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what helps you decide what pump?

Discussion in 'Insulin Pump Forum' started by Cobia, Jan 7, 2019.

  1. Cobia

    Cobia LADA · Well-Known Member

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    When you get your choice of pump what helps you decide whats best?

    Ive always said its not for me but my opinion is changing on whether i should use one....


    I showed my endo AAPS it covers her requirement of stopping insulin im booked in for a advanced carb counting course.

    In Aus we have the combo and the dana rs .... should a person go with better connectivity or better selection of consumables?
    I have a lean body im thinking set selection maybe one of the deciders....

    I know what the loopers think what do you guys think?


    Hopefully im not asking dumb questions.
     
  2. tim2000s

    tim2000s Type 1 · Expert
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    I think you should see if you can trial both pumps and sets and decide which you like best. I know a number of people are not fans of the Dana sets, and they have an odd reverse Luer lock on their cartridge which means the available range is limited.

    When a DIY loop fails (and they do from time to time), you have to be able to revert back to using the pump, so being familiar with the way the different pumps operate and being comfortable that you could live with one without the AAPS interface is also a good idea.
     
  3. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    Might be worth you joining the AAPS groups on facebook as there are very few users on this site.

    I personally use the Dana R with a right hand luer as the Combo wasn't an option I had.
     
  4. Cobia

    Cobia LADA · Well-Known Member

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    Tim you know im liable to reject both pumps just with how they feel. one advantage of this is hopefully better basel control. On the aaps facebook site the general recomendation is the dana having no extra software.....

    Does the ruffy simulation give much trouble?

    And yep with the left-hand lualock the dana raises questions here... I'm rural and here in the mallee its a place you really can only depend on your self....


    Could be an hour drive to find the sets for the dana.....
     
  5. Cobia

    Cobia LADA · Well-Known Member

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    Already on the AAPS site i was hoping for some general pump/set replies having only just starting in this direction.

    How did you get a dana pump with a right hand lure lock?

    Did you fit a conversion?
     
  6. Chowie

    Chowie Type 1 · Well-Known Member

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    @Cobia The only dumb question is the one you should have asked 60min ago!
    Which state do you live in?
    A big factor for me deciding which pump was the awesome and really knowledgeable pump nurse.
     
  7. Cobia

    Cobia LADA · Well-Known Member

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    @Chowie sigh being in Melb you should know where the mallee is ever hear of sunburnt country... I'm in the middle of it.... :)
    I will be in melb next week ...(to me its the never never)

    My endo knows all the pumps and given me advise on whether id get an improvement or not...

    I can still think of a few reasons why I shouldn't get one.
    And a few where i should... it's catch 22.:banghead:
     
  8. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Cobia, From my viewpoint as T1D and pumper in Adelaide, not as professional advice or opinion:
    Are you saying that you will only consider the DanaRS and the Accucheck Combo?
    Because in Oz there are also these companies providing pumps - Medtronic, Tandem, CellNovo and Ypsomed.
    see www.bioicwookie.com - Insulin Pumps In Australia - August 2018.
    Please do not restrict your choice until you have considered all of them.
    There are some web articles comparing one brand to another and also some forums commenting on pump reliability or otherwise, level of service provision and particular operational trouble with use of various pumps.
    Also checking which pumps are currently using CGM and which can be looped or will soon be upgraded to loop.
    And there is the question that whilst a private health insurance (or if you are very very lucky, the Aussie Govt) will pay for your pump, the consumables like reservoir and infusion set are on NDSS which still costs you plus CGM is not likely to be subsidised for you..
    Your endo can no doubt advise you on much the of options above (to some degree, you will still need to do your own homework), plus on how crucial it is(or not) to be on loop or CGM.
    Yes, some persons use basal only on their pumps but you would need to weigh up the convenience of being able to have the carb count and BSL inputted and bolus calculated and then readily bolused in by the pump, against having to do your own calculations, find the bolus insulin, draw up and inject then dispose of the needle/syringe etc.
    Best Wishes. :):):)
     
