# Remote pump starts



## everydayupsanddowns (May 22, 2020)

I was interested to get a phone call this week about measures being put in place for remote pump starts. My pump went out of warranty at the end of last year, but I didn’t get called for a ’show and tell’ of the current crop of options before lockdown.

It will be interesting to see how this plays out.

Ive an idea which direction I might go, but I would like to find out about all the available options before making the final choice.

Anyone else due for renewal or pump start any time soon?


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## SB2015 (May 22, 2020)

I got to go to a pump update the week before lockdown, which was nearly a year before my next pump was due.  I was told that I could have the next pump ahead of time as I was sure what I wanted, and the DSN was realistic enough to know that I would spend ages going round and round and round in circles.  

And then ..... lockdown.  I was emailed and asked to wait as my pump was still under warranty so no urgency.  I am not sure what has happened for those whose update was in these last few months.


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## Sally71 (May 23, 2020)

My daughter is due for renewal in July, I won’t be surprised if it doesn’t happen on time!  Haven’t heard anything yet, we mentioned it at clinic just before Christmas and nobody seemed in any hurry.


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## Pumper_Sue (May 23, 2020)

As you can read and write and follow simple instructions and know your basal rates, there is no reason what so ever that a pump of any make can not be sent to your home address for you to set up and plug in.
The only pump I have had a face to face set up was with my last pump, this was only due to my DSN not having much pump experience so it was mainly a learning curb for her. First pump I had I watched a video on line so just followed the basic set up from there.


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## trophywench (May 23, 2020)

Roche pumps don't die even though the 'Pump Timer' says they're beyond their replacement date, plus I believe they extended everyone's guarantee for 6 months when all 'this lot' started in March, so if it did run out in July, it's now next January.

What used to happen was, even though the pump didn't stop working and they'd still supply consumables, should it go wrong and need replacing after that date - they wouldn't send just replace it like they do when the guarantee is current.  I'd like another Combo TBH and we can still get them - but the meter/remote for the Insight is slow in comparison to the previous 'Expert' meter/handset and I think you get the same Insight handset now with the Combos. My pump tells me it times out in 111 days but my Clinic looked at their records and tell me it's December, so ?  Should be seeing them in August now anyway.

@Sally71 - you're likely to find out about the handset before me, so I'll be asking you about that!


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## Sally71 (May 23, 2020)

Our pumps have never had the timer switched on, will get a warning when it goes out of warranty but it will keep working, the old one did.  They just might not send a new one if we are unlucky and it fails, will have to check about the warranty!  The pump presumably will still think it’s out of warranty even if they have extended it.

Actually daughter fancies something with integrated sensors next so we'll probably be looking at Medtronic or T-Slim, I think she prefers the T-Slim but we don't know anyone who has one who can tell us whether it lives up to expectations or not. I've heard one or two not so good things about Medtronic.  I'll be sad to say goodbye to Roche, we’ve always had good service from them and I’ll miss the remote control capability, then again daughter turns 14 next week and is already doing quite a lot more for herself than she was doing at the last pump change, so I’m going to start to be sidelined anyway!


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## trophywench (May 24, 2020)

@Sally71  - when she gets her knickers in a twist - I rather predict she'll want you there to sort her out again LOL !


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## MrDaibetes (May 24, 2020)

@everydayupsanddowns How interesting for you, what pump are you thinking of upgrading/switching too?


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## everydayupsanddowns (May 24, 2020)

Pumper_Sue said:


> As you can read and write and follow simple instructions and know your basal rates, there is no reason what so ever that a pump of any make can not be sent to your home address for you to set up and plug in.
> The only pump I have had a face to face set up was with my last pump, this was only due to my DSN not having much pump experience so it was mainly a learning curb for her. First pump I had I watched a video on line so just followed the basic set up from there.



Well yes! You know that Sue... And I know that... but I have found HCPs get very twitchy about such things and require you to have a tick in the ‘has received training’ box. Which is probably fair enough tbh, though can be a little bit exasperating at times.

For example when I had to complete the online Libre training modules as per local policy despite having used the device self-funded for years and my consultant chuckling that he often referred people to the DTN Libre education videos that I took part in! 

Still... as tick-boxes go, it’s not really much of a bother to have an hour’s video call or whatever it will end up being!


