Hi everybody.. I have a problem of choosing the insulin pump for my lovely girl Layan. I live in Jordan with very limited choise of pumps..it seems that the medtronics is the most common. Although her endo did highly recommend it but I dont feel that I accept the idea of the tube..My little girl is 5 and was diagnosed one year ago..she is still on MDI..the insurance just accepted to cover the pump fully with no limitations..I want to get her the Omnipod but is not available in Jordan..I am not sure what to do...would appreciate any ideas that I can get.
I am a type 1 and I use the minimed and love it. To be honest, if I had a child, I would probably NOT use the Omnipod. Being tubeless is great, but I don't think it's good for kids for a couple of reasons.
First, the lowest basal rate you have with the Omnipod is 0.05 units per hour. Minimed's pump goes as low as 0.025 units per hour. This may not seem like a big deal, but when dealing with such a small child, that difference can be significant.
Second, there seems to be a lot of issues with Omnipod, including pod failures and such. In adults, I don't think this is as big of an issue, but kids can go into DKA very fast (and children's BGs are generally a little more variable and run a bit higher). The Minimed is just a really reliable pump.
Third, with tubed pumps, you have different infusion sets to choose from. If your daughter has an allergy to one, she can try a different kind. The Mios are great (very comfortable and easy to insert), but there are other kinds as well. There are no choices with the Omnipod.
The tubing really isn't a big deal. Lots of kids have tubed pumps and do just fine. I typically wear my infusion sets on my upper thigh/butt area and clip the pump to my pants or skirt. The tubing stays down inside my pants and never gets in the way. It's a lot less of an issue than I thought it would be.
Don't get me wrong - I think the Omnipod is great for some and it is to some degree a personal choice. But if I had a kid with type 1, I'd definitely go with the Minimed.
I personally use the Animas Ping, but I did want to address the issue of having a pump with a tube because I have a pump with a tube. I specifically chose the one with the tube because of the benefits I felt existed in a pump with a tube. I like that I can see it and know whats going on, not sure you can do that with the omnipod. I can dose with the pump and don't need a remote to bolus, which is fantastic because if you forget it your out of luck. I like that while the infusion set is changed every 3 days, I can move the pump to where ever its convenient- belt, bras, pocket, wherever. I THINK (not 100% sure about this one) that it is much easier for me to disconnect for short periods than the omnipod users.
Also, Medtronic is one of the few pump companies that I feel have really stood the test of time. I am a paramedic in the US, and I don't think I have ever even seen someone that had an insulin pump that was not medtronic, and I have seen quite a few over the years.
Yes, the tubing can get caught, the site can get pulled out, it is harder to hide. Some people have all of these issues, and some people have none. It is worth noting that some people with omnipods hate them because they have a lot of failures, some do not. I see it as a trial and error process. If they will cover the medtronic, why not give it a try first... then if you have reasons it doesn't work, fight to get the omnipod instead?
Good points. Would also note that the pods are not that small; on a child, they would seem quite large. I received a sample pod and one of the things I didn't like about it was the size (I'm fairly petite and it really stuck out under my clothing).
Also, agree, agree, agree about the benefit of being able to SEE what is going on with the tubing. On a few occasions, when I thought I had an occlusion in my tubing, I was able to disconnect and do a test bolus to see if anything was coming out. This is not something you can do with the Omnipod. Finally, with a tubed pump, you can change out your insulin without having to change your site (or vice versa). Again, can't do that with the pod, and people with the Omnipod sometimes complain about the amount of insulin that can get wasted.
Thanks for the reply..I am not sure if we even have the Minimed in Jordan..we have a very limited market and as I said it seems that the Medtronics is the dominant here..but maybe the problem is with me not with the tubed pumps, I dont feel that I do accept the pumps in general, to have a machine hooked to my angel's body 24/7 ..but thinking about its advantages made me obliged to consider them..but do you think if I bought the pump from another country I will be able to manage without having technical support close to me?
I am not sure how easy can that be , to get the Medtronics first and to change it afterwards if I did not like it, and the main issue will remain which is that we dont have Omnipod in Jordan, I will try to look for some support in this regard but not sure from where, We dont have any kind of organized support for Diabetic kids, Layan never met another diabetic child, for that any information that I have today is through my readings and the internet.I dont know any person who is using a pump, although Layans doctor tells me that there are many of them..thanks anyway for your advice.
The minimed is made by Medtronics ;)
She will need to learn how to deal with things like tubing etc at some point. It is best she learns now. She will likely pull a few of them out accidentally, but it is easy enough to put in a new one. Besides she will learn that it is easier to take care of it than to have to replace it often.
On the pods you can not see that they are properly inserted or in the cannula comes loose. On the tubed pumps you can see it.
Medtronic purchased Minimed many years ago, but People still call it Minimed for whatever reason.
I don't know if you can try a loaner pump where you are, but if you can, I suggest you do that.
If you don't have access to the Omnipod anyway, I would definitely go with Medtronic. It's a great pump and if you can get it covered, it's worth trying. Remember that if you or your daughter don't like pumping, you can always switch back to MDI. The pump is not permanent! Plenty of people go back and forth between pumping and using MDI throughout their lives.
