# Need Advice about a new pump



## G3m (Oct 26, 2021)

Hi there, 

I have been informed this morning that my Accu Chek Spirit Combo is discontinued so I have to pick a new pump for the first time in 8 years!! I currently have a Freestyle Libre 2. 
I have been offered; Tslim, Medtronic 640, Medtronic 780, Omnipod DASH and the Dana Pump. 

I would just like some advice and here some experiences of people who have these pumps. 

Thanks!


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## helli (Oct 26, 2021)

That's quite a long list - my CCG offer one Medtronic ... and that is it. 
I would start to narrow it down by listing what is important to me, check whether these pumps satisfy my criteria and then asking for feedback on my short list. For example, if I wanted a patch pump, why gather feedback on tubed pumps If I was not going to get funding for a CGM (apart from Libre) and can't afford to self-fund, why ask about closed loop. 

Given our individual requirements vary greatly, I recommend working out what your requirements are. 
I may tell you a pump is great because it is small but you may not care about the size. Someone else may love the large user interface on another and you may not care about that, ... 

There is a wealth of knowledge and experience on this forum and we are happy to provide advice if you give us some ideas about what you need from a pump. 

The other place to look is YouTube to see what they pumps look like, how easy they are to do set changes and set up.


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## Inka (Oct 26, 2021)

I have a Dana RS pump and I’m very happy with it @G3m It holds 300 units but is tiny (at the time I got it, I believe it was the smallest/lightest 300 unit pump). Importantly for me, it can also be controlled by my phone, meaning I can bolus, adjust basal rates, etc, all without getting my pump out. It also has a very good selection of high quality cannulas and sets, including a nifty rotating one. I’d also say it’s really important to have good and reliable customer service. People often forget that. Dana has excellent customer service.

The Dana RS can be looped with an official app, or can be used with Open APS for a DIY loop. It was developed with looping in mind.

@helli has given good advice about researching on YouTube. I had 6 pumps to choose between, so I eliminated any definite No pumps, and then researched the others, listing pros and cons and circling anything particularly concerning or particularly good. I narrowed my choice down to two, double-checked my decision, and went for the Dana. I haven’t regretted that decision for a moment.


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## SB2015 (Oct 26, 2021)

Like you I used a Combo and was very happy with that, apart from not being able to enter values form the Libre for bolusing.  I particularly liked the remote control of the pump from the handset so being able to put it in, tuck it away and ignore it after that.

I am now on a 780G and I am self funding their sensors so that I can use it in a closed loop.  I would not have wanted to go straight to closed loop and took quite a while to get used to the pump in manual first so that I was prepared if I had to revert to this (severe illness, sensor failure).  Having been on the close loop now since Feb 2021 I am very happy with it. For me the advantages of the closed loop outweigh the irritation I have with needing to access my pump to do the bolus and enter BG callibrations. The Basal insulin is adjusted every 5 minutes as my pump and sensor check in with each other every 5 min.


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## mark king (Nov 1, 2021)

Hello @G3m I use the DASH OmniPod and have been well pleased with it.  
Prior to this pump I delivered my insulin by injection and would only tolerate a pump if it was wireless and tubeless which to OmniPod is.
I settled down with the pod very quickly and soon got to grips with my pump adjustments.  I had about a 2 hour set up and learning time for the Pod with both my DSN and the Insulet [Pod] Techy lady present.

I highly recommend it.


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## everydayupsanddowns (Nov 1, 2021)

I was on the MM640 as my last pump (solid, reliable, and if run occasionally with sensors very effective at reducing hypos). There are some videos on my blog if they are of any interest.

I’m currently on the tSlim, with self-funded G6 Dexcom.

For me the tSlim/Dex is the best combination of tech I have used, and my Time in Range has never been so consistently good. It’s not really a fair comparison with the MM640, as Control IQ can add insulin to counter highs as well as stop insulin to prevent lows, but the factory calibrated Dexcom which also has the *option* of calibration means no pesky calibration alerts, but unlike Libre I can bring any slight sensor drift if I want to.

There’s a smartphone app you can download to have a nose around the tSlim menus as if your phone was a pump (because the tSlim operates largely by touchscreen).

