# Pump change



## Lorraine hunt (Nov 7, 2018)

due to having the animas pump, my health authority have said in January will be asked to choose a replacement, recent animas pumpers in my area had a number of choices 4 I believe, one being the omnipod which I was interested in, the choices now have dropped to 2 the Medtronic 640g and the ypsopump, was interested in the omnipod as could bolus without touching the  pump, but this seems to have been withdrawn as an option, I see with the 640g there is the  contour link 2.4 does this do the same or is this only usable with a CGM? Anyone give me any advice/information on either of these choices, disappointed in my hospital I seem to be one of the last groups and each time the choices drop infact I had no choice last time was told animas or nothing, would be nice if everyone given the same choices.


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## Ellie Jones (Nov 8, 2018)

I've just changed to the 640g... 

With the contour meter, you can bolus with it, but it's restricted to a standard bolus, no dual or square wave, you also don't get access to the bolus wizard.  

Even thought the CGM sends all information to the pump, this doesn't interact directly with the Meter (as far as I know) but all information that the CGM sends to the pump, will be sent to the meter logbook via the pump. 

My CGM is arriving tomorrow, so be able to be more clear about how it interacts with pump and meter.


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## everydayupsanddowns (Nov 8, 2018)

Yes as @Ellie Jones says, the contour 2.4 meter does allow limited remote bolus, but not the full bolus wizard that you get via the pump itself.

Any chance your clinic might offer some of the other pumps on the market? Dana RS, Cellnovo or TSlim?

INPUT the diabetes tech access charity has a website which might help.


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## Lorraine hunt (Nov 8, 2018)

So am I understanding that you can do a normal meal time bolus? Otherwise would need to put directly in pump, no they are saying have only the two choices mentioned nothing else, the tslim is one have been looking at also but sadly no her in Scotland they offer very limited choice or no choice, but I will persist in asking, am unhappy that seem to be one of the last to be changed and due to this my choices are greatly reduced, they gave me an omnipod to try which was the reason was moving towards having this however now saying it’s too expensive people using too many pods they are not putting anyone else on it, have also started loosing my hypo awareness the consultant said about CGM, as feels the libra wouldn’t suit due to my running etc but when went to see diabetic nurse was told they will only provide this if no awareness at all they would then advise dvla as would not be able to drive at all seems this is the only way they can justify funding, and I am no where near this extreme, ridiculous.


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## everydayupsanddowns (Nov 9, 2018)

Lorraine hunt said:


> So am I understanding that you can do a normal meal time bolus? Otherwise would need to put directly in pump, no they are saying have only the two choices mentioned nothing else, the tslim is one have been looking at also but sadly no her in Scotland they offer very limited choice or no choice, but I will persist in asking, am unhappy that seem to be one of the last to be changed and due to this my choices are greatly reduced, they gave me an omnipod to try which was the reason was moving towards having this however now saying it’s too expensive people using too many pods they are not putting anyone else on it, have also started loosing my hypo awareness the consultant said about CGM, as feels the libra wouldn’t suit due to my running etc but when went to see diabetic nurse was told they will only provide this if no awareness at all they would then advise dvla as would not be able to drive at all seems this is the only way they can justify funding, and I am no where near this extreme, ridiculous.


You can do a manual ‘normal’ bolus in any amount dialled up in 0.1u increments. Or you can do one of 5 preset ‘fancy’ boluses if you know units, split and duration beforehand and set them on the pump. So it has always felt to me that it would be fine for an occasional party with a frock on, or if you always ate the same lunch and could estimate any correction + or -

For the bolus wizard / ratios / correction factors you need to use the pump. 

IMO, the remote boluses on Medtronic pumps are occasional use only.


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## Ellie Jones (Nov 9, 2018)

I've just checked out the manual's for both meter and pump

The meter is able to send two types of remote bolus's to the pump.

1st is a basic bolus.
2nd,  is a preset bolus,  

you have to set this up via the pump. 

There is the ability to set 4 presets up, 

Within each preset, you can use both dual and square wave and detail how much insulin.  This will deliver the same amount of insulin with same spilt and/or timing that has been preset.  for example you know every breakfast time, your going to eat 50g's of carb,  the total insulin required is 15 units, and you normally use dual wave setting of 10 units, then 5 units over 1.30hr's.  you set this up as a preset.

You still won't be able to adjust from what I can see, any addition changes for extra or less carbs, or adjust for current BG reading.  But with saying that there's ways and means around this, such as setting a preset square wave bolus for a set amount, and then when you need to bolus,  you can send a remote preset and a manual bolus to cover the adjustments needed.


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## HOBIE (Nov 12, 2018)

Good luck Lorraine


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