# Insulin pump



## Clairel

My son has been offered an insulin pump so wanted to ask what people's experiences have been and whether they would recommend it. Also what pumps they are using.


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## helli

My experience in terms of my blood sugar management has been great.
I exercise a lot and find my basal requirements vary significantly during workouts. The ability to adjust and suspend my basal has really helped me avoid hypos. And the ability to dose a bolus in 0.05 units has avoided highs too.

The better management through pumping does not come for free. It takes some time to set up the first time to get basal rates correct and learn your way around the pump. It requires you to carry more diabetes paraphernalia with you when you go out (if you are not close to home) as you should carry stuff for a pump set change and back up if the pump fails (very rare but possible). I just carry a syringe as my backup. Whilst bolusing with a pump is quicker and easier than attaching a needle to a pen, injecting and sorting out sharps, that comes at the cost of set changes every 3 days which take 5 or 10 minutes each time. In addition to all of that, you need to be more accurate with carb counting or watch and correct more diligently because you have no "spare basal" (MDI assumes basal requirements are the same 24/7 but they are not so we often have extra basal on board).

Despite all that, I would fight hard if I my pump was taken away from me. It has helped me a lot.

I have had two pumps
- Animas Vibe. This is no longer available but as an introduction to pumping it was great and did everything it said on the tin. As a tubey pump, it was flexible.
- Medtrum A6 (soon to be replaced by Medtrum Nano). This is a patch pump. It is smaller and more discrete which as a petite female is wonderful (I found it difficult to hide the Animas so it was as if my diabetes was on display all the time). I love that it has a phone app to it is really easy to set up and tweak.


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## trophywench

Which pumps does you son have a choice between - this differs depending on where you live and which hospital - eg the Medtrum was never mentioned to me.


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## Clairel

Omnipod dash, Tandem T-slim and Medtronic 780g


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## Clairel

helli said:


> My experience in terms of my blood sugar management has been great.
> I exercise a lot and find my basal requirements vary significantly during workouts. The ability to adjust and suspend my basal has really helped me avoid hypos. And the ability to dose a bolus in 0.05 units has avoided highs too.
> 
> The better management through pumping does not come for free. It takes some time to set up the first time to get basal rates correct and learn your way around the pump. It requires you to carry more diabetes paraphernalia with you when you go out (if you are not close to home) as you should carry stuff for a pump set change and back up if the pump fails (very rare but possible). I just carry a syringe as my backup. Whilst bolusing with a pump is quicker and easier than attaching a needle to a pen, injecting and sorting out sharps, that comes at the cost of set changes every 3 days which take 5 or 10 minutes each time. In addition to all of that, you need to be more accurate with carb counting or watch and correct more diligently because you have no "spare basal" (MDI assumes basal requirements are the same 24/7 but they are not so we often have extra basal on board).
> 
> Despite all that, I would fight hard if I my pump was taken away from me. It has helped me a lot.
> 
> I have had two pumps
> - Animas Vibe. This is no longer available but as an introduction to pumping it was great and did everything it said on the tin. As a tubey pump, it was flexible.
> - Medtrum A6 (soon to be replaced by Medtrum Nano). This is a patch pump. It is smaller and more discrete which as a petite female is wonderful (I found it difficult to hide the Animas so it was as if my diabetes was on display all the time). I love that it has a phone app to it is really easy to set up and tweak.


Thank you for that I'm pretty accurate at carb counting so won't be something I'd worry about to much. I do worry about tubing as he is already conscience about his libre sensor.


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## Pumper_Sue

Clairel said:


> Thank you for that I'm pretty accurate at carb counting so won't be something I'd worry about to much. I do worry about tubing as he is already conscience about his libre sensor.


Tubing is hidden under clothing so no issues at at all  I class my pump as my pocket pancreas


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## Lucy Honeychurch

Two young people in know on a pump have the omnipod and like it as no tubing, @stephknits on here has one too. You can go on the website and order a fake trial one to see if he likes it. 
I think @everydayupsanddowns has the tandem t-slim.


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## helli

Clairel said:


> Thank you for that I'm pretty accurate at carb counting so won't be something I'd worry about to much. I do worry about tubing as he is already conscience about his libre sensor.