Good luck with your choice - I don’t think there’s a bad one in that lot, though I’d go for the MM780 over the MM640 myself as it’s so much newer.


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## Squirrel768 (Nov 15, 2021)

_Good luck with your choice - I don’t think there’s a bad one in that lot, though I’d go for the MM780 over the MM640 myself as it’s so much newer._

I was offered the 640 but none of the other later ones. I didn't want the 640 because it is now very old tech. I'm trying to get the t:slim after starting on the Dash next month!


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## trophywench (Nov 15, 2021)

@Squirrel768 - That doesn't seem to make too much sense - I've never heard of anyone being able to obtain a different pump on the NHS when they've only just started on another one.


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## Squirrel768 (Nov 15, 2021)

trophywench said:


> @Squirrel768 - That doesn't seem to make too much sense - I've never heard of anyone being able to obtain a different pump on the NHS when they've only just started on another one.


It is something that is, as far as I'm aware, unique to Insulet! They even tell about it on their website when going into how wonderful it is - but if you disaree you can change your mind within 90 days  

I think it is because each pod is essentially the pump mechanism and therefore disposable (they do provide a means of sending them back for recycling), while the PDM part f it is only around £150 to £200, so not a massive investment. The hospital just apply for a credit note for the pods used, and the PDM which gets returned anyway. Compare that to a tethered pump which costs a few thousand £, it is a very different commitment for the trust and the manufacturer.


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## mark king (Nov 16, 2021)

@Squirrel768 - Intrigued so I got onto Dr. Google>>>
Wrong link added now deleted  
I see this is dated Feb 2020








						Insulet's Omnipod to integrate with Dexcom, Abbott CGMs for automated, smartphone-controlled dosing
					

Both CGM competitors announced integrations with Insulet yesterday during the Advanced Technologies & Treatment for Diabetes Congress in Madrid.




					www.mobihealthnews.com


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## Drifter (Nov 16, 2021)

I'm in much the same position as G3m. I have been on the Roche Accu Chek Combo for almost 8 years with a self-funded Libre for several years. My problem is that, as far as I can see, none of the replacement pumps offered by the local Health authority have a fingerstick BS meter. Some of them will integrate with a Dexcom and some you can manually input BS numbers from a standalone BS meter or Libre IG numbers. My experience of Libre is that there is often a significant difference with respect to a BS measurement so I am concerned about using Libre for bolus calculation. I have no experience of Dexcom. My understanding is that NICE guidelines indicate BS measurements should be taken a number of times a day. Does anyone have advice?


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## helli (Nov 16, 2021)

@Drifter I believe having a finger prick meter connected to the pump is unusual. I have never had it and never had a problem pressing a few buttons to input it when I enter my carb count.
You should always have a finger prick meter regardless of CGM as the CGM could fail. The NHS will fund this and strips.


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## SB2015 (Nov 16, 2021)

Drifter said:


> I'm in much the same position as G3m. I have been on the Roche Accu Chek Combo for almost 8 years with a self-funded Libre for several years. My problem is that, as far as I can see, none of the replacement pumps offered by the local Health authority have a fingerstick BS meter. Some of them will integrate with a Dexcom and some you can manually input BS numbers from a standalone BS meter or Libre IG numbers. My experience of Libre is that there is often a significant difference with respect to a BS measurement so I am concerned about using Libre for bolus calculation. I have no experience of Dexcom. My understanding is that NICE guidelines indicate BS measurements should be taken a number of times a day. Does anyone have advice?


The Combo was a bit different to others, in that the BG meter  also acted as the PDM for the pump, and I loved that facility, as I did not have to get the pump out at all during the day.  The Disadvantage of that system was that I was not able to manually enter readings form the Libre that I used alongside it, which I wanted to do where I had confidence with the levels shown.  

Having switched to the G3, used alongside the 780 the pump picks up the levels from the sensor, as does my phone.  In manual mode this will then alarm, or in a closed loop system the pump also makes adjustments to my basal insulin every 5 minutes.   The pump comes with a Bg meter which sends the readings to the pump automatically but it does no more than that.  I found the test strips for that so fiddly that I switched back to an old one with cassettes so I then manually enter the readings.

