Pregnancy and Pump Suggestions

Hey there,

So, this is my second post ever, and is kind of a follow up to my meet and greet and a question for all you ladies who are or have been pregnant insulin pump users.
First off though, I’ve been using the Dexcom G6 for about 3 months now and just got my A1c results - down 2 whole points!!! There’s still some room for improvement, but my husband and I are absolutely floored to see such awesome results. I was so reluctant to get on a CGM or pump for years because I thought it would make me feel like an invalid hooked up to machines, but I can honestly say I haven’t had a moment’s regret about getting my CGM - I love it! Which leads me to insulin pumps: I’m excitedly pursuing getting one, but I feel a little overwhelmed by all of the options and some of the technical lingo I don’t understand yet. I’ve been doing a lot of research and have worn a demo Omnipod, but really I’d love some input from women who have been on insulin pumps during pregnancy and your preferences. I like the idea of a no-tubes pump, but I’m wondering if it’s really ideal for all the fine-tuning and increased insulin requirements as compared to say, the Tandem T-Slim x2 or the Minimed 670G…? We’ve still got at least 9 months before we start TTC, but I love research and want to put us in the best possible place before a baby is in the mix. :slight_smile:
Anyway, thanks for reading this novel of a post, and for any advice or input!

~ Dawn
T1D since 2003

@Dawnifer
Not related to pregnancy but if you really like the Dexcom, I am sure you are aware that the Tandem t:slim X2 now has integration with the Dexcom G6 including the Basal-IQ algorithm which is designed to reduce the frequency and duration of low BG. We have been using the Basal-IQ actively now for about four weeks and have been extremely impressed.

Omnipod is a partner with Dexcom and is working on cgm integration but does not have an integrated product available yet.

If you were to go with the Medtronic and wanted their integrated solution then you would need to use the Medtronic cgm system. Dexcom does not integrate with Medtronic.

Tim35,

Thank you for responding!
I was aware of Dexcom’s integration with Tandem, and I vaguely remember my educator mentioning something about Dexcom and Omnipod as well, but thank you for the reminder!
I knew Medtronic used their own CGMS, but I wasn’t sure if others loved the Minimed so much that it outweighed the inconvenience. I am kind of leaning toward Omnipod for a variety of reasons (no tubing is probably a good idea when I have a 95lb puppy in the house :joy:), but I guess I’m just concerned about things like the smaller insulin reservoir and the inability to refill it if you run out before the 3 day set period. I’m guessing you’d just have to up the prescription for the pods…? Also, what if pre-pregnancy I don’t use 200u in 3 days? Is the remaining insulin discarded with the pump?

Dawn,
The FUD site has a lot of Omnipod users. We use a Tandem so I don’t have great information on the Omnipods.

Let me know if you have any Tandem questions though !!!
:slight_smile:
(But I will defer the pregnancy specifics for others - lol)

BTW - We have an active 70 pounder who likes to jump and hug and never had a site ripped from this.

https://forum.fudiabetes.org/search?q=omnipod

I was in your shoes a few months ago. I finally went on the Freestyle Libre. I loved it so much, a few months later I decided to bite the bullet and ordered my first insulin pump: The Medtronic. I actually hated it. Going from nothing attached to me, to having tubes, a bulky machine stuck to me, etc, it was too much. I sent it back a week later and started speaking with a rep from Omnipod. I got the demo kit and LOVED how lightweight and small it was compared to the medtronic. I’ve been using the Omnipod for 6 months now and wouldn’t change it for anything! I feel really free. It’s not that bulky and I like that it’s tubeless. The PDM is a little big, but I’ve never had an issue with it :slight_smile: I went from a 6.7 A1C to a 5.5 A1C this month! My best ever in 20years!

28 years ago, I went on a pump after fighting it for awhile. Just didn’t want something attached to me all the time. But my endo said we could never get the blood sugars tight enough to get the ok to try for a pregnancy. We wanted a child so I went on a pump. At the time it was MiniMed. After a few months of struggling, I settled in and haven’t looked back.used MiniMed/Medtronic for many years. Switched to Tandem 4 years ago and will be getting their new one in a few months. Selling point was programmable for new downloads, works with Dexcom G6 and my favorite part is the turning off when blood sugars are heading down. Just think, lows will become a thing of the past!
The good thing now is there are options. Be careful with whichever one you go with because you are in for at least 4 years before you can make a change. Good luck!

Thank you all for your responses!

Based on everything I’ve gathered so far, I’m definitely between Tandem and Omnipod.
I do have a Tandem question: are you able to refill the reservoir before switching sites as with some other pumps? I know that’s not a possibility with Omnipod but it would certainly be a plus for Tandem.

Sally,
That’s funny you mention that about preventing lows, because I feel like I’m borderline phobic about them. Not something as high as the 60’s, but seeing a number in the 40’s has sent me into a full blown anxiety attack. The crazy thing is I’ve never even had a low where I’ve passed out, but I’m terrified of it!

@Dawnifer
Yes but why would you want to? You would have to using a decent amount of insulin per day in order for that to be a good idea. The Tandem t:slim X2 cartridge is rated at 300 units although all of that is not usable.

The issue is that every Endocrinologist we have ever seen has repeatedly told us never to leave an infusion site in longer than three days. This is to prevent lipohypertrophy.

However from a technical point of view with the Tandem, the infusion site and the cartridge can be changed out separately from each other. We change them both at the same time every three days.

Tim,

Thanks for the info! I’m hoping I’ll never have to change out the reservoir between sites (like you said, that’s a lot of insulin), but I was curious if it was possible in case I had some crazy high insulin requirements during pregnancy. I read about others doing that a few years back with Paradigm, but wasn’t sure if other models had the same capabilities.
I’ve been reading posts under the Diabetes and Pregnancy category for the past few weeks and am almost to the very first post! Like I said, I like research. :stuck_out_tongue_winking_eye:

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Ah - That totally makes sense. And certainly way outside my experiences.

Haha, hey, it never hurts to check! Especially since I don’t have any pump experience yet.

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I am a long-term pump user and, during pregnancy, I found the ability to fine-tune basal rates even more helpful than other times. Personally, I still use a Medtronic Paradigm pump and I usually change my cartridges when they run low, on a completely different schedule from my pump site changes. My doctor is fine with that as long as I change sites every 2-3 days and change insulin once a week (or a bit more often in hot weather). In pregnancy my insulin doses did increase like crazy: for most of the third trimester, my total daily dose was double my pre-pregnancy total. BUT, I also had to change my catheters much more often because of skin issues, stretching, etc. During most of my pregnancy I was lucky to get a full two days out of a catheter. So you might find that the Omnipod site changes and catheter changes both need to happen frequently in any case.