My current pump (the Medtrum) has no tubing.
There are a few options although it depends upon the CCG what is available to you. 
Before setting your heart on one, I would strongly encourage you to ask your son's diabetes team what pumps they offer. There is little value researching them when you don't know what you can have.


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## Clairel

Omnipod dash, Tandem T-slim and Medtronic 780g these are what's on offer to him.


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## SB2015

I am using a Medtronic 780G.  Before that I used an Accu Check Combo.

Whichever pump you use, as @helli says there is some work in getting it to match your own needs, but from my perspective I think it is well worth it.  It has tubing but for me that has never proved to be an issue, as the tubing is tucked away and also gives me the option of siting my cannula where I want.

A pump offers a much more accurate basal insulin dose as it has an adjustable rate hour by hour, rather than relying on one or two injections of basal insulin each day.  The bolus increments are also tiny so can better match the carbs without crude rounding off.  Having said that any carb estimate is exactly that, an estimate.  When I first wen onto a pump my HbA1c dropped by 10!!  It did take a time to sort it out but it was well worth it.

I use my 780 with the addition of sensors which I self fund.  This enables me to used a closed loop system which works well for me. 

Any questions you have.  Just ask


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## Inka

I love my pump and the way I can fine-tune my basal and do tiny boluses. It’s part of me. It’s a DANA RS. It’s tubed, which is what I prefer because I find it more flexible.

I’ve been pumping for 17 years and had various pumps. The main disadvantages are the increased risk of site infections and the issue of poor absorption. Blood sugar can go high quickly as we have no long-lasting insulin on board.

I haven’t used any of the pumps you’ve mentioned but I urge you to do as much research on each as possible, make a list of pros and cons of each, watch YouTube videos about them. You and he will then find it much easier to pick what suits him.


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## Clairel

What is a closed loop system?


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## trophywench

See - I could have had a Medtronic 640, OTOH as they will NOT supply CCG (hoops to jump through) I spose there's little point in offering pumps that work hand in hand with CCG, so very surpised I could have had a T slim.

(Bean counters to Cov & N Warks ...... )


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## Lucyr

trophywench said:


> See - I could have had a Medtronic 640, OTOH as they will NOT supply CCG (hoops to jump through) I spose there's little point in offering pumps that work hand in hand with CCG, so very surpised I could have had a T slim.
> 
> (Bean counters to Cov & N Warks ...... )


Do you mean CGM rather than CCG? Or is CCG a closed loop acronym?


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## Sally71

Clairel said:


> What is a closed loop system?


It’s where the pump will link with sensors and adjust basal continually in line with blood glucose measurements, so you only have to enter carbs at mealtimes.  We have the Tslim which links with Dexcom G6 sensors, we aren’t using it fully closed loop at the moment though.  It knows constantly what blood sugars are and if my daughter is dropping too low it will turn the basal off, which depending how fast she is dropping will either prevent a hypo altogether or at least make it less severe.  It also acts as the reader for the sensors so you get the low and high alerts on the pump and don’t need a separate reader, there are also phone apps.  If we upgrade to the full system it should also make adjustments when blood sugars are high, by doing tiny boluses or increasing basal rates.  We haven’t got round to doing the extra training required yet though, daughter likes the pump how it is and is a bit scared of changing it I think.  I believe it would help her a lot though so shall try and encourage her when we get to the school holidays and have nothing to do!!

Just a basic pump is amazing though, the teeny tiny adjustments you can do can make all the difference between them going low every day or not.  It makes it much easier to eat what you want when you want, you only change the cannula every 2-3 days and then in between are only pushing buttons to do your doses.  There are also tricks they can do which would be almost impossible with pens to deal with things like illness, exercise, foods which digest slowly etc etc.

TSlim is a great pump, the refill procedure is a bit more fiddly than some, although my daughter has it down to a fine art now and can get it done within a few minutes.  Colour touch screen and all very pretty when it’s showing your blood sugar graph for the last few hours!  Be aware though, the sensors are expensive and not many people can get funding for them.  Also, how old is your son?  I think you can only use it with sensors if the child is older than 6 years, because of the low doses that young children tend to need.


