Dazed and Confused

Diabetes Technology Insulin Pumps
1

You all are killing me! Just when I thought I had my choices down to the Ping / Omnipod I start reading this section of the forum, and I am reconsidering going to a pump at all. I understand the old saying "do good and never remember, do bad and never forget" but it seems like all I see are a lot of complaints for both insulin delivery systems.

I am about to make a decision that will last for years, and have a very active lifestyle (mainly boating, jet-skiing, hunting, fishing, 4-wheeling, snowmobiling...well, you get the point.) and travel for work between 40 and 50%. I need to come up with a way to get off my MDI's and get to a pump.

I can't be in a tree stand and take an injection! Waterproof is a MUST as that is my entire life outside work.

I would really like to hear about GOOD experiences from people like me who are outside more than inside. I know that things will happen - a bad pod, an inclusion alarm, a pulled infusion set, etc.. but at this point, after reading through the forum I am starting to second guess my options.

I am a type II (and not overweight, no bad eating habbits, i.e. non-typical of the mainstream endo's and media's description) that has recently become insulin dependent and very happy with my results. I am currently on Lantis and Humalog with a TDD of 50 - 60 units. However, I need a system that will allow my life to continue, not just get by day to day. I have had diabetes since I was in the Marines as a teenager and was able to control it with oral meds until the last couple of months. That is almost 20 years. I DO NOT want to look at insulin as a failure, but a way to make my life better. With that said, my life since going on MDI's has taken a toll - hell, it has pretty much come to a sudden halt due to the restrictions placed upon me with MDI's.

I welcome positive recommendations and reviews on pump therapy - instead of the girl on Youtube who says that OmniPod should be banned because she is an idiot!

I know I have been a bit long winded, but I am seriously looking out to all of you to assist me in making a decision that will have ramifications for the next 4-5 years. I have spoken to reps from both companies, and they all "assure" me that theirs is better in good old salesmanship fashion. Animas has obviously spent a LOT more on marketing, as their presentation was outstanding. Omnipod just says that they don't need to spend it there as their product is "Changing Lives Without Tubes" and sent me a demo kit.

I really hope that you all can help me come to a decision. My life, my family and my lifestyle is on the line here.

Very Sincerely,
Gary

2

The decision to pump is a personal one. MDI versus pump is a tough decision. When switching from MDI to pumping you are trading one set of problems for another. Most folks find pumping problems easier to swallow but insulin use in any form does effect your life. It is a burden we all must bear because we have no choice.

Even though the burden is there constantly the test is how we handle it. You can lead the active lifestyle that you love all the while taking care of your D. You can sit in a deer stand and inject insulin or any other place you wish to be in your active lifestyle, you just have to plan and make the right preparations. Before I started pumping I injected in the cab of my truck each day at work. I always had insulin with me and injected where ever I needed. I did not let it stop me from doing what I want to do.

With my pump I still always have insulin with me. The delivery system is different because it is a few button pushes but the preparation factor is greater. Some things are still the same. You must still test your bg before meals and even though the pump will help calculate your bolus, You must still make the decisions.

You get no free pass with either system but I feel that pumping better fits my lifestyle.

Gary

3

Both my kids PING. We are very active outside. They wear their pumps at waterparks, swimming, playing sports, everything. We have never had a problem with the Ping. Yes it is a tubed pump but it hasn't stopped them from any activity. The ping remote allows them to wear their pumps in spi-belts and bolus remotely - thus not having to have access to the pump at all times. The Meter is not waterproof but neither is the Omnipod meter. They will be wearing their pumps downhill skiing next month and we will use the spi-belts for that as well - wearing the pumps next to their skin under all the winter clothing will also protect the insulin from cold temps out on the slopes.
Yes you will still need to test before meals, before sleeping, before being extremely active - just like on MDI - the difference is you have more freedom. IMHO. There is nothing wrong with MDI and my daughter has occasionally taken a pump hiatus but always returns to the pump. Ive got adult friends on both sides and they make their decisions on what works best for them. Im not sure if Animas has any trial type programs - like try before you buy - worth asking them. Best of luck to you.

