This is the very first place i turn to when i have a question about diabetes. I am switching to a pump from MDIs. I have decided to go with the Medtronics pump compared to others coz of its reliability. thou i hate the fact that i have to used the tube instead of being wireless (with omnipod).
Basically my question is .. currently my TDD for insulin is about 40-45 units. Will the 523 be enough in the long run(4 years)or should i go with the 723 with the 300units reservoir. My understanding is with better control with the pump (which i am hoping), i will be requiring less insulin than i do today. My Endo indicated that, it will be down about 20% since about 20% is lost in the skin when you use MDIs.
Given your current TDD, you'll probably end up using about 35-40 units per day with the pump at most. Keep in mind that you need about an additional 10 units to "prime" the pump, and you may find that you use a bit more insulin than estimated because you'll be correcting more (at least, that's what I found). But yes, in general, most people's TDD goes down by about 10-20%. I think mine only went down by about 10%, but that probably has more to do with the fact that I eat a bit more "freely" on the pump.
So, let's assume you'll use about 40 units/day at most on the pump -- you'll need 120 units over a 3-day period, 160 units at most if you stretch it out to four days. Assuming you're not planning on making any drastic life changes (like getting pregnant, which since you're a guy would be kinda hard) and don't anticipate something happening that would change your insulin needs drastically, you'll probably be fine with the smaller pump.
Now, keep in mind that if you do decide to go with the larger model, you don't have to fill up the reservoir all the way. Also, think about things that could drastically change your insulin needs (weight gain, sudden decrease in physical activity, change in weather, etc). If any of these things could result in you needing MORE insulin, go with the larger model.
I agree with prior poster. My TDD is around 25 units, but life changes may make it higher (we are planning a family). I went with the 300 u reservoir, I don't think you can go wrog with the larger reservoir - you can always put in less insulin, and actually use the smaller reservoirs, but if your needs go up for some reason, you would have to change the reservoir of the 523 more often.
I also recommend that you get the 723 with the larger reservoir. Once you've been pumping a while, you'll learn that you don't have to change your infusion set and your reservoir at the same time. My TDD averages about 20 units per day. I use the 523 pump, fill the reservoir to the max, and then use it for about a week. I have never noticed any degradation in my insulin, and it makes my life so much easier this way. Saves a ton of time when changing out sets because it is the reservoir fill and prime that takes the most time.
You should also know that they say the 523 holds 180 units. However, when you fill the reservoir, the pump usually says you have about 160 units left. The rumor is that Medtronic pumps do this so that you have a "hidden reserve." So if you're using 40 units a day, you can get by with the 523, but you'll be forced to change your reservoir every 3 days (or stretch it to 4). You lose about 10-20 units when you prime and fill the tubing.
Also, I am one who never likes to be out and about with my reservoir running low on insulin. That forces you to always carry a vial of insulin with you in case you run out. I like knowing that if something happened, I always have enough insulin in my reservoir to carry me through for a day or two or three. Because I save so much insulin by not having frequent reservoir changes, I usually change it out once I get to 20 units left. Many other people use their reservoirs to the last drop. You'll figure out what works best for you.
When I started pumping, they initially reduced my basals by 20%. That didn't work for me and I ended up at exactly the amount of basal that my Lantus provided. So as I said above, I think you'd be better off with the bigger reservoir. Do you want to be running out of insulin if you're out at dinner and want to have carb fest dessert? Or what if you have to go on steroids and need to double your basals for a few days or weeks?
Just one comment. If you really want the Omnipod, most users find it very reliable and are very happy with it. So you should really think through your decision to go with the Medtronic pump unless you're totally committed. I personally think that the Medtronic pumps are currently the best pumps out there and tubing is not a problem for me. But since this will be your pump for the next 4-5 years, be sure it's the right answer for you.
Thanks all.. I ordered the 723 with the larger reservoir. As you all suggested that, even if i dont use all the insulin, i can still have extra units in the reservoir enough for priming and TDD.
