Pump theory and advice

Ijust joined your site yesterday, so let me introduce myself and then I will ask for your help. I have been Type I for about 21 years. I was diagnosed right before the start of my freshman year of high school. I am a civil engineer that works for a construction company. I now live in Everett, WA, about 30 miles north of Seattle. I am married with one kid and one on the way.

Now the questions. I have taken shots since I have been diabetic. In the last 20 years my A1c's have been between 7.4-8.0. I am pretty consistant. I beleive that I control my diabetes right where I want it. The problem is that is not good for my long term health. With shots, I have to plan 12-24 hours in advance of physical activity and adjust my Lantus. This has taught me to keep my bloodsugar a little high to allow for the unseen events that may occcur. In order to keep that flexabiltiy and decrease my A1c, I am starting to think that swithing from injections to a pump would be a good decision. Do you guys think that is a reasonalbe expectation?

I think that it is. Hence my second question. I have read several posts regarding which pump is best. I'll be honest, I believe they are all capable of achieveing the same basic result and I have meetings setup with all of the reps. I really like the idea of the Omnipod and I have placed a lot of the on the no hose feature. But it seems that of the people that use them, seem to have a more issues than the Medtronics and Animas. I understand that you take the internet with a grain of salt, but the Omnipod gripes have validity, to me, becasue of the sheer volume.

Thanks for your help and I appreciate any and all input.

I just got MM as that's what they used at the clinic I got "pumped" at but I agree that it seems like there's lots more reports of issues w/ Omnipod. The hose doesn't bug me at all. I got used to it really quickly as I felt a lot better pumping.

Welcome to the TuD family! It's great that you've set up to actually see/handle various pumps.

I use a Ping (tubed). The tubing becomes second nature, after a bit it doesn't interfere a bit. I chose it over the omnipod for the very reasons you stated. I also didn't want a lump sticking out somewhere (pod). Very happy with it :)

I researched all the pumps that I could when the thought of going on a pump system was first investigated. My Endo recommended MiniMed. I looked at it and it looked good. Then I looked at the Omnipod and ruled it out because or all the problems that people were writing about and because I thought it would be easily knocked off its mount by the work that I do.

I looked at an Animas, and due to a recommendation from a friend, and a relative who showed me in detail how it worked, I was sold on that pump. Like Acidrock, I have had no issues with the tubing. I have knocked out one infusion set, only because I wasn't paying attention to what I was doing. I knocked it out by catching it on the corner of an church organ console. I like the fact that the Animas has the ability to communicate with the meter, so all pump control may be done by either the meter or the pump. The colour screen is easy on my old eyes. The software is wonderful, and I take my laptop to each endo appointment. I like the fail-safe features of the pump that makes one think before asking the pump to act. the Animas is waterproof, but that isn't a big deal to me. The set-up features are easy. The Animas customer service has been second to none thorough out this process.

Now, my endo likes the Animas too. I have nothing against MiniMed. I just thought the Animas was a better pump for me. I understand that the MiniMed has exclusive features as well. I am not really familiar with them. I had a bad experience with the MiniMed sales people.

I can't tell you whether going to a pump is a reasonable decision. that is something you must decide for yourself. What I can tell you is that my A1-c dropped significantly after switching to the pump. I use less insulin. I am happy not to be taking Lantus. I never really liked it. You have to manage a pump just as you have to manage MDI. For me, the pump was life-changing. I have to watch lows. Testing is still a way of life.

Please let us know of your decision.

Keep in touch. Be well

Brian Wittman

I use a MiniMed 732 with CGMS. My A!C was like yours before I started pumping insulin. I'm a maniacal engineer and my day can change without warning. I can spend 6-7 days a week in front of a workstation or months running between my office and the plant or catch a flight to a job site just about anywhere on the planet, the equipment I design is used in utility construction and the oil and gas industry.

If you are going to lower your A1C you will need to test 8-10 times a day and more if there is a problem. Correcting your BG anytime it's out of your target range is the key to intensive insulin therapy.

The Animas is a good pump but the MiniMed has the best BG management software, bolus calculator, and tracks total active insulin on a curve based on Humalog and Novolog. Don't waist your time with the Omnipod unless you have a big problem with vanity it's unreliable and technically not as good as the MiniMed or Animas pumps.

Minimed, Animas and Omnipod are all great, and the "best" pump is the one that will work best to meet your needs. No technology is perfect, so I never expect it to be. I have been using the Omnipod for a year, and I love it - because it meets my needs at this point in time. You've made the right choice to meet with each of the reps - you'll be able to check out each of your options up close and personal.