I am still in the habit of doing a Bg reading at each meal, which keeps the pump happy as it requires at least two a day to calibrate it.  I understand that the next sensors will not require this.

I hope that this helps


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## Squirrel768 (Nov 16, 2021)

mark king said:


> @Squirrel768 - Intrigued so I got onto Dr. Google>>>
> Wrong link added now deleted
> I see this is dated Feb 2020
> 
> ...


It may be dated 2020, but there is no sign of it coming over the Horizon in the near future!!!


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## Pattidevans (Nov 24, 2021)

Squirrel768 said:


> It is something that is, as far as I'm aware, unique to Insulet! They even tell about it on their website when going into how wonderful it is - but if you disaree you can change your mind within 90 days


I was with the DSN yesterday and was offered the 640G or the Omnipod dash.  I specifically asked about the 90 day change of mind policy.  She said "read the small print".  Apparently it's not quite as advertised and in reality you have about 5 days to change your mind so all the gubbins can be returned within 30 days to the manufacturer.  A job for today is to look that up... though I have already chosen the Omnipod.


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## Squirrel768 (Nov 24, 2021)

Pattidevans said:


> I was with the DSN yesterday and was offered the 640G or the Omnipod dash.  I specifically asked about the 90 day change of mind policy.  She said "read the small print".  Apparently it's not quite as advertised and in reality you have about 5 days to change your mind so all the gubbins can be returned within 30 days to the manufacturer.  A job for today is to look that up... though I have already chosen the Omnipod.


"If after 90 days of use you and your diabetes healthcare provider decide that the Omnipod DASH® System is not suitable for your needs, Insulet will refund the PDM cost to your diabetes healthcare provider, and you are free to choose another treatment option."

The only proviso is that the PDM must be returned to Insulet within 30 days of the end of the 90-day period ... That is very clearly stated, so any small print variation of that statement would need to be very robust to contradict it. No mention of having to decide within 5 days to allow it to be returned ... unless that is within 5 days of the end of the 90-day period (which would then leave a smaller window to return the PDM).

I suspect that either your DSN has not fully understood the terms of the 90-days, or is trying to deter people from changing their mind because it requires a small amount of extra admin. My DSN is fully aware of what would be involved, and said that it would just mean putting in a credit note to Insulet and returning the PDM. No big hassle involved!

I would really like the t:slim, but training etc. for both the team and for me couldn't be arranged until the New Year, so I'm starting on the pod in a couple of weeks, with my DSN fully aware that (and in agreement with me), unless it find it far exceeds my expectations, I will likely be changing my mind within 3 months!


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## Pattidevans (Nov 24, 2021)

Squirrel768 said:


> "If after 90 days of use you and your diabetes healthcare provider decide that the Omnipod DASH® System is not suitable for your needs, Insulet will refund the PDM cost to your diabetes healthcare provider, and you are free to choose another treatment option."
> 
> The only proviso is that the PDM must be returned to Insulet within 30 days of the end of the 90-day period ... That is very clearly stated, so any small print variation of that statement would need to be very robust to contradict it. No mention of having to decide within 5 days to allow it to be returned ... unless that is within 5 days of the end of the 90-day period (which would then leave a smaller window to return the PDM).
> 
> I suspect that either your DSN has not fully understood the terms of the 90-days, or is trying to deter people from changing their mind because it requires a small amount of extra admin. My DSN is fully aware of what would be involved, and said that it would just mean putting in a credit note to Insulet and returning the PDM. No big hassle involved!


Ahhh... my apologies, you are absolutely correct and I suspect that either my DSN has misunderstood, or more likely some bod from "accounts" has told her about it as they don't want the hassle.  I have emailed her with the correct terminology from the website and suggested that there's been a misunderstanding.  I've never understood the accounts process at the hospital as over the years Roche have sent me stuff I haven't asked for (e.g. 5 applicators instead of reservoirs) and when I have rung to return the items and ask if they've sent a credit to the accounts dept they haven't and as I pointed out to the consultant pump supplies are expensive and there seem to be no checks in place.


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