# Which pump to choose?



## reedo (Jan 12, 2012)

Hi there
My name is Peter and I'm a 31 year type 1 diabetic, I was wondering if anyone might be able to assit me.  I have just been approved to receive a pump through the NHS and I have been given 3 options to choose from:

Animas 2020
Medtronic Paradigm 515
Accu-chek combo

I was hoping someone here might be using one of these pumps and could advise how they have found it and whether they might have encountered any problems?

Any help would be much appriciated as I'm really not sure what one to choose.  

Many Thanks!


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## sofaraway (Jan 12, 2012)

Hi peter, I use an Animas Vibe (basically the same as the 2020, just the newest model which has CGM capability). 

I chose my pump for the general appearance, I think it's the nicest looking pump. The animas has the best screen of those three. In my opinion it is the easiest to use.

All the pumps can do the same things, it's the small differences between them that one might appeal over another. e.g the combo has a handset which is a BG meter and remote for the pump, so all the bolusing, basal adjustments can be done from the handset with no fishing the pump out from whereever you are wearing it. This wasn't important for me but may be for you. 

Can you have a look and trial with the pumps first to see which you prefer? 

Whichever you chose I am sure you will be happy with it


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## Northerner (Jan 12, 2012)

Hi Peter, welcome to the forum  I removed your other post as this question is fine here. I don't have a pump, but this question has been asked before so you might find this thread of use:

http://www.diabetessupport.co.uk/boards/showthread.php?t=16761

Od course, that doesn't mean you won't get any more answers here!


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## reedo (Jan 12, 2012)

Hi thanks for the replies.

I did see the 3 pumps without having much of a play with them. I did pefer the medtronic paradign 515 as it seemed small and easy to hide but i have later found out that its quite an old model and an not sure if its a bit dated now?

From what ive read it seems that all the pumps are similar without the CGM which unfortunatly is not option.


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## Northerner (Jan 12, 2012)

Have you read this Peter? It shows what most people are using (although possibly not by choice!)

http://www.diabetessupport.co.uk/boards/showthread.php?t=24373


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## HOBIE (Jan 12, 2012)

I like my medtronic & have  a good relationship with medtronic people with regular meetings & talks on new features & gizmos.


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## reedo (Jan 12, 2012)

Hi Hobie what model have you got? cant find any reveiws or anyone using the medtronic paradigm 515, or whats the difference to the more resent models? any help would be great


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## HOBIE (Jan 12, 2012)

Am on a paradigm 722 that takes blood sencors (not on any).  Latest pump is  the veo. Is on medtronic web site. Lots of stuff on web to have a try etc. Have had pump for over 2yrs and woudnt be without one now !!


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## Adrienne (Jan 12, 2012)

HIya

The Medtronic 515 is a very old version, they do still manufacture them because some PCT's only will pay for an old cheaper model and will no doubt have a deal to pay even less.  

As an adult I would suggest that you go for a 7 series pump anyway as the reservoir is bigger and I would imagine you may need that.   All their pumps have the 5 or 7.   

There have been three pumps since the 515 so personally I would argue your case.   The VEO is the latest but the one before that was the 522/722.  Both these the 722 and the VEO are the sensor pumps so you could pay for sensors at a later date if you wanted to but the pumps are great.  I cannot fault Medtronic.

Animas also has a later pump out called the VIBE.  It is the 2020 with sensor capability using Dexcom sensors.  The VIBE has a few better features than the 2020 but I know lots of kids on the 2020 and they love them.  

The Accu Chek combo is their latest pump out, its been out a while now and does not have sensor capability.  It uses a remote control though which is a plus for some people.  You do not have to touch the pump, you can do it all through the remote which is also a glucometer so you would use that to test your finger and work the pump !

I hate it when PCT's offer old pumps.  

I love Medtronic I really really do, I personally feel they have the best screen and easiest menu to use and the better looking pump but I wouldn't go for a 5 series, you need a 7 for size of reservoir as an adult plus the pump is such an old model.   I have a real problem you being offered this pump.   I think its a cop out by the PCT's arghhhh.

THe Animas 2020 is a good pump.

The Accu chek is a good pump.  It depends what you want.  I prefer the Animas company if that is a plus point maybe.

Good luck with your decision.


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## seasiderdave (Jan 12, 2012)

Reading above I wouldn't be certain about 'needing' a bigger reservoir. Everyone's diabetes is different and for me the smaller Veo is perfectly adequate as I'm on well under 100u over three days. Size is an entirely personal thing. 