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## everydayupsanddowns (May 24, 2020)

Sally71 said:


> Actually daughter fancies something with integrated sensors next so we'll probably be looking at Medtronic or T-Slim, I think she prefers the T-Slim but we don't know anyone who has one who can tell us whether it lives up to expectations or not. I've heard one or two not so good things about Medtronic. I'll be sad to say goodbye to Roche, we’ve always had good service from them and I’ll miss the remote control capability, then again daughter turns 14 next week and is already doing quite a lot more for herself than she was doing at the last pump change, so I’m going to start to be sidelined anyway!





MrDaibetes said:


> @everydayupsanddowns How interesting for you, what pump are you thinking of upgrading/switching too?



It’s the Medtronic and TSlim that are most on my radar.

I know you get on well with the MM670 @MrDaibetes, and I half wonder if I could stretch out my MM640 until the MM780 launches... but i have a few niggles with the form and ux of the 640, as brilliant as it has been for me... I wish they were changing the chassis, and could give you the option of getting rid of 50% of those (FDA required?) ‘hard of thinking’ button presses once you’d got used to the functionality.

So the TSlim is an interesting option. I much prefer the form of it, and know a couple of people using it who like it very much. The reservoir filling seems a bit fiddly, but OK. My main reservation I think, is the rechargeable battery which probably needs a daily top-up. not quite sure when I would best fit that in.

Plus I need to spring for a Dexcom G6 Starter pack just to make sure my body gets on OK with Dex sensors as Ive never used them

There are other options too (Including the fancy new Omnipod)... but I‘ve slightly taken my eye off the ball tbh, and could do with a refresher of what’s current and what’s coming (Roche Solo??)


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## everydayupsanddowns (May 24, 2020)

Sally71 said:


> we mentioned it at clinic just before Christmas and nobody seemed in any hurry.



Yes I’ve been waiting to start Libre since September! Time just seems to drift with clinics. Doubly so now!


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## Sally71 (May 24, 2020)

Yes it's the charging which my daughter isn’t sure about, she doesn’t want to be plugged into the mains! If it can be done every day then I would suggest that she does it while she's having her shower and will have the pump off anyway.  My dad used to be an electrical engineer, and always says that rechargeable batteries last longer if you run them right down and then charge them all the way up again; probably not so critical with modern lithium-ion batteries as it was with nickel cadmiums, but probably still some truth in it. But you wouldn't want your pump to suddenly die when you were out and about would you - we have portable battery packs, but that would be a lot of stuff hanging off you!

As we are probably changing pumps next time I would want some proper training if possible, even if it was only an hour with a rep.  But we'll have to see what happens.  Last time, because we had the same pump again, we didn’t need any training but the nurses said I still had to go in and have a session with the rep to collect the new pump.  I didn’t bother to take my daughter though, just took a vial of insulin and a cartridge and just sat there loading the new pump up and programming the basals in while the rep was talking!  And then just swapped pumps that evening.


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## m1dnc (May 24, 2020)

My 640G 'expires' this summer too. I'm still stuck out in the tropics and still no flights back to Blighty, or anywhere else for that matter. I'm booked on a flight in July and I reckon there might be a 50/50 chance that will take place. We haven't had any confirmed covid cases on island since the end of April and the only two remaining cases are expected to recover shortly. We'll then be officially 'covid-free'. I can't tell you how lucky I feel being here. Our curfew has been progressively lifted over the last couple of weeks. We still can't have social gatherings of any sort, but we can get out and about. The only downside is that it is getting blinking hot now (it was 34 C at 9:30 this morning), and the hurricane season officially starts on 1st June.

I had my annual review by email last week, and a local doctor did an HbA1C for me. I was really chuffed with the result: 6.1.

My pump clinic say that when I change pump in September (assuming I'm back), training will be by video call. I've decided to go for an Omnipod. I couldn't get on with the Medtronic CGM sensors, but the Dexcom G6 works really well for me (I got my nephew to courier me a new supply of sensors this week - certainly not available here) and it sounds like the Omnipod and Dexcom will work together in the not too distant future.

BTW the local doctor told me that T1 is very rare here - no more than 100 patients - whereas T2 is very common. He reckoned 10% of the population i.e. 10,000 people. Sobering.


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## everydayupsanddowns (May 24, 2020)

Sally71 said:


> Yes it's the charging which my daughter isn’t sure about, she doesn’t want to be plugged into the mains! If it can be done every day then I would suggest that she does it while she's having her shower and will have the pump off anyway. My dad used to be an electrical engineer, and always says that rechargeable batteries last longer if you run them right down and then charge them all the way up again; probably not so critical with modern lithium-ion batteries as it was with nickel cadmiums, but probably still some truth in it.



