Need help...Getting a pump for the first time!

Diabetes Technology Insulin Pumps
1

Help! I saw my endo last night, and she says that she'd endorse me getting a pump. I was just diagnosed on 12/11/11, so this is all new new new to me, BUT I'm super duper excited to get this ball rolling.

How do I go about researching pumps? What do you guys love and recommend?

A bit about me, I'm super athletic and play roller derby. I'm currently looking at the Minimed paradigm and plan on wearing in my bra when I'm skating...I may also take it off for games. My partner is also diabetic, and has the minimed pump and loves it. I fear though, that I'm just going to choose this pump because it's what is familiar to me, and not because it's necessarily the best choice for me. Oh, and I think the Omnipod may be out due to the full contact sport I play, could be dangerous, and I may not be able to find a place where it would be safe and unobtrusive. Let me know if this is a misnomer.

Thanks for your help!
Janie G.

2

Hi Janie,
Minimed or the Animas Ping would be a good choice. The ping remote is the reason I went with Animas... you can bolus without dragging your pump out.

http://www.animas.com/animas-insulin-pumps/onetouch-ping

3

Welcome to the "club"! Sorry that you had to join, but I'm glad you found TuD!

It sounds like you and your endo are on the same page regarding a pump - that's great! Remember that it is ultimately your decision, your endo and your partner will not wear YOUR pump. I think each pump will have it's pro's and con's. Can your endo set you up with a trial of each? Perhaps wearing each one for a few days could help you sort out which is best for you?

Best of luck with the journey! Let us know what you decide :)

4

Great news! The pump is really an excellent tool for managing D provided that you are committed and willing to tough out the adjustment period as you set your basal rates.

As for pumps...my endo recommended either the Minimed Revel or the Ping (she will not work with Omnipods because she feels they are not reliable enough, although I know there are people on here who love them).

The biggest differences between the Revel and the Ping are as follows:

1. The Ping is marketed as waterproof. However, my trainer told me that the Revel is technically pretty waterproof, but they only market it as water resistant because of the tiny cracks that can develop in the plastic, thus allowing water to leak in. I've gotten my Revel wet (not submerged, but wet) plenty of times and it's just fine.

2. Sizes - the Ping only comes in one size reservoir (200 units). The revel comes in 2 sizes - one that holds 180 units and another that holds 300 units. Consider what your total daily dosage is. If you use A LOT of insulin, go with the Revel's larger reservoir. I am pretty insulin sensitive and can get by with the smaller 1.8ml reservoir, which means the pump itself is smaller.

3. CGM - the Revel currently has the integrated CGM. I don't usually use it, but it's a nice feature to have. If you want to use a CGM and don't want to carry yet another device around with you, the Revel might be the way to go. However, keep in mind that the Revel's CGM isn't as accurate as the Dexcom.

4. The Ping has a really nice screen that is easier to read than the Revel's. But I've heard some people complain about the screen getting scratched.

5. I think (not positive) that the Revel is a bit smaller, at least the 500 series (which uses the 1.8 ml reservoirs) is. I have no trouble hiding it down my bra or in the waistband of my pants. I really like that.

6. From what I understand, the Ping requires a few more button pushes compared to the Revel when bolusing and doing other things.

My ultimate decision to go with the Revel had to do largely with my past experience with Minimed. Overall, they were really supportive in terms of getting approval pushed through my insurance company and answering questions whenever I've had them. They've been doing the pump thing for awhile.

The Revel pump itself is pretty darn sturdy. I'm very active and while I do my best to keep my pump protected, it inevitably gets banged up from time to time. So far, it keeps on ticking. And that is important to me. It seems from what I've seen posted here that the Ping is a tad more delicate, but I don't have any data to back that up. That said, I am active and I can tell you that the Revel has withstood my punishment.

The Revel also has a HUGE selection of skins (including ones you can design yourself) through Skinit.com. I order a few a year to keep my pump dressed up and looking a little less like a piece of medical equipment.

I would urge you to look at youTube videos. a lot of people have posted videos showing the features on their Revels and Pings. This is what I did and it helped make both pumps a bit more familiar to me.

In terms of features, both pumps have the same basic set of features, including a really low basal rate delivery of 0.025 u/H. So there's not much difference there.

Finally, I LOVE Carelink, the online software to which I upload all my data. I use it all the time to review my settings and how I'm doing. Beats old fashioned logging for sure!

5

Well, I know everyone is giving you good advice on selecting a pump and for many a pump can really improve your ability to control things. But I'd also like to pipe in that it is ok to take things step by step. A pump is complicated. Just because you have a bazillion buttons and switches, it doesn't mean that it is automatic, in fact it can demand more of your attention, require more details and be a hassle. And a pump is not a replacement for the core principles. Establishing proper dosing and timing for insulin. Counting your carbs. Testing when needed and the overall discipline to put it all together throughout your life as well as when you are skating.

