Newbie Pumper Confusion

Never having a pump before I’m just a little confused after meeting with the reps from Medtronic and Animas. My questions may seem foolish but this is all new to me. My diabetes educator estimated that I will be using approximately 120 units every 3 days with an extra added cushion of about 25 units for flushing the tubing and catheter totaling about 145-150 units for 3 days.

My questions are for those using the Ping and Paradigm the rep from Medtronic pointed out that there is no “Back” button and if you made a mistake you have to start all over again. When changing batteries the Ping doesn’t account for active insulin and you might double stack. Not sure what double stacking is? Do I need the constant monitoring offered by both companies? My insurance will cover the cost of all pumps and peripherals.

If anybody has used both pump brands in the past I would appreciate some insight or just your some guidance from those with a lot more experience than I have.

Thank you.

Hey there,
I use a MM paradigm 522. I wanted to comment on the no “back” button. I’m not sure what circumstance they were referring to, but you can “back up” during a bolus If you use the paradigm’s built in bolus wizard. You can use the “Esc” button to “back up”/ edit the info you’re feeding it up until you’ve selected to “set” your bolus. (ie; you want to change the amount of carbs you just entered, but haven’t completed the bolus yet.) After you’ve set the bolus and the pump starts to deliver, the only way to stop would be to suspend the pump for a second and then restart.

I haven’t used the animas, but what it sounds like they mean by “stacking” is that if you change the batteries after a bolus, the pump won’t remember that there is already insulin in your system (or IOB “insulin on board”) from that bolus, and won’t remember to account for it in your next bolus.
Meaning you may take more insulin than you need if you take another bolus before the previous bolus’ insulin has finished working. (called “stacking” insulin) again, I haven’t used it, so hopefully someone who has can comment on that for you.

I am not on a CGMS, so I don’t know if you should get one. They are very beneficial when they work, but a lot of people have complaints about them not being so accurate. I plan to get one down the road when they have these issues ironed out.

Hope I helped!

Mark , now I am confused …in your discussion " new to pumping , Oct. 02 , you stated , that it was estimated, that you use 110-130 u daily ; in this discussion 120 u every 3 days ???..if indeed you require this amount , than a pump with a larger reservoir ( medtronic 722 ) may not be as of a big concern …otherwise I still stay with my original suggestion : MM 722
I am a MM user , and it is no concern for me, if I " have to start all over again " exceptwhen I am delivering ; then I suspend, cancel the suspend , look at my history and view , what I have done as Amanda described below.
Double stacking is always of a concern and may create low blood sugars . My pump is set for " active insulin time " for 3 hours , meaning when I bolus now, 3 hours later there is NO insulin left in the system ( other than the basal …equals for a different reason ) and my pump allows for me ( in the bolus wizzard set up ) to correct when HI …UNLESS I manually override …not always a good idea. Were you able to ask the reps/pump educator for a trial run ?
I am not clear , if it is wise to start pumping AND start using CGMS at the same time …maybe someone can advise ?
For my mental wellbeing it was easier to learn at a different interval .A good idea to get Pumping Insulin, 4 th Edition by John Walsh ??

I’m with Nel on the continuous monitoring. One step at a time. Master the pumping first, then work in the CGM.

True, there is not ‘Back’ button, but on the MM you can go back a few steps while inputting your current BG and carb intake. You do, however, reach a point of no return where you have to cancel everything and start over if you realize you should have done something differently.

Double stacking is where you give yourself a double dose of insulin by failing to account for the insulin that’s already in your bloodstream. Really only a concern if you are bolusing more than once within two or three hours.

I highly recommend that you get a copy of Pumping Insulin by John Walsh. Many of your questions and concerns will be answered there. You can find it on Amazon and in most major book retailers.

Terry

With all the educator was telling me that day, I thought total units of 110-130 was per day. That figure was based on 3 day supply. Thank you for your comments. What a great group.

In my response double stacking to read stacking …thanks Dave …it’s a bit like 2 positives or 2 negatives in one sentence ( this is why I like this stuff : English lessons included :slight_smile: )

Look and look though I might, I cannot find a “back” button on my MM. :slight_smile:

You can go backwards through menus, but I understand that we’re talking about backing out of a bolus. In terms of bolusing, there comes a point where once you push 'ACT" there’s no going back unless you stop everything and start all over again. I’m not going to try it now because I don’t want to stack or double stack, but my recollection is that while using the wizard, once you push ‘ACT’ after choosing among normal, dual wave or square wave bolus, you’re going to get your bolus unless you suspend the pump and cancel the bolus. Then you have to start over again. Up to that point you can press 'Esc" and get back to the initial Wizard screen to change you inputs.