Lots of users on the TSlim group seem to use that shower strategy.

I am also trying to break the old rechargeable battery habit too - as I understand it modern batteries dont need that ‘full cycle’ trick any more.


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## trophywench (May 24, 2020)

No they don't Mike - it's the Insight handset that needs the battery recharging so that gets done overnight every other night - the Insight pump uses an AAA Battery that has to be replaced every fortnight, even the Lithium ones,  However if you have anything else that uses AAAs, the 'old' pump batteries continue for a VERY long time thereafter in the other thing.  Pete's used them for a fortnight in eg head torches when we've been camping on fishing lakes.


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## CosmicHedgehog (Jun 2, 2020)

I'm over due my pump upgrade(march 20), i have already been approved for the t-slimx2 (YAY! i'm so excited to be using that with my dexcom and basal IQ) but i recieved a letter saying that my current warrenty had been extended on my combo pump and my pump should be fine untill corona virus is done with  i really wan't to do training via skype or zoom something and have them just send the thing to me, I'm pretty sure i can figure out a cannula and read a manual to program anyway lol. i haven't contacted my team though as i don't want to nag when everyone is so busy


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## Deleted member 27171 (Jun 3, 2020)

My son’s 640 was up in November but team wanted to see more effort from him before doing anything about it. They are now happy for him to get the T:slim as already has G6 funded but have said are not doing any new pumps until face to face consults restart, so still waiting.


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## LoLiz (Jun 20, 2020)

Hello! Mine ran out in May and I've been told that the warranty has been extended as some of you have for some months.

I did want a 670 - I'm on the 640 atm. Are there other pumps that do high blood sugar and cut out when going low? That saves my life a lot at night. My worry is the availability of sensors, reservoirs etc. I'm so fed up with them being on 'back order'. Plus the number of button pushes. 

I have no idea what is available! 

My gold standard would be the pump that has been designed by the father for the son, which needs no calibrating, also gives glucagon as well as insulin and has a sensor that simply does its own thing. But that's not available in the UK.


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## everydayupsanddowns (Jun 21, 2020)

LoLiz said:


> I did want a 670 - I'm on the 640 atm. Are there other pumps that do high blood sugar and cut out when going low?



The Tandem TSlim is the one that I am most aware of.

I’m not sure what sort of hybrid-closed-loop semi automation the Medtrum system offers, but I’ve always been a little less sure of them.

Plus there are the open source options, such as Loop, and Android APS. 

And the ongoing rumours of Omnipod and Libre integration (though not out yet)

Plus the MM780 has now been CE marked, so may become available in parts of Europe soon

Lots of options!


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## LoLiz (Jun 21, 2020)

780? How is that better than the 670?


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## LoLiz (Jun 21, 2020)

I've just been to have a look. It looks great - smaller than the 640 and 670 even. I might see if I can wait until it is available and skip the 670 - if the hospital will allow it. Wonder how long it takes from CE mark to accepting it for use? And will the CE mark mean anything after Brexit?


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## everydayupsanddowns (Jun 21, 2020)

LoLiz said:


> 780? How is that better than the 670?



It has a new improved algorithm, which I believe offers improved outcomes over the MM670G in clinical trials, and allows more user-adjustment of BG target that the pump aims for.

More details, and marketing fluff here:






						Medtronic Secures CE Mark for MiniMed™ 780G Advanced Hybrid Closed Loop System Designed to Further Simplify Type 1 Diabetes Management | Medtronic
					

Next Generation Closed Loop Insulin Pump System Features  Auto-Correction Algorithm and Bluetooth Connectivity DUBLIN, June 11, 2020 (GLOBE NEWSWIRE) -- Medtronic plc  (NYSE:MDT), the global leader in medical technology, today announced CE (Conformité Européenne) Marking of its MiniMed™ 780G




					newsroom.medtronic.com
				









						MiniMed™ 780G System | Medtronic Diabetes
					

Automatically adjusts insulin delivery to your needs, day and night, for an easier* way to stabilise glucose levels1,2. Your glucose levels can now be viewed on your smartphone. *Compared vs the MiniMed™ 670G system. Refer to System User Guide - SmartGuard™ feature. Some user interaction required.




					www.medtronic-diabetes.co.uk


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