Welcome! I too found it very difficult to manage physical activity while taking any kind of long-acting insulin. I also would "run high" because I was so scared of tanking during a run. I hated having to think 24 hours in advance of what I wanted to do in terms of activity. The pump definitely helped me with this, although it was a significant learning curve to figure out exactly how much of a basal reduction I needed to do for runs and other forms of exercise (not all exercise is equal for me when it comes to affect on BGs).

In addition, on MDI, I just wasn't correcting highs. I was often too scared to take a whole unit of insulin for a high that was in the low 200s, because more often than not I would come crashing down.

For me, the pump has been a lifesaver. I got my A1C down significantly (I'm in the low to mid 7s now, which is where I want to be) and I generally feel better. I am correcting highs more accurately.

In addition, the pump has also given me an easy way to log ALL my data. I was a horrible logger on MDI, and this made it even more difficult to figure out how I should be adjusting things. The pump captures everything and uploads it to a website. My endo can access my data and help me make adjustments when necessary (although, to be honest, I usually just make changes myself).

I have the Revel (Minimed) and love it. I am very active and, after a lot of research, this pump made the most sense for my needs. I have a relatively small TDD (almost always under 30 units), so the 1.8 ml reservoir is perfect. The pumps are durable and seem to have relatively few issues considering the number of them out there. The tubing does not bother me in the least. I considered the Omnipod, but there were just too make issues with them, and my endo was not a fan. I think the Omnipod is great for some, but for me, the Revel has worked perfectly. I have been very happy with their customer service. I considered the Ping, but it was a little bigger and while I loved the screen, the reliability and solidity of the Revel sold me.

I was able to try various pumps before I made my most recent pump choice, and I did try the OmniPod. I didn't have any technical issues with it, but what drove me away from OmniPod was the "brains" are separate from the delivery mechanism.

That's the whole point of tubeless ;-) Since I've been tube-pumping for nearly 20 years, though, I ran into trouble one day when I was out working in the yard and realize I should lower my basal. Right, the "brains" were in on the kitchen table, so rather than being able to press a few buttons and continue working, I had to go back to the house to adjust things.

I think the idea of the OmniPod is SPOT ON and perhaps after a few generations of innovation, it'll be more what I'd need. Other pumps are well into their innovations already and have some features that the Omni doesn't.

Interesting -- this idea of having to plan 24 hours in advance of exercise (I see both the OP as well as a respondent do the same...). Hmm. I have never done this (I'm on Lantus for basal and Huma-/Novo-log... whichever is handy... for bolusing). Admittedly (and I have said this same thing here before...), this affliction tends to affect us all a bit differently, but I just don't worry about it in advance. If needed, I 'tank up' before a big ride (I'm a passionate mountain biker), to push myself high, but mostly I don't think about it.

I recently joined this forum because I got a Dexcom CGM, which I find helps me catch trends tremendously well. I don't really think a pump would help me all that much as it's just a different way of delivering the insulin I must get into me (I've been MDI since the start back in January of 1982 when I was shooting pork insulin).

You might consider getting a CGM first to see if that helps before getting all wired up with a pump.


I am very active and for me this was just a huge problem. On MDI, I would always crash on runs and wasn't able to consume enough carbs to keep my BGs stable. So, this meant I had to adjust my basal insulin the day before and even then I usually got it wrong. With my pump, that whole issue is GONE! I just turn down my basal rate (usually when I start running) and I'm good to go!

Well, I am going to suggest why a pump might not be a golden bullet. Understand also that I am T2 and I don't have a pump, but that doesn't mean I don't have opinions. I have mentioned this before, but a study of T1s moving from MDI to a pump showed an average HbA1c reduction of 0.5%, not particularly resounding (and these were people that had control similar to yours). The same study showed that a pump with a CGM resulted in a drop of HbA1c of almost 1%.

Perhaps a pump will allow you to be more agile and tighten your control, but it is worth at least a bit of time to really understand what it is about your physical activity or changing insulin demands that is causing you difficulty. If you know hours ahead of time that your going to be doing something that will change your insulin needs, then perhaps a pump can work. But if you just suffer from lows during a highly variable day, a pump may not be useful on it's own. You may need to increase your testing frequency or even get a CGM to see any real change.

So I would encourage you to do some introspection. Look at the key factors that influence your control, like your activity and your knowledge and accuracy of carb counting and your testing practices. Just some thoughts.

Hi thorne. You might be interested in "Your Diabetes Science Experiment" by Ginger Vieira, a book that addresses exercising among other things.

My own opinion is that exercise is easier to handle on a pump because of being able to make temporary changes in your basal during the exercising. I also think that on MDI, Levemir as the basal insulin works better than Lantus since it has smaller peaks, resulting in fewer lows.