4

How are "[we] all killing [you]"? I see a lot of favorable reviews by many pumpers here. Not everyone likes them. I just wrote this in the last couple of days:

A pump works by providing insulin 2x ways. It puts out a steady "drip" of basal insulin, which you need to keep your body working ok. This is set at a rate, like .825U/hour. It is very handy because if, for example, your BG runs up every morning, you can change your .825 to .875, see if that works, if it works a little, you can try .9 and see how that goes until it's "set". Then things might change again but you can be very precise in your control. If you get sick, you can turn it up to 200% of normal and "cover" the rise from an infection. If you are going for a 2 hour bike ride, you can turn it down to 20% of normal (or whatever, there's often trial and error in these sort of basal adjustments, or at least there were for me...) and be good to go.

Then, when you want to eat something, you use the pump to administer an amount based on the # of carbs your ratio is determined to be, say 10G of carb/ unit. So if you eat a sandwich that's 25G of carbs, you bolus 2.5U of insulin and eat. You can have different ratios at different times of day, just like the basal rate time adjustment.
In terms of logistics, the pump has a pump motor and a reservoir to keep the insulin in and some hardware and software to run the stuff on. There's two kinds of pumps, tubed, with a pump, about the size of a flip phone, a tube connecting the reservoir to an infusion set and the set itself, a small plastic tube you stick into your preferred location with a needle, take the needle out and leave the set in for a 3-4 days maybe. There's also the Omnipod which just has the Pod gizmo that you stick to your body with the pump and rf gear and needle that sticks itself into you. You run it through the controller, which is another cell phone sized gizmo.

I've enjoyed my pump since about 2 hours after I got it, when I tested at 85 after 3x Taco Bell tacos (I'd been at the doc getting set up for a couple of hours and didn't want to waste more time @ the tastier taco place so I headed for the border...). It's helped me do a lot of things much more easily than I think it would have been with shots for me.

One thing left out of that that I really like about it is that the data compilation that my pump does, both on it's own and then the additional layer with the CGM, has been very useful. If you are having issues or wondering how to tweak things to make them run more smoothly, upload your pump and see a sort of "forest" you might not get with the daily "trees" of one BG test after another.

I have the Medtronic Pump which is not waterproof. I've gotten rained on a couple of times and it's survived tucked into a pocket. I had a "BUTTON ERROR" failure 3.5 years into pump number one (4 year warranty...), after a sweaty 14 mile run at 87 very humid degrees. I dunno if that did it in or not as they didn't provide a report (although I didn't ask for one...) but I had a new one the day after the next business day. Eerily, the error, which I've seen other reports about it being humidity/wetness related, seemed cured by putting the pump in the freezer since it was beeping and I didn't want to take the battery out for some weird reason and we were partying. The next morning, I took it out, let it warm up and, amazingly, it seemed cured. I still sent it back. I have no idea what Medtronic made of that...

5

Nothing your are saying makes any since, I have given myself injections on top of mountains in Colorado, Deer stands on the Edwards plateau, in ski boats, on air planes, at amusement parks, and standing in the middle of a biker bar at Daytona Bike Week. I also have a MiniMed pump that has been all of these places and more (It's not water proof). You can overcome the water proof issue and if your a Type II (get a 300u pump), going with a pump with less ammo will be your biggest mistake Marine....never sweat the small things...;-)

6

I'd be leery of jet skiiing with a Medtronic pump!

7

I would be worried about it being striped from my body during a crash, I have a plastic pouch that protects it from water. I have been on my Harleys in rain storms going 7O+ mph and so wet when we would stop my wife and I would pour water out of our boots and helmets. My corporate lawyer water skies with his old Accu-Chek pump, I just leave my MM in the boat.

8

There is always a good and bad side to all pumps. It depends on what features you value the most. Given what you describe, I'd say go with the Ping. It seems like waterproof is the biggest feature you need to consider. The pods are water proof, but the PDM is not, and if you're around water a lot, that would become an issue.

There are some legitimate concerns with the Omnipod, and I don't think it's a good pump for people like myself who can go into DKA very quickly. But if someone places a really high value on having something without a tube, that would obviously be the pump for them. It's all a matter of what you need most.

What is your total daily dose? One thing to consider is the Ping holds 200 units, whereas the Minimed has a 300 unit capacity model. Something to consider.

