# Please help!  Advice needed on which pump to ask for



## Maradie (Sep 24, 2012)

Hi all,

I have been told by my consultant and DSN that the paperwork is ready to go to the PCT asking for funding of an insulin pump.
I just need to make the decision about which pump I would like to apply for.
After reading all the literature, and playing with the available pumps in the clinic today I have cut my options down to two pump systems.
Medtronic Paradigm Veo
Accu-Chek Combo.

Both have positive and negative features but I am looking for honest feedback from people who use these pumps as to how easy they are to use etc on a day to day basis.  
Are they comfortable?  
Is having a remote and not needing to touch the pump (Accu-Chek) worth losing the CGM availability (Medtronic)?  
Has anyone self-funded the CGM and is it worth it?  
How easy is it to program in CHO (carbs) and BM readings so that the Bolus wizard can calculate the insulin?  
Ladies, this question is for you....can you set Basal profiles for different times of the month? And can these be automatically programmed or do you just have to select the profile depending on your cycle?

Some background on me....I am 29, female, IDDM since 1997, work full time in an office environment (so lots of sitting at a computer screen), am often catching public transport to and from meetings across Kent and London (as I can no longer drive due to hypo fits this year) and I am really struggling with my diabetes.  
Have no energy, hypos in the late afternoon/early evening on a regular basis and dawn phenomenon most mornings.  I am hoping that the pump will allow me to get a handle on my blood control and will help me feel better in the long run.  I have lost most of my 20's due to being ill and in hospital because of my diabetes...I don't want to lose my 30's too!

Thank you in advance for any and all help and advice you can provide.
Thank you for reading


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## Northerner (Sep 24, 2012)

Hi Maradie, welcome to the forum  I'm not a pumper so can;t help you with your decision, but I know we have members using both of your choices so I'm sure they will be along to help soon!


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## Maradie (Sep 24, 2012)

Thank you for the kind and speedy welcome x


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## Northerner (Sep 24, 2012)

Maradie said:


> Thank you for the kind and speedy welcome x


You might find this discussion useful as it concerns the same choices 

http://www.diabetessupport.co.uk/boards/showthread.php?t=30855


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## HOBIE (Sep 24, 2012)

Hi mardie, i love my Medtronic. It has a remote but i wouldnt thank you for it. Pushing buttons for something so important to get right .   It has cgm & i have tried it for a week. I learnt about what different things did to my bgs but dont self fund it.  Its good to have choice !   Good luck


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## Pumper_Sue (Sep 25, 2012)

Hi Welcome to the forum 
 The only advice I can give you is what ever one you choose you will love as you know no different.


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## everydayupsanddowns (Sep 25, 2012)

Maradie said:


> Hi all,
> 
> I have been told by my consultant and DSN that the paperwork is ready to go to the PCT asking for funding of an insulin pump.
> I just need to make the decision about which pump I would like to apply for.
> ...



Great news - both excellent choices.



Maradie said:


> Are they comfortable?


Both come with a variety of different styles of infusion set - teflon/metal/straight/angled/different cannula length/different tubing length. You should be able to find one that is comfortable and convenient for either I'd have thought.



Maradie said:


> Is having a remote and not needing to touch the pump (Accu-Chek) worth losing the CGM availability (Medtronic)?
> Has anyone self-funded the CGM and is it worth it?


What you've hit on there is effectively the big feature difference between the two. Some people do self-fund CGM and find it hugely beneficial. Some people (even _adults_! ) manage to get CGM funded by the NHS. Others find the Combo's remote handset allows them to just bury the pump and use it with only the BG meter and love that the don;t have to keep the pump somewhere 'accessible'. Having said that there are 101 places to wear a pump so you'd have to make an instinctive judgement on that score.



Maradie said:


> How easy is it to program in CHO (carbs) and BM readings so that the Bolus wizard can calculate the insulin?