You were only diagnosed a month ago. Get and read the book "Pumping Insulin." You should make sure you get all the fundamentals down "pat," cause in the end without those fundamentals you will never realize the true benefits of the pump.

6

Hi Janie ~

Good to meet you, and welcome to our little exclusive club. I pursued a pump for a year before it was finally a reality. I couldn't be4 more happy for you in getting an early endorsement from your endo. For me, the pump was life-changing; definitely for the better.

I have an Animas Ping. Several things about the Animas over the MiniMed appealed to me. First of all, it seemed to me to be a lot more fail-safe steps were worth the extra button pushes that it takes to bolus. I liked the ability to change warning and advisement tunes. The colour screen is easy on my old eyes. I liked the idea that the Ping communicates with the pump, so that the pump can be oncealed and still be manipulated. Although there are threads where the Animas customer service isn't highly praised, my experience with the company representatives and their service has been nothing but stellar. I also appreciated the ease of insertion of the Inset infusion sets. I have had no trouble with them. I also like the Diasend tracking software. I bring my laptop to each endo appointment.

I don't know anything about MiniMed, other than I have been told that they are a good pump. the sales rep for my area was a jerk and I didn't want to deal with him.

You will love the pump, once you become accustomed to it.

Be well

Brian Wittman

7

My insurance company required I be on MDI for at least 6 months prior to submitting for a pump. At the time I was annoyed, but in retrospect learning good control on injections made the transition to a pump quick and easy.

I'm on the Ping, and I like it a lot. I wore an OmniPod demo pod over the weekend, and I will say I can really see some advantages there, too.

8

Not only that, but you really need to know HOW To effectively do MDI in the case that your pump fails. Remember, pumps are gadgets and all gadgets have the potential to malfunction or break. Medtronic does a great job of getting a replacement pump out to you, but if you're traveling or it's a holiday, you may have to do MDI for several days before getting your pump back.

9

Everyone, thanks SO SO much for all of your great tips, stories and advice. I'm aware of just how long it can take to get a pump, so really, I'm starting the process now, with the awareness that it make take at least of few months (if not longer...up to a year even) to square away insurance and get educated.

I've been on MDI since I was diagnosed, and plan to be on it until the pump is received. My doctor wouldn't advise that I even approach the pump until I have good control with the MDI, which I do right now. One issue I have with the MDI is that I can't dose less than one unit, or in microdoses. At this point, the difference between 3 units and 4 can be great, especially for me as an athlete. I'm on skates about 10 hours a week, not including cross training, yoga and running. Also, I can't turn down my basal rate when I work out (I'm on Lantus for slow acting), so that's a bit of a challenge that will be greatly helped by a pump.

In no way do I think that the pump is going to work automatically or that it won't take work. Witnessing my partner work with hers has been a great education. I just feel that the pump is the best therapy and technology out there, and I want to take advantage of it. I've also gotten a second opinion with another great endo in town, and he wholeheartedly agrees that I'm a good candidate for a pump. I'm a bit, oh, proactive. :)

Oh, and mybusted...your review of the revel and the comparison to the animas is super helpful. thank you!

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Thanks Brian! I'm thinking the animas ping and the minimed revel are the two frontrunners right now.

11

I think the MiniMed pumps have a "remote" option too, I think that usually the intent is for health care people who want to leave the pump on "elderly" patients or small kids or whatever. I haven't heard of that many posters reporting on them. I like my MM pump and it survived several years of Tae Kwon Do, falls, a couple of bicycle accidents and various other mishaps without any problems. I have not tried roller skating ever though! Yike!

12

Hi there -

Everyone has given good advice, I just want to add something that might seem a bit trivial but is actually pretty important. If you go with any tubed pump, you need to use an insertion set. You should check out the sets available with each pump and find one that you like. In the past, you could only use Minimed's proprietory sets with their pump. I'm not sure if that is still the csae. That's fine if you like one of them but if you don't....

Maurie

13

Yes, the Minimed does have a remote option, but my endo told me that it's not as 'robust' as the Ping's remote.

14

Microdosing has been a HUGE benefit of pump therapy for me. On MDI, I was not correcting highs that much because the difference of a unit here or there could make me crash. Also, like you, I am very active. The ability to change my basal rates to account for exercise has been another huge benefit. On MDI, I was always adjusting the night before, running high, or having to eat a lot of carbs in the course of some activity just to stay conscious. You'll probably see a huge benefit there (at least I have).

In terms of process - it really depends on your insurance company. My last pump was provided to me lightening fast. My endo submitted all the paperwork to Minimed and it was approved by my insurance within a week. I think I had the pump in my hands a week after that. I still had to go through the whole process of meeting with a trainer (even though I had a pump in the past), so that took a bit more time.

Make sure during this time to keep really good logs of everything (BGs, insulin doses, carbs consumed, etc). Your endo will use that information to determine your initial basal rates and I:C ratios. From there, you may have to do a lot of tweaking on your own.