Just for the record, there’s no “any” button on my computer keyboard, either. :slight_smile:

Terry

We’ve been using the Paradigm pump for Eric for a little over a month now and I sure can sympathize with your confusion–I still feel like I’m only just getting the hang of it even after reviewing all their educational info and getting a lot of support from the educator. Treating diabetes requires a different mindset using the pump, it really does! So don’t feel foolish asking questions, the more you learn now before you decide on a pump, the better off you’ll be when it comes to using it.

I don’t know why they told you there’s no “back” button because you CAN back up just by hitting the escape button, up to the point where you give it the order to deliver a bolus. Once the bolus is started you have to suspend the pump to stop it, and that may take some quick thinking on your part… I tried to stop a bolus once after Eric threw up the juice I’d given him and I couldn’t figure out the sequence of button-pushes I needed to do to reach “suspend” before it finished delivery because I was all panicked, but in the end wasn’t able to stop it in time and wound up just giving him more juice and praying he’d keep it down (he did). But, Eric’s boluses are super small and take only a few seconds to deliver, so probably you’d have more time to figure out how to stop it!

As far as continuous glucose monitoring is concerned, my understanding is that the its principal benefit is that you can see what’s going on with your blood glucose in between the times you’d normally test, and that helps you to adjust your basal rate to compensate for the times your body needs less or more insulin (especially at night). If you find yourself having lows at night, this could be a real help toward making sure that doesn’t happen. We can’t have it for Eric’s pump till he’s old enough for it (right now he’s so little, he doesn’t have enough “real estate” on his little bum for both a pump site and a CGM site, and we can’t put them on his belly because he’d pull them off). So I guess the question for you is, do you feel like you have reasonably good control of your blood glucose during the nighttime hours? Do you have problems with lows or highs in that time frame? If so, CGM might be a good idea, especially if you can get insurance coverage for it.

As far as the Animas pump is concerned, wow, that stacking problem would really scare me–you’d have to make a point of only changing the battery in the morning before you’d eaten so that there’d be no boluses on board to lose track of. That would be the only way you could be sure that you’d never have an issue with delivering insulin when you already had some in your system.

I’m going to have to RTFM . . .

The amount per day changes the picture …thanks for clearing that up ! You may not even be insulin resistant ? And yes, there is soooo much info to be absorbed in such a short time and all the lingo …hang in there Mark !

Thank goodness for " googlin " …I have a much better idea now what RTFM stands for Terry

I’m an Animas 2020 user - and I’m going to have to look into this “stacking” prob you are talking about. Never thought about the insulin on board (IOB) not still being in the memory banks after a battery change. I know when I change my battery (about every 3-4 months - use Lithium) - I try to do it when I’m having to change the insulin reservoir. Usually before a major meal, but sometimes it can occur in the p.m. - but no major boluses have been taken before. So, I’ll look into this.
Also Mark, you can ask the question for Medtronic pump stuff here - and Animas pump stuff here!
I have to agree with a few of the posters here - to not go onto the CGMS at the same time as the pump. I did this when I first did a test run with the Paradigm. Between having to relearn about diabetes after 41 years of multiple doseage injections (MDI) and using the CGMS - I found it all abit overwhelming to the point it disrupted my work life due to lack of sleep (CGMS kept on alarming). I think I would have been better getting used to the pump first and then going onto the CGMS. That’s just me tho’ - maybe you can handle more then two learning curves - guys tend to be more techie :slight_smile:
Keep on doing your research. Not sure if you’ll be able to get a loaner pump from both companies. I was very fortunate to test drive both (4 months each - gave it a good spin on the roads). In the end I went with the Animas 2020, found it easier to use, any key touched stops a bolus in a second (maybe Medtronic Paradigm pump has changed since Oct 2007 when I was using it). Plus the screen I found better for viewing.

Anna from Montreal - aka FatCatAnna at The Trials and Tribulations of a Diabetic