Insulin Pump/CGM During Pregnancy

I have been a Type 1 for 4 years. I have already had one pregnancy (my daughter is 2 1/2) and we're starting to think about baby #2. I currently use the Minimed 722 which I used with my last pregnancy. I am thinking about making the switch to Animas since I am due for a new pump in a few months. With my minimed the reservoir holds 300 units. However the Animas only holds 200. With the increased insulin needs later in the pregnancy, how did any of you deal with this? Change site more often? If so how did your insurance respond to the extra sets you needed?

I currently have a TDD of about 50-55 units. So, as it is to go down to a 200 unit reservoir is "tight" so I'm worried how it would be during pregnancy... I am just in the beginning stages of researching for a new pump. I am attracted to the Animas because of the 1) Meter/Remote 2)waterproof 3)color screen 4)partnership with Dexcom

Also I am interested in getting a CGM. I have done a trial with the Minimed CGM and I was not impressed. I'm hoping to try the Dexcom to compare, but I've heard good things about it.

Any thoughts or advice is greatly appreciated!

I love my Animas Ping and my Dexcom CGM. No matter what pump you end up choosing I highly suggest using the Dexcom CGM. I did a trial with the Minimed and was not super impressed, but the new Dexcom G4 is SOOO much better and more accurate than the Dexcom SevenPlus, it's totally worth getting , in my opinion. I am currently pregnant with my first, and am kind of wishing that I had a pump with a larger reservoir, so I don't really know what to tell you there, I'm still in my first trimester so I haven't had any insulin resistance hit yet.

Other than the small reservoir I've been pretty happy with my Animas Ping. I do think that Animas uses cheap materials to make their stuff, but if anything has ever broken, they've been really good about replacing it. Mostly the "cheapness" of materials has manifested itself in things like broken belt clips for the pump and scuff marks on the outside of the pump, I've never had an actual pump malfunction or anything. I can't really compare quality of materials to current MiniMed pumps, since the last MiniMed pump I had was a 508 about 10 years ago. I'm interested to see what others say about increased insulin needs and the Animas, too, since I will be hitting that part of the road soon! OK, this is really rambling, sorry!

But seriously, get the Dexcom if your insurance will cover it, you will not regret it!

Thanks so much for the info! It is so nice to be able to chat with fellow diabetics! Were you able to do a trial of the Dexcom? If so did you contact Dexcom directly or go through your Endo? When I tried the medtronic CGM I did it through my Endo. I was definitely not impressed with it. It was super uncomfortable to wear and I kept getting a ton of error messages and it was super inaccurate - ugh! But I hear (read) a lot of great things about Dexcom and mostly people seem to be really happy with it.

Congrats on your pregnancy! It's a roller coaster ride but its definitely worth it! :) The third trimester insulin increases are CRAZY!!! It got to a point that my breakfast ratio was 1:1 then I was ADDING an additional 20 units!!!! So even with the 300 units things were "tight" and there were many days I had to change the set before 3 days. Good luck with everything and thanks again for the info! :)

I’m in the final weeks of my pregnancy (holy insulin usage!!!). I’m not sure this is totally recommended but what I’ve done is just rewind the pump, shoot 100u or so of insulin back into the reservoir using a syringe and restart it. That will buy me a little more time and at least stretches the supplies a bit :slight_smile:

I know some women gave large boluses via syringe or pen later in the pregnancy. This can buy more time for you by allowing the insulin in the reservoir to be saved for basal. The other benefit is that insulin is absorbed more quickly when it is injected in a new site, I think.

The downside is that it won't be in your pump memory or in the bolus on board / active insulin.

But when you need a 20+ unit bolus for lunch, this might be a good option :)

Hi there,
For what it's worth, my CDE and OB have both told me they recommend changing infusion sites at least every 2 days, if not every day, during pregnancy. So if your endo or OB recommends that, too, you can ask him/her to write a letter to your insurance company explaining the need for more supplies. This may or may not work, but it is worth a try if you like the Animas better for all the other reasons you mentioned.

I have a Minimed pump and CGM, but I don't use the CGM because it's terrible. Which is sad because it's neat that it's integrated with the pump. My endo tells me that Minimed has a new (or at least much improved CGM) coming out soon, and she seemed excited about it (this is not official, so she couldn't give me any details).

Thanks ladies for all the helpful tips! Now I feel a little more comfortable considering a pump with a smaller reservoir knowing I can make it work during pregnancy. Researching for a new pump is always a bit overwhelming knowing that you will be stuck with this device for 4 years. I just want to make sure I consider all options. I hope to get the ball rolling for the Dexcom soon too!!!

The new Enlite sensors are out in Europe and I read much better reviews about them. There was a post on TuD about it as well here.

I also have a MM, but haven't tried the new sensor yet. I did OK without CGMS last pregnancy. So I am thinking about whether or not to pay for it before the next one (no insurance coverage for it here).

I also highly recommend steel infusion sets during pregnancy because then you can reinsert them. When my insulin needs were higher, I changed my infusion set every day, but still got 3-6 days out of a single infusion set (Sure T). I disinfected and reinserted and never had any infections or adsorption problems.

I also did not need to worry about kinks. When ever I had a high that I couldn't explain, I moved my infusion set to be sure that that wasn't the problem.

The Sure T has always seemed a bit uncomfortable to me....but you make some good points about no kinks and from what I have read many people swear by them. Might be worth a try! Thanks! :) I also went through my first pregnancy without a sensor and did pretty good. However I had a GREAT team working with me who was constantly helping me tweak my numbers. I have since moved and have a different team of doctors that I am not as comfortable I'm thinking that the sensor might be helpful. Let me know if you end up getting the Enlite or doing a trial with it. I would be curious to see what you think of it.

I didn't do a trial for the dexcom, because I knew I needed a CGM and I did a lot of research and knew it was the one I wanted (i'd just heard SO many good things about it). I did a trial of the Medtronic CGM through my endo (and didn't like it). I bet you can do a trial through either your endo's office or just call up the local Dexcom rep and see if they'll hook you up with one. It sells itself, so I'd be surprised if they didn't let you do a trial, to be honest. I love my Dexcom!

Just wanted to let everyone know - I spoke to Dexcom today. They said the G4 is not available for trial because it is only approved by the FDA for single users so they aren't available yet to be used in trials by multiple users yet.

Boo, I was excited about it! Thanks for the info!