As others have suggested be sure to read Pumping Insulin. It's the insulin-pumping bible as far as I'm concerned.

Yes, I agree that the pump is really the best tool for managing T1D. If you're really active it has even more benefits. It's a lot of work, but, as far as I'm concerned, worth it because it makes me feel better throughout the day.

You'll do great!

15

Hi Janie:
I had been on the Animas (most recently the PING) for 9 years after doing injections for 16. I switched recently to the OmniPod and am very happy with it. I think choice of pump has alot to do with the features you are looking for, as well as comfort with the device itself (it's going to be with you 24/7). I was happy, for the most part, with the PING, but my decision to move was influenced by the innovation that seemed to be coming out of other companies. For me, having a wireless BG meter/remote was not enough anymore.

I considered the Medtronic with the integrated CGM, but after the rep demoed it for me in person, I realized that Minimed and Animas did the same thing more or less, with the big "feature" being the integrated CGM. I took a look at the CGM sensor/needle, and realized that I wanted to be less burdened by my device, not wear more stuff. Head to head, once I ruled out the CGM the Minimed didn't appeal to me anymore.

The OmniPod I found to be the most liberating; fewer parts to deal with and a much more simplified setup to change sites, plus the tubeless thing. I also found my blood sugars have improved because I can realistically where the omnipod in more places (multiple sites on arms/legs and back) without the issues imposed by the tubing. More site choices means better overall absorption and less over-use of the same places over and over again. I also found the shorter cannula was more comfortable to wear on the thigh and back, and hurt far less (if at all) to place since it's automatic and quick with the pod.

AGree with everyone here, but if possible, find a way to see what it's like to wear a device as you may find that influences your decision and lifestyle.

16

Hi Janie~
You're getting great advice on the virtues of different pumps so I'll just add that my MM is terrific!
On a personal note, I want to send you ooodles of empathy re your challenges with only being able to dose in 1 unit increments. I too had these challenges (x 18 yrs!) as I am very tiny and exercise a lot. Oh how I feel your pain!
Whatever your pump brand, I want to tell you how excited you are going to be with micro-doses of insulin, and the ability to stop your basal. You are going to love having a computer that calculates doses using your very own personal settings. And most of all, you are going to know the JOY of an accurate (mostly) background basal infusion of insulin!!
Of course it's a personal decision, but if it were me, I'd love to be apples and apples with my partner. It would really help with your learning curve (to be honest there is a steep one!) My son is on the verge of pumping now and he wants to follow in my footsteps with MM so we can speak the same language.
I'm sooooooooooo excited for you!
cindy

17

Hey Janie...I'm just starting my pump training this week. I decided on the Medtronic Revel 523 w/CGM. It's the one that will deliver the smallest doses, I'm very insulin sensitive too. The same issues for me, trying to manage my levemir (even 2 shots made it difficult) and not being able to make small corrections on MDI's..a 1/2 of any insulin can make a big difference in numbers (good and/or bad) for me too.

In terms of process, literally just days. My endo faxed something to Medtronic, they called me that afternoon, another rep called me the following Monday, aksed me some questions, they sent something to my insurance that same day..and within 3 days I had the pump..very fast. The doctor just needs to supply the info to them..they do all the work. What's taking 'time' is the training or it can be just setting up an appointment to see your pump trainer - nurse. Good luck!

18

hello.. pump selection is a big decision... i have an Animas Ping...not a real fan of it... unless you like pushing buttons ( i mean like 40-50 just to dose yourself for a snack and 60 buttons to change cartridges...) i had a minimed paradigm 720 before... much better because 300 unit cartridge verses the 200 in the animas... that may not seem like a big deal, but when it takes up to 20-25 unites to prime, you waste a lot of insulin and time changing them out.. the 2 things i like about the animas are: the lcd screen, and the infusions which i have never had an occlusion in nearly 3.5 years... well one more thing is that it is waterproof.. and the minimed is not..
best advise i can give is go to your endo and ask if they can instruct you on how to navigate both pumps... make sure they let you hold and operate it, don't just watch... count the number of buttons you push and ease of use... remember you will have to do this multiple times a day... if it takes you 3 minutes to dose for a meal, you are going to get real tired real quick... find the one that is the easiest to use.. too many steps to go thru every time you pick up an animas pump. the only way you will know is if you demo it yourself... and customer service at animas on average is 40 minutes on hold and most things you will need their assistance to make adjustments to settings.. i wish apple computers would be contacted to design and program an insulin pump..:) best of luck to you

19

Wow! I am glad I have a Minimed! The waterproof angle doesn't bother me that much as swimming kills my BG so I take it off. I guess that it's sort of de-motivated me to swim a lot but I haven't really swum a lot since I was a kid.

20

take a look at what the future of pumping holds:

http://www.pancreum.com/

http://www.tandemdiabetes.com/products/t-slim/

and some of the new gluco meters:

http://www.onetouch.ca/verioiqmeter