Used correctly, the pump can be a great tool. It can give much greater flexibility with eating and activities with fewer severe lows and highs. For me, it has really made a huge difference in my life (and I was resistant to it at first).
If you can't meet another pumper in real life, this forum is a great substitute. Lots of folks on here are ready and willing to offer up their experiences. Also, make sure to read the book Pumping Insulin; it's a great general guide for pumping.
I agree with all the others on Medtronic/Minimed. It is a really user friendly pump as well as all the reasons stated above. Even as an adult I did NOT like how large Omnipod was, that and just all the stories I hear of pods failing Im so glad I did NOT make that choice. The tubing really isnt a big deal, and neither is having a piece of machinery attached to you.
My friends' daughter was dxed at something like 18 months old and has had a Minimed/ Medtronics, whatever, Revel from pretty early on. I was pretty gung ho about my pump at the time and had gotten a CGM shortly after we'd gotten reacquainted. I don't think they have a CGM yet although we haven't talked for a while about how things were going, they'd never mentioned the pump or tubes being a problem.
I was totally opposed to pumps/ tubes for years, until I got one. I was pretty motivated at the time and I was amazed at how much easier my life got with it.
I think really in my opinion its ONLY a big deal if you make it a big deal. Its one part of life if you choose this kind of insulin delivery system. You adjust, cope and move on. Before you know it, its a normal part of your life. I know personally the freedom it has allowed me far outweighs any inconvience of having something "attached" to me.
Why not ask your doctor to see if some of his patients on pumps, expecially parents with children on pumps, will talk with you?
The tube really isn't a problem. Once I tuck my tubing and go I don't even notice it. I was concerned about the tube and sleeping, again a non issue. I clip the pump to the front of my shirt and roll around as I did before I started the using the pump which was only this past Tuesday.
As for wanting the Omnipod my concern for you is if it is unavailable in Jordan, you might have difficulty getting replacement pods as frequently as you might need them, just a thought. I have the medtronic revel and so far so good. The tubing really isn't a problem for me, can't speak from a kid's point of view, but I've seen plenty of children your daughters age on tubed pumps, Best of Luck.
i don't have a lot to add to this discussion except to concur with the others in saying that a tubed pump is not a problem, once the user becomes accustomed to it. I think your daughter will be able to easily adapt to a tubed pump because adapting to situations given to them by their parents, and other special people around them, is one of the many ways in which they learn. Personally, I have an Animas Ping, and like it because of its remote feature with the meter communicating with the pump. I do not believe MiniMed has that option, although I could be wrong. MiniMed is a good pump, and if it is readily available to you, it would be a good choice. I urge you to consider the Animas as well, as it has some features that MiniMed doesn't; such as the remote feature, colour screen and excellent recording software. The Animas pump is a Johnson and Johnson company, and I believe they are world wide. They are both very reliable pumps.
Please give your daughter a great big hug from all of us here, and know that you aren't alone. Good luck in your choice, and keep us posted as to what you decide.
Be well.
Brian Wittman
Thanks to all your responses. We have in Jordan one National diabetes center ( for all adults and kids type 1's and 2's) but I have to admit that I never took layan there, She was diagnosed in a private hospital, then her pediatric has recommended an endo who is really great but she can’t do it all, she cannot be the educator and the dietician and the product specialist so she gave me a place to start from and the rest lies on me, she told me to read and read and read because there is no organized system that caters for diabetics in Jordan (other than the medical part) and and she told me that I can go to the diabetic center but they have a different treatment system which is the use of the mixed insulin. and since my insurance is just great and fully covers any expenses related to Layan's case , so I did not need to go to the national center and get Layan's insulin from there . But I guess I need to have a visit to this center and try to have a feeling of the different products available. Thanks again, this really is helping, just to be able to communicate with people who do understand. I will keep you posted.
Wow, that's interesting to me, and a bit scary, to conceive of an entire country (ok, I looked it up, 6 million people!) making everyone use mixed insulin! I'm glad for your daughter you were able to make other arrangements!
Definitely get a pump, but are you able to go to Israel in the event that you need/want more specialized care or a second opinion? Tel Aviv is not that far (2 hours drive?) and there are lots of great specialists there from what I understand.
The good thing about diabetes (if there is something good about it) is that you really don't need a whole lot of professional medical advice/direction. A lot of how type 1 diabetes is managed is just through experience (i.e., trial and error). Keep track of all your daughter's readings; learn the effect of foods and activities on her blood sugar levels; and learn how to adjust her insulin accordingly. There's nothing a doctor can do to really help you and your daughter learn how to do this. Rather, it's something you have to learn how to do yourself.
Hi nisreen. One small point: cloth tape can fasten the tubing down quite effectively, just make a little loop of the tubing and tape across it. You can also tape around or across the infusion site itself. Medtronics usually will give you different samples of the type of infusion sets to try; Sure-Ts are often used by children.
That's an intriguing suggestion. I've read an interesting book about urban planning in Israel-- "Hollow Land" -- that would make me think that perhaps it would be more complicated to get from Jordan to Tel Aviv than that?