I have and from people that may have been in the same boat.

To set the scene: my current pump (Accu-Check Spirit Combo) is now out of warranty so I'm eligible for an upgrade, and considering it's something I'll be using for the next 4 years, I don't want to take the decision lightly.

I've been using Accu-Check pumps for 10+ years now so I'm used to how they work, good customer helpline etc, however I've been told by the nurse today, that Accu-Check are not moving as fast in the market as other pumps, and also if I go with Accu-Check again it's hard to get the data from the pump for appointments etc etc. So going for the same pump again feels like a bad choice.

Before I go into the options I have, just want to note a few of the pros/ cons with the current pump:
Pros: Easy to use, great helpline, battery lasts a long time, easy to change cartridge, used to functionality, can wear on a run, can bolus discreetly using buttons
Cons: don't use the blood kit that pairs with it as have a Freestyle Libre - so handset is redundant, can't download data at hospital anymore which makes reviewing information very difficult, pump has 'occlusions' on a regular basis which ends up with pump going into stop in the middle of the night, better solutions now on the market, doesn't enable best control of diabetes

The pumps I've been offered the chance to upgrade to are below, and I've listed a few pros/ cons against them :–

Omnipod DASH
Pros: No tubing, gives more flexibility to lifestyle, would change life not having a pump and tubing attached - might make me happier in general
Cons: Quite big, no ability to bolus without handset, no smartphone app as alternative to handset, have read it can cause skin reactions, can fall off in hot/ sweaty conditions, doesn't sync with Freestyle Libre

Question: Anyone who uses the Omnipod - any thoughts on the above? Have read people say that the helpline are quick to get replacements out etc, however how many do you get on a prescription/ is it limited supply?

Tandem T:Slim X2
Pros: Sleek design, interface looks easy to use,
Cons: doesn't sync with Freestyle Libre, re-chargable battery (it's easier with current pump to just replace battery and not have to worry for over a month - though I know it's not as environmentally friendly), looks like a nightmare to replace insulin cartridge

Question: Anyone who uses the Tandem - any thoughts on the above? Is it as bad as it looks to change the insulin? Any more pros about it? Is the closed loop tech ("Control-IQ advanced hybrid closed-loop technology adjusts insulin delivery to help prevent highs and lows") as standard or only if you have the pairing Dexcom CGM?

Medtronic MM640G
To be honest, have written this one off and putting the choice between the above two. This one looks too big/ clunky for me.
Though open to hearing any feedback from anyone who uses this one!

As always, thanks in advance for replies!

Cheers,
Rick

Chas C said:

I moved after using Combo and Insight to the t:slim. I don't recognise the worries you have over it. The battery lasts when fully charged about 4 days, I charge it daily whilst having breakfast (I have charged it in the car when travelling and from a power pack before when on holiday, never had any issues). The cartridge is no different than a Combo really, but not as good as the Insight, easy to change. If you have any more questions please ask.

I'm using the CIQ function which is great, you would likely need to move to the Dexcom (recent Nice announcement should ease this).

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Thanks for the reply, Chas. Good to know you were in a similar position moving from the Combo to the T:Slim and the hesitancies I have you don't think are an issue. It does look good, and definitely an option I'm swaying towards.

Is there a handset with this device or does everything need to be done on the pump itself? And on the Dexcom front, keen to explore that though believe you need to self-fun at the moment. Assuming the NICE announcement mentioned might mean different in the future?

Cheers!
Rick

Juicyj said:

Yes definitely write off the 640g, that was my last pump and have now been on the tandem slim for a year.

Recharging the battery is no issue at all, just keep a couple of spare chargers lying about and you can recharge whilst driving, in the shower etc etc, I just make sure that I charge when it goes down to around 40% and charge it twice a week.

Changing insulin is a minor point, it's easy once you know what your doing. All pumps require a set change so it's not a tool for comparison IMO.

When used with Control IQ and Dexcom, it's doing the minor basal tweaks for you, it can't be used for this without the Dexcom. It doesn't prevent the highs and lows but it does make it easier to manage them, you will still need to keep an eye on levels to tweak pump settings, but your more likely to stay within your range once you've finely tuned your settings, the Clarity software on Dexcom makes it easier to pinpoint issues with control though. Pro's for me are sleep quality, I have never had great sleep since being diagnosed with type 1 but can honestly say my sleep now is so much better, it's rare to get night time hypos once your basal settings are tweaked, I now see a flat line every night in range which for me has been a massive game changer as more relaxed. Also my time in range is hugely improved. The only downside on this pump for me is that I still struggle a bit when exercising for longer than an hour as the exercise mode doesn't quite hit the nail for me, I can drop suddenly when exercising but of course I am mindful of this so have other ways to manage it.

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Thanks for the detailed response @Juicyj! You've given me a bit more peace of mind re my thoughts on the 640G too. Battery feels less of an issue now, and as you say, once you get used to changing the cartridge it's probably a doddle. I remember hating changing the cartridge and priming on my Combo but it's second nature now.

Regarding spare cartridges with the T:Slim - do they provide enough backups etc? That's one thing I'm fond of with Accu-Check in that I have a good backup supply of cartridges, needles, infusion sets etc. Hoping that would be the same with a new pump supplier.

Good to know about 'exercise mode' too, assuming it doesn't have a 'temporary basel' functionality like the Accu-Check?

Thanks again!
Rick

Juicyj said:

Hello @Rickmac1988

I always order in 3 months of supplies and call them up a month before I run low, the service is pretty good and get supplies within 2 days.

There's 2 preset modes already set up - sleep and exercise, however if the exercise mode doesn't work for you then you can set up your own basal setting, I find that if I keep either exercise or sleep in use constantly then I can run a tighter range as they are based on operating on tighter ranges. I find that for me personally using the tandem that I prefer to low carb most of the time to keep this running in range, but of course when I fancy a takeaway/blowout then that's fine too, but like seeing the line stay within range and can keep within the range around 70-80% of the time, but that's me, some run better than this - join the FB Tandem page if you decide this is the one for you as lots of useful advice on there from other users, you'll find Tandem Slim pump users are pretty happy with the performance of this

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Thanks @Juicyj! Ah 3 months supply is perfect and the 2 day delivery sounds the same as Roche!

Thanks for the clarity on the preset modes as well, good to know it offers that functionality. I wish I could be the same as you and low carb but unfortunately I am a big fan of carbs FB group sounds interesting too, I've just requested to join so will be good to see what others have to say about it too!