Good luck with whatever you decide.


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## trophywench (Jan 12, 2012)

How do you mean 'prefer the Animas company' Adrienne?


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## Julia (Jan 12, 2012)

Hello Reedo. Welcome. I knew someone like Adrienne would come along and write something useful. 
I had the choice of medtronic or animas, and chose medtronic as it seemed simple and the hospital said they had more experience of medtronics. So can't really give you any useful information as have had no comparison. 
...but I love my pump! And very happy with medtronic - great service etc.
I'm on an older model paradigm 522, but still happy with it. I know alot of people have a lot of discussion regarding how to wear the pump and I use the clip with the pump 99.9% of the time without any problems even during exercise.
I don't really understand all the different models. Is the 522 the smaller reservoir, Adrienne? If it is, as an adult on approx 35-40 units a day the reservoir is more than big enough for me. I change my set every 48-72 hours and there's always loads of insulin left.
I think (hope) that whatever pump you chose you'll love it (certainly true for most people)


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## Adrienne (Jan 12, 2012)

I have met people from all the pump companies and the ones I was least impressed with and actually had an heated discussion with was Accu chek.  Obviously that was only one person but she was the head person at a conference and her stance was not good.   I complained.   Not going to go into it anymore than that as this is a public forum but my opinion is purely based on this one person's opinion which was advice she was dishing out to people enquiring and I challenged her and couldn't believe what she was saying.


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## Adrienne (Jan 12, 2012)

seasiderdave said:


> Reading above I wouldn't be certain about 'needing' a bigger reservoir. Everyone's diabetes is different and for me the smaller Veo is perfectly adequate as I'm on well under 100u over three days. Size is an entirely personal thing.
> 
> Good luck with whatever you decide.





Julia said:


> Hello Reedo. Welcome. I knew someone like Adrienne would come along and write something useful.
> I had the choice of medtronic or animas, and chose medtronic as it seemed simple and the hospital said they had more experience of medtronics. So can't really give you any useful information as have had no comparison.
> ...but I love my pump! And very happy with medtronic - great service etc.
> I'm on an older model paradigm 522, but still happy with it. I know alot of people have a lot of discussion regarding how to wear the pump and I use the clip with the pump 99.9% of the time without any problems even during exercise.
> ...



Ah right ok size of reservoir.

The 5's takes a reservoir of 1.8 units and the 7's reservoir is 300 u so a big difference really.

It really does depend on your insulin intake.   Jessica is nearly 12 and hormones raging and her insulin needs have gone up mega and will continue to rise as she goes into puberty.   She is on between 40 and 60 units a day.

If you fill up the 1.8 to 1.8 then that is potentially not going to be enough for Jessica over 3 days.  You are supposed to change canula and reservoir and tubing every 3 days.  You have to account for potential bubbles so that takes down some of the insulin.  There are boys whose insulin needs are up over 100 u a day due to teenage years.   Jessica and those like her are on the large pumps.   We personally don't fill the reservoir and waste insulin.  We fill it to about 200 u and that is fine for 3 days generally.  

Many adults need the bigger one but as you have stated some may only need to smaller one.

If there was a choice I would always recommend larger for teens and adults as it is better to get slightly too big than not big enough maybe.  The pumps are not that much bigger in themselves only a tiny bit length wise.

Hope that explains abit better.


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## everydayupsanddowns (Jan 13, 2012)

Adrienne said:


> The 5's takes a reservoir of 1.8 units and the 7's reservoir is 300 u so a big difference really.



Just to correct a typing error in the above... 5 series have reservoirs of 1.8ml (180 units) 7's are 3ml (300 units).

Sets are changed every 2-3 days. I have a 5 series and even over Christmas with all the extra food involved I didn't need to fill the reservoir to more than 120u (there are bars on the side so you can see approx how many units you are loading before the pump gives you the real reading).

Your DSN will probably ask you for an approximation of TDD (total daily dose) on MDI. It is likely that you will need less insulin on a pump as infusion is generally more efficient - some people only need 60% of their MDI totals others need more or less the same.

If you were 'on the edge' as Adrienne suggests it would be wise to go for larger (especially for times of illness etc), but as my MDI TDD was rarely much more than 35u the 5 series gave me enough slack.