Lemon squeezy. Both the Veo and the Combo have a BG meter which send BG results to the pump via bluetooth (you could use the Veo without this and keep using your old meter, but it is very convenient). I've used the Expert meter (very like the combo handset) and the Veo and the bolus wizard is just a few short button presses and you are done. On either you can set a bewildering array of different insulin:carb ratios for different times of day should you need to.



Maradie said:


> Ladies, this question is for you....can you set Basal profiles for different times of the month? And can these be automatically programmed or do you just have to select the profile depending on your cycle?


Can't answer from a ladies perspective... but yes. You'd set one of your basal profiles to suit and select is when appropriate. If that didn't work out well, or if (as during illness) there was a sort of 'ramp up'/'drop back' requirement of rising/falling basal need you could use TBRs (temporary basal rates) of up to 24hours which is what I do during illness.



Maradie said:


> Some background on me....I am 29, female, IDDM since 1997, work full time in an office environment (so lots of sitting at a computer screen), am often catching public transport to and from meetings across Kent and London (as I can no longer drive due to hypo fits this year) and I am really struggling with my diabetes.
> Have no energy, hypos in the late afternoon/early evening on a regular basis and dawn phenomenon most mornings.  I am hoping that the pump will allow me to get a handle on my blood control and will help me feel better in the long run.  I have lost most of my 20's due to being ill and in hospital because of my diabetes...I don't want to lose my 30's too!
> 
> Thank you in advance for any and all help and advice you can provide.
> Thank you for reading



Really hope the pump works out well for you. I's a fair bit of work, especially to begin with - and it will drive you nuts from time to time, but for precision and ease of use it's hard to beat.

Have you got a copy of 'Pumping Insulin' by John Walsh yet? If you can get hold of a 5th edition copy (only newly out and a bit patchy on Amazon availability) it will massively help you in your pumping endeavours.


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## trophywench (Sep 25, 2012)

What Mike said - hear hear LOL

Re different basal patterns - on the Combo you set them up in advance, but do have to change which Basal pattern you want, each time you want it.  But whatever you tell it will still be there every month for as long as you leave it there - doesn't disappear and you have to reset it every time.  Then turn it back from Basal Pattern 2 to BP 1 again once your period is over (may just be needed beforehand, or whatever, we're all different)

You should be able to ekiminate that DP and the afternoon hypos once you get your basal pattern sorted.  However be aware that your pattern will change.  I was on near enough 20u a day on MDI and 18 months on, I'm now on under 10u !  Carb ratio is exactly the same as MDI.

When playing with basal patterns as Mike says the TBR feature is great cos you try it (and obviously write down what you did) tweak it where it needs it but only actually change the BP itself once you are sure you've got it right.

Oh and I hated mine after a month cos I was all over the place and it needed so much tweaking.  But I persevered (wasn't gonna be beaten by a bit of plastic and circuits) and after another 3 weeks we were friends again.  Have remained bosom buddies ever since .....

I use the Combo and I love the remote.  I like the bolus wiz being on the meter - you always have to testyour blood anyway don't you? - so not having to swap about from meter to pump, yes I like.  Or you can let it work it all out and then tell the pump itself to deliver whatever, but why do that when you can just push another button on the meter?

If you happen to be wearing it down your knicker leg or something you'd get annoyed, wouldn't you?  This pump is easier in an evening dress (or I'm sure - would be in a wedding dress) or anything you might wear when you decide to dangle it off your bra etc so as not to spoil the line - which probably doesn't bother chaps .....


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## Laura D (Oct 11, 2012)

Hi All, thanks for posting all this, it is really helpful to browse when making similar decisions.


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## HOBIE (Nov 4, 2012)

Its a nice problem to have.     Which One ??


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## Turtle11 (Nov 15, 2012)

I've found that the pump casing on the veo doesn't cope well when it is worn on the bra. The heat has caused cracks in the reservoir window so I can't wear it there any longer. I always kept my animas pump clipped to my bra and it wasn't a problem. Just something to consider if you wanted to wear it there.


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## trophywench (Nov 16, 2012)

Will Medronic replace it, Turtle?


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