9

Gary,

I've been on the pod for a little over a year with few problems. I've had 2-3 bad pods which they replaced, and one PDM which went bad, which they also replaced. My A1C improved dramatically - from 7 on MDI to 6.2 on the pump, with far fewer hypoglycemic episodes. I used to be unable to get good overnight BG (due to dawn phenomenon) AND simultaneously not go low in the afternoon. I tried splitting the Lantus does, but that didn't work. The pump (any pump) lets you have just the right basal you need for the time of day as well as dynamically adjust it to your activity levels.

For me, the tubeless aspect has been great - I shower, swim, etc with the pod on and have never had a problem Yes, the PDM is not waterproof, but neither is my cell phone
and I don't drown that at the beach.

The good thing about pumps is there are so many to choose from.... if one doesn't work for you, try another . Most will usually let you try it out (or your endo/CDE might have a loaner you can try)

Expect a month or so adjustment period to get all the settings tuned in for you. You really need to be familiar with carb counting and it really helps to be comfortable with self-adjustment of insulin dosae. Books like "Think like a pnacreas", "Using Insulin", and "Pumping Insulin" are very helpful.

10

Hi everyone, I'm new to this forum but not TuDiabetes. I have a question. Do any of you have the very new "t:slim" touch screen pump by Tandem? I'm coming due for my 4th pump soon and it looks like it meets my needs. (Google t:slim) It's not the pump for folks who frequently swim, just disconnect. It's 3 feet for 15 minutes, so better stay out of the water. I am very curious. It works just like your smart phone. It's clearly next generation.

11

There's a Tslim group. One thing that makes me less than crazy about groups is that they seem to peel off some groups of folks from the main forum so we don't get to read about things, like the Tslim.

http://www.tudiabetes.org/group/tandem-t-slim?xg_source=msg_wel_group

12

It's obvious I didn't look hard enough for it. Thanks

13

IMO I think that you should look most closely at the Minimed 723 and the Tandem. Both of them have 300 unit reservoirs. At your 50-60 units per day, you might find yourself running out of insulin by Day 3 with the pumps with the smaller reservoirs. Many people find that they need 10-20% less insulin with pumps than with MDI. I am one who didn’t. My total insulin is exactly the same when pumping or injecting.

Changing reservoirs is the most time-consuming part of pumping, so IMO the less often you do that, the easier your life is. I am a Type 1 with a low TDD ( total daily dose) which allows me to go a week between reservoir changes. I still change my infusion set every 2-3 days, but that is super quick.

I was with Medtronic for 8+ years and just switched to Ping. The only reason I switched to the Ping is to get the next generation Animas pump which will be integrated with the Dexcom G4. I’ve been with the Ping a month now and still find it incredibly frustrating. The menus are absurd and the constant scrolling is time-consuming and IMO dangerous. It’s so easy to dial in the wrong dose. Despite that, I am OK with my decision because I still have my eye on the Vibe.

But if I weren’t interested in CGM, I would definitely have stayed with Medtronic or gone to the Tandem, which is the new kid on the block but very exciting.

14

Lathump, you and I manage our pumping the same way. I change out the infusion set every 3 days. With the Cozmo 300 U reservoir it works great. The Cozmo, which I'll be giving up soon, works well for me. I wish the company had stayed in the pump business. I do all my boluses by touch with a single button. I rarely even look at my pump. The t:slim would change that because it appears very easy to access the pump functions. I don't like the Ping because the reservoir is too small at 200 U. I have a Dexcom and can't decide whether or not to go to their latest model. Dexcom is offering current users the new Dexcom to us for $399 until January 31. I can't make up my mind. In any case, the t:slim is very tempting. I like simple, and it seems to be the easiest pump to use on the market today.

Regarding HPNpilot's comment above re: pumps in general, I know the pump has added years to my life. On MDI for over 30 years my A1c was always in the 9's or greater. I haven't been over 7 for the last 12 years with a pump. In addition nighttime lows are as rare as fine paintings at a garage sale. I should add that it requires very close BG monitoring. It can be a nuisance but you gotta do it. There are no really bad pumps. Some just fit one person's needs better than another.

15

I’ve been using the animas ping for about a year now and have never had a single problem. I was very nervous at first wondering how often occasions and bad set and all that jazz would happen. Well, for me it never has which may just be me being lucky but I think comications are the exception not the rule.