If in doubt go larger - your pump has to work for you for 4 years I think...

Alison (occasional poster here) wrote her own 'roundup' of pumps on the market in 2011 on her blog here:
http://www.shootuporputup.co.uk/2011/01/picking-a-pump-in-2011/


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## reedo (Jan 13, 2012)

Thanks everyone for your help.

Not sure abour how much insulin i would need in the pump as im on 18u of lantus and about 20u of novarapid per day on MDI?

The nurse i spoke to did seem quite keen for me to go for the medtronic as she said it was the one they had the most experience with, she also mentioned a blood meter that blue toothes results to the pump. Is such a meter availble for the animas?

Will ask the nurse about the newer versions of the medtroinic but im pretty sure the 3 ive mentioned are all thats on offer. I cant be to ungreatful as i didnt meet the cretira 100% and they pushed it through for me


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## Robster65 (Jan 13, 2012)

Hi reedo. Out of interest, can I ask what criteria you got approval on ?

Just to give the rest of us half-hopers something to push for in the future. 

Rob


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## everydayupsanddowns (Jan 13, 2012)

reedo said:


> Not sure abour how much insulin i would need in the pump as im on 18u of lantus and about 20u of novarapid per day on MDI?



Approx TDD of 38u

Allow +20% for illness = 46u

Allow for 3 full days before set change = 138u

Assuming that your TDD remains roughly consistent and doesn't rise (it likely to fall) that would give you a 25% margin for error on a full 1.8ml reservoir (eg 5 series Medtronic) even during times of illness.


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## reedo (Jan 13, 2012)

Robster65 said:


> Hi reedo. Out of interest, can I ask what criteria you got approval on ?
> 
> Just to give the rest of us half-hopers something to push for in the future.
> 
> Rob



The certria is to have 3 hb1a tests above 8.5 in a row. My last test was 7.8 (the best its been for years) and i got pushed through by agreeing with the nurse that i have a fear of hypos


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## novorapidboi26 (Jan 13, 2012)

reedo said:


> and i got pushed through by agreeing with the nurse that i have a fear of hypos



Have you a fear of hypos...........


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## Pumper_Sue (Jan 13, 2012)

reedo said:


> The certria is to have 3 hb1a tests above 8.5 in a row. My last test was 7.8 (the best its been for years) and i got pushed through by agreeing with the nurse that i have a fear of hypos



Your nurse needs to reread the guidelines 
As to what pump you decide on it would be better to go for a bigger cartridge as some pcts are getting very strict about the cost of consumables and expect many pumpers to use one cartridge every 6 days.
As you are a 1st time pumper what ever pump you choose will be the best thing since sliced bread as you know no different.
I'm on my 2nd pump and have had to have a change of make due to my previous pump not being made anymore. To say it would not be on my wish list ever again in an understatement. But it works and the backup and customer support is fantastic.  My statement re the pump is just me comparing the two pumps. There is nothing wrong with the pump it's self.


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## trophywench (Jan 13, 2012)

That was something like what happened to me reedo!

My consultant remembered what I'd told him you see.  I had to agree that it did (of course, obviously   ) colour the numbers I aimed for day to day 

The Roche Spirit Combo remote/meter/bolus wizard Bluetooths the pump to see if you've entered any boluses it doesn't know about already, then calculates, and beams it's results to the pump, then asks if you want to deliver the bolus and if you do, you press the button on the remote and it tells the pump to do it. 

I didn't know either of the others had that capability.  My understanding was that the others you use whatever meter you want to, then manually input that into the pump; the pump has the bolus wizard so you tell the pump (instead of the remote/meter) your carbs and it calculates the bolus, and you tell it to deliver.

It's not much different really; except I will say it's annoying if the remote goes tits up because until they get a new one to you (usually the next day) - you have no bolus wizard.  You also have to get your spare meter out and work your boluses out yourself, then press the buttons on the pump to deliver.  Still, it's just 24 hours on MDI again, really!  If the pump itself (of any make) goes wrong and they have to send a new pump - then you are back on MDI anyway in the interim.

NB you do need to have an alternative method of insulin delivery at your disposal whilst you have a pump.  Because we use 10ml vials of insulin rather than pen cartridges, most people opt for syringes.  You don't even need to carry spare insulin - because you'll have insulin in the reservoir, if the pump fails you can draw up what you need from the reservoir into a syringe.