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  9. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Cobia, I thought I would post this separate:
    Choice of pump:
    Advantages over multiple injections:
    - indwelling cannula under the skin means only one actual injection through the skin every 72 hours (sometimes only 48 hours)
    - the basal rate is 'sculpted' by the endo to best cover basal needs including DP (Dawn Phenomenon) see on Home Page under Type one Diabetes - DP. The basal rate can vary between day and night, something that long acting insulin cannot always cover.
    - with the bolus side set up, the bolus doses for meals and for correction of high BSLs are easily done
    - reminders and alerts prompt one to do forgotten meal bolus and remind one of when to change sites etc
    - option of some pumps to display and use CGM and loop which greatly simplifies control of BSLs
    - the finer tuning of the pump reduces the number/risk of hypos
    - insulin doses can be given more discretely in company, at restaurants etc and many types of carrying devices are on the market.
    - most pump companies provide pumps with excellent reliability and service and prompt provision of supplies, and through their reps, help train Diabetes Nurses about the latest models and work well with such nurses to help solve patient's problems
    Disadvantages:
    - bolus doses may sting
    - sometimes a cannula goes in bent, or becomes bent, or detaches and BSLs rise more quickly as there is no long-acting reservoir of insulin in the body (alarms often do not detect these 'slow-downs in insulin delivery). Finding the right length and style of cannula can take time. Cannula troubles as above are the most usual pump problem.
    - The tubing between indwelling cannula and the pump can become tangled on things and lead to the cannula being pulled out so requiring extra vigilance and taping etc.
    - a scar tissue can form at old infusion sites and make insulin delivery near those sites less reliable - the problems usually takes years to develop
    - cosmetic - some find the bulk of the pump unsightly and the need to find more suitable places difficult
    - some pumps have a degree of waterproofness but not all - the ability of a pump to survive being splashed or immersed briefly may enhance its use for persons who undertake certain sports.
    -some pumps seem more prone to failure and need of replacement or repair, some companies are not as prompt with provision of supplies or advice
    - some pumpers complain of the difficulties with removing the pump for showers, intimacy etc. and the pump getting in the way.
    - whilst pumps have come a long way, there are still occasional failures of the pump, so supplies of short and long acting insulin and syringes need to be carried in case of the need to revert to multiple insulin injections, spare batteries or charging cord and power bank etc.
    I hope that helps.
     
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  10. Cobia

    Cobia LADA · Well-Known Member

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    Yep I know about http://www.bioicwookie.com/ thier lastest pump avalibility/writeup was in Nov 7 pumps all up in aus.
    I intend to get in contact with them all its funny huh i run a farm and im daunted by what i want to do. I dont know anyone in the same situation. Here its smooth stable and as far as I'm concerned only diabetic for parts of the day... for the last 24hrs tho it reminds me again its watching.... 2 hrs swinging a shearing handpiece and it was nuts...


    One thing that comes to mind is when i first got t1 3 years ago was the dana thread on reality check... it was an eye opener and its one reason to ask here....

    I drive heavy machinery every day the summer temps here most cant handle it im not even sure its right but it makes a bit of sense if i can make an unpredictable enviroment a little safer.

    I plan to take my time ....
     
  11. Cobia

    Cobia LADA · Well-Known Member

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    Thanks for posting this @kitedoc its all things i have to consider.

    There could be another drawback or 2 from my perspective.

    Temps here get to 45C or more direct sunlight makes things damn hot to handle (fairly often in summer)......


    I handle stock not sure how a pump would handle this situation.

    Im not on here every day sorry I took a while to get back.
     
  12. kitedoc

    kitedoc Type 1 · Well-Known Member

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    HI @Cobia, Glad you have all the latest information.
    Whilst I am not out in the heat most days, I do live in Adelaide and so am used to ensuring my insulin stays cool enough.
    So cooler blocks for the spare kit carried around, ice brick inside the shirt if need be or the pump carried in a bag strapped to my waist with a block inside it.
    I also fly kites in summer, so have had to cope with standing, walking, running on the sizzling beach sand for hours at time. The ability of the adhesive patches, used on pumps or infusion sets, to withstand the heat and sweat is a real issue, too.
    One thing that was reassuring for me was that my new pump, the Tandem Slim. has an alarm to indicate if the insulin in the cartridge of the pump is nearing maximum safe temperature (= 30 degrees C) ( and also when getting to 2 degrees C ), plus an alarm if the pump itself is reaching a temperature at which the electronics are likely to fizzle out.
    I am not sure if other pumps brands have these temperature alarms but they sound like a good idea for those in Oz.
    With exercise, the beauty of the pump is that usually (there is never an always) adjusting the basal rate of the pump down say 20, 30, 40 % at a specified starting time and finishing time around the exercise time plus perhaps repeating this at a ? different % for part of the night when exercise has occurred in the afternoon, early evening as well - helps to prevent hypos due to exercise (BSL drops near after the exercise time and the later BSL dip ? 6 to 12 hours later) and is actually easier and usually much more accurate than trying to do it with adjusting doses of the multiple insulin injections.
    The main reason I was put on a pump was to prevent night hypos, that 8 plus injections of insulin per day could not cope with and probably contributed to!.
    So preventing hypos, particularly at night was a big deal for me.
    Please do take your time and keep asking questions!! :):):)
     
