# Confusion about pump options



## ElsieH (Feb 17, 2021)

Hi all

I'd appreciate your advice on new pumps.

I am 65 and have been diabetic for over 45 years, having spent the last 8 years on Acchchek pumps, I now need to upgrade and the trust no longer offers Roche products. I am sensitive to insulin and have 12 units over 24 hours.

The choices are;
* Omnipod (I have discounted this as there are no controls on the pod to allow managing it if the remote is forgotten or broken)
* Medtronic
* Tandem

The bloods monitors for both Tandem and Medtronic require additional funding which I do not yet know if I will be approved for, does anyone use either of them without the addition?
One feature of Accuchek I will miss is being able to input blood readings to get a suggested insulin dose. I won't miss bashing it on the worktop to prime it!

Can anyone who has picked one over the other please confirm what features you feel were better? Open to all feedback on both as I am really struggling to decide and need to get the funding application in ASAP.

Thank you.


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## Pumper_Sue (Feb 17, 2021)

ElsieH said:


> The bloods monitors for both Tandem and Medtronic require additional funding which I do not yet know if I will be approved for, does anyone use either of them without the addition?
> One feature of Accuchek I will miss is being able to input blood readings to get a suggested insulin dose. I won't miss bashing it on the worktop to prime it!


Hello Elsie,
all the pumps can be operated without using CGM. All pumps also have a bolus wizard so as long as you set your ratios up correctly everything in that dept will work fine 
Have you done a you tube search for the pumps so you can see how they operate?


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## ElsieH (Feb 17, 2021)

Thank you. I have watched numerous Youtube videos, just really struggling to see the main reasons for choosing one versus another. It is good to know that all have the bolus wizard as I wasn't clear on this following the  manufacturers info so thanks for setting my mind at rest on that part.


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## trophywench (Feb 18, 2021)

Yeah - BUT you have to test your BG  -and manually input the result into the pumps themselves and enter the carbs, so that the pump can calculate the bolus - none of them have a remote control handset/BG meter like Roche.

We've both been spoilt by having Roche !

With a deep sigh, I've gone back to a Combo as my CCG will not fund eg Dexcoms etc unless you're a special case.  I may think I'm special myself - who doesn't? - but as far as the NHS is concerned I'm just another ancient ordinary T1.


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## Sally71 (Feb 19, 2021)

We used the Tandem as a stand-alone pump for the first month and it works fine, you can input a BG reading from any other source and it will calculate doses for you just like the Roche pumps.  Refill procedure is a bit fiddly though, more so than Roche, that's probably the biggest downside for me (although I don’t have to do it myself, daughter has taken that over all on her own).  As a pump it's great, it can do much more precise doses than Roche can.


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## Pumper_Sue (Feb 19, 2021)

trophywench said:


> Yeah - BUT you have to test your BG -and manually input the result into the pumps themselves and enter the carbs, so that the pump can calculate the bolus - none of them have a remote control handset/BG meter like Roche.


The meter with the medtronic pump tells the pump what your blood glucose is


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## trophywench (Feb 19, 2021)

OK Sue - but to calculate and then deliver the bolus/correction you need the pump itself in your hand.

Not that most of us wear costumes from period dramas or anything else with long boned bodices and reinforced crinoline skirts, but if you happen to be in that line of work/hobby it would take some planning, same as it must for Henry Slade when he's on the rugby field and was for Sir Steve Redgrave rowing in the Olympics.


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## Inka (Feb 19, 2021)

@trophywench @ElsieH My DANA RS pump is controlled via the DANA app on my phone so I can input BG, etc into my phone to calculate a bolus and don’t need to get my pump out at all. Same with setting basal rates, temp basals, etc.

So little do I actually see my pump I actually get it out occasionally just to admire the colour


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## Pumper_Sue (Feb 19, 2021)

trophywench said:


> it would take some planning, same as it must for Henry Slade when he's on the rugby field


Henry uses MDI


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## trophywench (Feb 20, 2021)

Henry also uses Libre by the looks of him on telly/photos - but whatever he uses, Planning for it prior to a game, was the point I was making.