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## Clairel

This sounds amazing I wish we could try all of them. He's 8 years old. He's currently on a waiting list which I'm told will take three months so want to find out about them as much as I can from people who actually live with them rather than someone who doesn't.


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## Pumper_Sue

Clairel said:


> This sounds amazing I wish we could try all of them. He's 8 years old. He's currently on a waiting list which I'm told will take three months so want to find out about them as much as I can from people who actually live with them rather than someone who doesn't.


Hi Claire,
may I suggest you invest in the book pumping insulin by John Walsh  It's known as the pumpers Bible and probably one of the best investments you will make besides the pump being offered obviously. Book can be found on Amazon.


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## Sally71

My daughter has been on pumps since she was 6, we had the Roche Combo twice and then the T-Slim last August (they usually replace them every 4 years when the warranty runs out).  We have never had a problem with tubing getting in the way, it can be tucked under clothes easily enough.  It does mean you have to carry a lot of stuff around if you are away from home - cannulas, cartridges, batteries/charger, backup pens etc etc, but the pros definitely outweigh the cons I think.


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## Clairel

I did meet someone whos type 1 themselves and they spoke about the omnipod dash and mentioned it was going to be upgraded in the next 18 months has anyone else heard this? Im really excited for him to get a pump and he can't wait either, tubing is not something he would want but so far it seems that it doesn't really bother anyone as much as I would have thought.


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## stephknits

Hi, I use the omnipod dash system so am happy to answer any questions about it.  If I was choosing a new pump, I would want to know if I would get funding for any of the blood monitoring systems, or cgms that can work with them.  As an adult I am lucky to get libre 2 funded, which doesn't work with the pumps currently, so was able to choose based on which pump Iiked best, and am very happy with my patch pump.  If I had dexcom funded, I would go with t-slim.  
Omnipod are bringing put the horizon, which talks to some of the cgms, but not sure when available in the UK.


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## Clairel

He's currently using libre 2 I think this is similar to what I was told. How amazing would that be.


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## SB2015

I am using the Medtronic 780.  It can be used as a stand alone pump.  This enables you to programme the pump to give different amounts of background insulin hour by hour throughout the day.  You can also turn this up or down as appropriate to suit the different levels of activity.  It is a lot more flexible than injections, but does require some work to get it set up to suit your son.  

I have always used pumps with tubing, as it gives me the flexibility to put the cannula anywhere I want.  The tubing is tucked away under clothes so does not cause any issues. 

The book by Gary Sheiner Pumping insulin is excellent but not necessarily an easy read, until you actually have a pump.  

Many pumps, including the 780  and tslim can be used in conjunction with a sensor which will then enable the pump to give alarms when you are going high or low.  Each pump links up with a specific sensor.  

It is great that you are doing your homework now. Do ask any questions that you have.


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## trophywench

Didn't Gary Scheiner write 'Think Like a Pancreas' and John Walsh 'Pumping Insulin'? - different books.


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## Thebearcametoo

My daughter (11) has a t-slim and we self fund a dexcom so that they can talk to each other. The advantage is that it will cut out the basal if it senses a drop and help avoid hypos (it doesn’t always stop them but you get fewer). Management has been very good for us although it was pretty good in injections too. The big advantage for us with the dexcom is we can see her data on our phones so can help manage things from afar. For us there have been some issues with her finding it overwhelming having the pump attached all the time but that coincided with big puberty changes too. All the options you have a good. It just depends what your priorities are with integrating things like a CGM or going for no tubing etc.  Here we had a session where you could have a play with each type of pump and see how they feel in your hands and how easy the interface is. There was a lot of support from the team in choosing and setting up the pump etc although with corona restrictions only one of us could go to the training and I haven’t really caught up on changing stuff on the pump so have to get my husband to do it but it won’t be long before daughter is doing it herself anyway. She does all the day to day stuff with it.


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## Pumper_Sue

trophywench said:


> Didn't Gary Scheiner write 'Think Like a Pancreas' and John Walsh 'Pumping Insulin'? - different books.


Well John Walsh def wrote pumping insulin


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