Yep, I think that's the right decision for you. Let us know how you like the Revel. I've really enjoyed it; switching from MDI to a pump always requires a bit of adjustment, but once you get all the basal rates and I:C ratios figured out, it's really a wonderful tool. Use their Carelink software; it's pretty good for figuring out patterns as you make adjustments to your basal rates.
As for the tubing (one concern you note), I really haven't had too many issues with it. It took about 5 days to get used to and after that I just barely noticed it. I use the 32" tubing so that I have a lot of flexibility with where I stash the pump and where I attach my sites.
Oh man, sorry I'm late to the party, I would want the smaller pump. I like running and every little bit counts. I called them to look into getting a new one but didn't get an answer, just VM, "look at the website" which I've been too lazy to do. I don't think the pump is that much smaller but if you can switch, and the size of the pump is a consideration, I'd consider getting the smallest one possible.
Mines the 523 and it works very good for me, I average probably between 33-40 units daily. Lately I have been on the higher end and I can get about 3 and half days out of mine. I usually after filling my reservoir, and priming have around 160 units. For me it works well, Im nearing 40 am NOT having any more kids, I dont see my insulin needs changing significantly enough to warrant getting the bigger pump.
Since i already ordered the pump.. now i have to figure out the carbs to be on top of my carb counting for proper boluses.Is there a good iphone app that helps you count the carbs. Atleast from common restaurants like CPK, Cheesecake factory etc.
I downloaded some from appstore like Diabetes Buddy and Glucose buddy .. but they really arent that great.. the search is very very slow. and the apps crash
Thats one thing i dont like about the minimed pump is that it does not have any directory for carbs for common foods atleast.
I like "Lose It!", the interface is really easy to use and I haven't had any problems with crashing. I have a Droid but MrsAcidRock is using it on her iphone and is similarly pleased with it. I've tried a few BG oriented apps and I kind of like keeping the "food" and "diabetes" gizmos separate. At first I was concerned I'd overlook stuff but the other day I looked at the daily log on my pump and it was 137, just like Lose It!
No unfortuantely it doesn't. LOL I just decided to download the app you suggested I LOVE THAT FEATURE. I dont think I ever bolus right for those yummy Atkin's Bars but it was showing 8 grams of carbs, Im usually bolusing around 2 or 3 for those. That was SOOOO cool.
hey..congrats...i just got my pump today. looks like i got the revel/cgm 523. geez, it's like opening up a christmas present(ha) and the box weighs about 10 lbs.; 4 huge boxes full of infustion sets, meter, 4 boxes of reserviors, IV prep, carelink USB...guess I'll just stare at it until next week. good luck with your pump...i hope we BOTH love it! :)
Haahaaha I know so much box for such a tiny thing. LOL I dumped it all out over my bedroom floor and Im like where am I going to PUT all of this. Excited you got your pump. I can't wait to hear how you like it.
That's really handy, I'm ok w/ cups/ spoons/ ounces/ etc. but the converter thing is handy.
I think I blathered somewhere else that it also has a "nutrients" tab that keeps track of what %age fat/carbs/ protein your diet/ day and week is composed of. So if you let 'er rip, you can sort of trade off somewhere else?
thanks, christy...I know, my condo looks like a pharmacy, ha! i didn't know what size was ordered, but the rep asked how much insulin i use per day..so I guess the 523 will work just fine for me, that gives me about 50 units per day, i guess..more then enough. I can't wait either..scared though..I know it's gonna take some adjusting but nothing ventured nothing gained i suppose. thanks!
That's really cool. I think Im going to have to watch my protein intake, I noticed my BUN is a tiny bit elevated...BUT all my other kidney function tests are perfectly normal.. and by a tiny bit elevated I think 22 is the cutoff for normal and mine was 24.
I think Im probably just consuming too much protein. But lol I've just started seeing a new Internal Medicine Dr and she really thinks just due to age...and how long I've been diabetic I should be on a really low dose ace inhibitor and statin...
I'm sort of aiming the opposite way, 86 carbs/ sub protein...I have an endo appointment soon and will see what pork rinds and beef jerky do to my numbers...heh heh heh...