Incidentally the Roche uses 'big' reservoirs but unless it's 40 in the shade I just fill em and only change them when they are virtually empty which is not very often at the same time as a set change.  So a res lasts me 12 days plus.  If it's red hot I'll half fill em - a week-ish.


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## everydayupsanddowns (Jan 13, 2012)

Very intersting that both you and Pumper_Sue reuse your reservoirs TW.

I can't remember exactly, but I'm pretty sure I was told in my initial pump lessons *not* to do that.

Wonder if its another postcode difference?


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## Pumper_Sue (Jan 13, 2012)

everydayupsanddowns said:


> Very intersting that both you and Pumper_Sue reuse your reservoirs TW.
> 
> I can't remember exactly, but I'm pretty sure I was told in my initial pump lessons *not* to do that.
> 
> Wonder if its another postcode difference?



I don't reuse my reservoirs  A full tank 200 units lasts me about 10 days.
The reason for not reusing is down to the extra strain on the pump having to push a not so well lubricated plunger.


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## everydayupsanddowns (Jan 13, 2012)

Sorry! I didn't write very clearly...

When I change sets the process involves rewinding everything and starting again. Consequently I only part-fill the reservoir so that it only has enough to last 3 days. Whereas it looks like you fill up completely and use it till empty (with more than one tube/cannula).

M


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## Pumper_Sue (Jan 13, 2012)

everydayupsanddowns said:


> Sorry! I didn't write very clearly...
> 
> When I change sets the process involves rewinding everything and starting again. Consequently I only part-fill the reservoir so that it only has enough to last 3 days. Whereas it looks like you fill up completely and use it till empty (with more than one tube/cannula).
> 
> M



yep cannulas are changed every 2 days now as using steel cannulas tubing get changed when cartridge does.


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## everydayupsanddowns (Jan 13, 2012)

That does sound quite a lot more efficient.


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## Pumper_Sue (Jan 13, 2012)

everydayupsanddowns said:


> That does sound quite a lot more efficient.



yep saves insulin and cartridges plus time  Waste not want not


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## reedo (Jan 13, 2012)

novorapidboi26 said:


> Have you a fear of hypos...........



maybe i certainly dont like them


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## reedo (Jan 13, 2012)

Pumper_Sue said:


> Your nurse needs to reread the guidelines



That was my understanding of the guidelines, could be wrong.

Asked for a pump a few years ago and was told that if i did the BERTIE course it was a posibility


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## Adrienne (Jan 13, 2012)

everydayupsanddowns said:


> Just to correct a typing error in the above... 5 series have reservoirs of 1.8ml (180 units) 7's are 3ml (300 units).



Hehehe thanks for that, my maths was never much good, goodness knows how I can carb count but I do ........


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## HOBIE (Jan 14, 2012)

Good luck with choosing   Reedo


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## reedo (Jan 14, 2012)

HOBIE said:


> Good luck with choosing   Reedo



Thanks HOBIE think im gonna go for the medtronic one, dont think there is much difference between them to be honest,i like the idea of the blood tooth meter, just looking forward to starting on 20th march. 


Thank everyone for your help much appriciated


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## HOBIE (Jan 16, 2012)

Current VEO has smallest bolus of 0.025 units/hr. Has basal ajustments of same !    Sensor menu of VEO much more advanced with predictive alerts & Low Blood Glucose Suspend !!!


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## ypauly (Jan 16, 2012)

I have chosen the accu check combo and will start 6tb feb. I picked it mainly as i can adjust it without taking it out (bluetooth) which will be important as j work in a factory. It also has 5 different basal programs that wil
l help with my shift patterns.


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## everydayupsanddowns (Jan 16, 2012)

ypauly said:


> It also has 5 different basal programs that wil
> l help with my shift patterns.



Didn't know that ypauly. The Veo only has three patterns - plenty for me, but might be a factor for others.


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## Northerner (Jan 16, 2012)

ypauly said:


> I have chosen the accu check combo and will start 6tb feb. I picked it mainly as i can adjust it without taking it out (bluetooth) which will be important as j work in a factory. It also has 5 different basal programs that wil
> l help with my shift patterns.



Ooh! Good luck Paul! I see it has BLUEtooth so you will feel an affiliation to it


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## ypauly (Jan 16, 2012)

Northerner said:


> Ooh! Good luck Paul! I see it has BLUEtooth so you will feel an affiliation to it




Yes alan this pump is not for turning lol


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