  13. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Gidday again @Cobia, one thing about all the pumps is that you cannot read the ##** screens in the full sunlight.
    Just the same as with mobile phones !!
    The waterproofness of most pumps would handle a sheep dip but you would wish to have a good extra patch of protective adhesive over the cannula entry site. Wearing a pump inside the shirt, in a pouch with ice blocks may do the trick , temperature-wise.. There could be the risk of damaging a pump on railings, gates etc so padding ++.
    It might pay to try putting a thermometer and ice brick in a neck or waist wallet , wear it on a couple of hot working days and to see how the temperatures go plus see how long the ice bricks last before needing changeover and how well back -up ones in the esky last.
     
  14. kitedoc

    kitedoc Type 1 · Well-Known Member

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    @Cobia, also the test strips for glucometers become inaccurate over a temperature of 30 degrees C or under zero degrees C.
    My meter can operate between 5 and 45 degrees C. Some meters have a message to say when the meter is too hot to use.
     
  15. Cobia

    Cobia LADA · Well-Known Member

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    Hi @kitedoc yea the glucose meters just shutdown when too hot or cold... not to accurate with hand cleaner either.... now i try to just use it to calibrate glimp or xdrip every morning.. on farm is the best method... driving every vehicle has AC. CGM helped me a lot.
     
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  16. Cobia

    Cobia LADA · Well-Known Member

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    Well to me the buttons on my S7 are bigger than on a pump my paws arnt exactly small.. :)

    The ice pack idea is worth checking out..... I'm thinking in truck i may have to add some sort of evap AC just to give its AC an assist during harvest.....
     
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  17. Cobia

    Cobia LADA · Well-Known Member

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    The tandem interests me ... on the us forum thier beta testers are trying the basle IQ out now with the G6. Unique pump too from what ive read doesnt put a load on the resevor...

    You fly kites i love to fish the cobia is one that's always eluded me..

    Night hypoes are hard... for me so far I've handled them glimp helped me sort most of them out....

    Atm still playing with androidaps even with just a virtual pump its helps me spot basle errors and still trying to get the cgm part stable enough for it... it seems ok for 2 or 3 weeks then glimp and xdrip start playing up with the miomio... I'm wondering if a change of os in the phone may help... Will try an official lineage for it over the weekend.

    Linux is simpler than android...,
     
  18. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Cobia, your user namesake looks like quite a challenge - up to 2 m long. There is always next season, next year to catch one - I guess that is part of what keeps people fishing.
    They believe that the first kites were invented and used in the Pacific Islands to help catch fish. Unfortunately historic records from that part of the world are not as durable as Chinese records, so in the past the Chinese have been credited with inventing kites.
    But for catching Cobia, you might need a man-lifter size kite !!
    @tim2000s is the go to person on site for info about Libre, apps and CGM.
    The Tandem is a really neat pump but as I put in an earlier post any pump is likely to have practical issues with the adhesive patches holding the reservoir (e.g. Ypsomed) or infusion set (all the others) in place in such fierce temperatures. I imagine it depends on how often you are in the 45 degree heat and how often in the a/c cabin and the amount of sweating.
    I have used areas of adhesive tape and crepe bandages to hold infusion sets on in the hot summers on the beach. And all that is going to cause more sweating !! It usually works but I still have had some failures. You only know about the failures when you have time to check or the BSL starts rising and rising.
    How to you get on with the Libre sensors ? Do they stay in during hot weather? Their 'staying in place' performance could give you a guide as to the possible success or other wise of a pump.
    Someone needs to invent a gecko foot adhesive patch !!
     
  19. Cobia

    Cobia LADA · Well-Known Member

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    Hi @kitedoc yep in my 20s it was what i was after seeing the spool spin with a torpedo on the line....
    Biggest fish for me was a 5ft bronzewhaler bay of plenty NZ... 20lb line 13ft surfed bent tip to tip 40 mins... was looking for what i know Australian salmon... the kiwis that watched me bring it in didnt want it so i did a Rexie...:)

    Back on track....

    I use opsite flexfix to keep the libre on gooie stuff. Had one batch do 3 weeks but the norm is about 14 days 12 hrs they time out.

    Now trying linage 16 in the s7 with xdrip so far so good seems stable i just need time.....
     
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  20. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Ha! Ha! Rex would have been proud. Sounds like a real battle and well fought.
    I am glad opsite works well for you. Hope the apps help.
    Next challenge to 'catch'
    P4040177.jpg
     
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