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## Pumper_Sue (Feb 20, 2021)

trophywench said:


> Henry also uses Libre by the looks of him on telly/photos - but whatever he uses, Planning for it prior to a game, was the point I was making.


Ah ok I believe he has the Dexcom G6 so the staff can keep an eye on him from a distance whilst playing.


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## T1 mom (Feb 20, 2021)

I was going to post a similar question but I'll just carry on from here. My 6 year old currently has a medtronic pump with a dexcom cgm. At first we used the medtronic cgm but didn't like it. His contract with medtronic is coming to an end and we're confused about where to go next. The medtronic pump is good but a little outdated. The tubing is also an issue as he's a very active 6 year old. Can anyone give some advice as to which pump would be better suited for him? Tubeless is a bonus, but ideally a pump which tells us that insulin isn't getting through due to a blockage or other issue. We've had so many blocked cannula issues recently. Many thanks in advance.


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## Inka (Feb 20, 2021)

@T1 mom Have you tried different cannula types? I use different types for different areas of the body. Some cannulas simply don’t work as well as others. It depends on body composition.

 Also, some sets and cannulas aren’t as well-made and/or designed IMO. He shouldn’t be getting that many blocked cannulas. I get maybe one or two a year where the cannula is bent.


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## Inka (Feb 20, 2021)

Oops - didn’t answer your pump query. Are you in the US (looking at your name)? I’d recommend looking at DANA pumps. I love mine.


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## T1 mom (Feb 20, 2021)

Inka said:


> Oops - didn’t answer your pump query. Are you in the US (looking at your name)? I’d recommend looking at DANA pumps. I love mine.


I'm in the UK. Thank you for your reply. I will definitely look into different cannula types. My son only allows us to use his legs as cannula sites, so this could be a reason for blockages and bent cannulas, as using the same area toughens up and hardens the skin. Although we do rotate the legs and use different areas on the legs. We've tried so hard to encourage him to try his tummy area but he doesn't like that idea. Is DANA available here in the UK?


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## Inka (Feb 20, 2021)

Yes, the DANA is offered by some hospitals in the U.K.   Its the most popular pump at mine so well worth a look.

My legs are my favourite site too. I do use my tummy but find it very sensitive. If his team ok it, you could try his lower back/top of bum if he would let you.  I used that for a while with good success.

I’ve used three different types of cannula - metal needle straight in, Teflon tube straight in, and Teflon angled sets. The last of those are the ones that work best in my tummy. I find the cannula tube flexes better. They also don’t ‘scratch’ when they’re in, unlike the straight-in ones.

I also pinch up before I insert a cannula. I do them all manually too.

The DANA is a tubed pump but it’s very good quality and the thing I like about it is that I can control it all from my phone. Of course, the first thing you need to do is see what pumps are available for him. Then you could maybe ask for opinions from users here. I’ve also found YouTube good for getting a general look at them.


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## Pumper_Sue (Feb 20, 2021)

T1 mom said:


> The tubing is also an issue as he's a very active 6 year old.


The tubing is easy to fix just roll it up like a hose pipe with a bit of tape around it. 
Personally I can not see why pump companies do not offer shorter tubing for the youngsters.


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## helli (Feb 20, 2021)

@T1 mom one thing to consider with tubeless pumps is the lack of choice of cannulas.
The other thing, I have found is that a tubeless pump requires a larger skin area to place it on.
Omnipod is the most common tubeless pump. It is not available in all areas in the UK but, if it is an option for you, Omnipod offer a free dummy pump that you may be able to trial on your son.

I would emphasise the need to ask your local team what is available in your Ccg. There is no pint researching all the options, setting your heart on one and then finding out you can’t get it.


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## T1 mom (Feb 20, 2021)

Thank you all for your replies.


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