As a very active T1 who was on MDI for 25 years before switching to the pump I can tell you that a pump can most definitely give you much more flexibility and a much smaller window with which to make insulin dosing adjustments. However, in order to make those types of management decisions, like bsc says, you will need a whole ton more information to work with. There is already a learning curve when if comes to using a pump but if you are switching over because of variable activity, that learning curve gets a whole lot steeper.

However, based on what I went through, I really don't think you will gain much by doing a whole lot of testing while on MDI in order to figure out what you need to do while on a pump. They are just two completely different animals. I got the CGM first, mostly because the paperwork went through a lot faster. I did learn a lot about my daily, weekly, and monthly BG profile while on MDI with the CGM and it was definitely useful information, but when I went over to the pump it was like starting all over again.

The bottom line is that if you feel like you want to give a pump a try, give it a try. You have absolutely nothing to lose and, based on what you are trying to accomplish, a lot to gain. A pump will bring a whole new set of issues to deal with, however, so it will defintely not be set and forget. If you are willing to put in the time to learn how to work with a pump and how a pump can work with you, your reward will be much more flexibility without costing you BG control. If you are not willing to put in more work, there just isn't much more to gain by switching to a pump.

I would also like to add, as an Omnipod user, don't let the horror stories about the Omnipod dissuade you from getting one if you think going tubeless is your best option. I have between a 5 and 10% failure rate. If the pods that have failed, Insulet has replace 90% of them. So, I've been using the Omnipod for 17 months and have completely lost about 5. With adhesive help from Opsite, it can take a lot of abuse.

If tubes don't bother you, there are a lot more options, but I can't say anything about how they work. Other people seemed to be happy with their choices, while others don't seem to be all that happy.

Good luck!

I was on injections for 21 years and finally switched to the pump 4 years ago.Too many low blood sugar comas was the part of the reason for my switch.An insulin pump will give you greater flexibility in the foods you can eat and it will also keep your sugars within range.You still have to do some adjusting for exercise but you can do it without eating alot of food beforehand.It allows you to change your basal rate for physical activity.You can also increase it for sickdays when you aren't active at all.I think an insulin pump would be a benefit to you.I am on the Animas Ping.I liked the idea of the pump screen is illuminated and that it has the lowest basal increment of.025.

Hi thorne, I've been Type 1 on injections for 25 years and I am moving to the OmniPod in 4 days. I stayed on MDI for so long because my numbers were pretty good and it was easy for me to manage my diabetes plus I was not (and still am not) a fan of being hooked to a tube. I didn't have issues with Dawn Phenomenon so didn't really have a need for varying basal rates and I was able to exercise on Lantus with intake of carbs.

Within the last year, my diabetes has changed significantly due to female hormones. My new norm is more variability in basal needs due to fluctuating hormones, less coverage with Lantus, fast drops from Lantus peaks, and a fierce Dawn Phenomenon. These issues are difficult or near to impossible to address with MDI. So that's why I decided to try a pump.

I started with the Dexcom cgm because I'm hypo unaware now. This has been a lifesaver and also helped me learn so much about my patterns and timing of patterns. I started with the Dex first because my CDE suggested I get used to the Dex first and then add the pump.

For me, the OmniPod was it. I don't like the idea of being tied to a tube and the insertion sets scare me honestly. I'm sure it's like everything else and you get used to it but I just don't want to deal with that. When I did a saline trial of the OmniPod, I was bracing myself. It was so easy to set up and insert. I liked that the insertion is automated. You simply place it where you want it, press a button on the PDM, and it's on. I was amazed that while everyone points out as a con the bulkiness of the pod, I didn't even feel that I had it on. Actually wearing one is what sold me.

I read all the cons against OmniPod before I decided to go with it. Sure there are issues with occlusions and such with OmniPod but I've read just as many stories of similar issues with the other pumps. I think each pump has pros and cons and, for me, the pros of the OmniPod outweigh the cons.

You are the only one who can decide which is the best fit for you and you're doing the right thing by talking to each rep. Best of luck to you!

I've been on both the Minimed (522) and the Omnipod. I currently pod and love it. I rarely ever have issues (people usually don't complain about something that doesn't give them problems) and I'm sure that the majority of pod users are the same. The no-tubing changed my life, so even if I did have issues with my pods, I would probably still remain on it.

The biggest advantage of tubed pumps over the pod, IMHO, is that the tubed pumps offer multiple different infusion sets. You can get a short or long cannula, angled or straight, Teflon or metal. I personally think lots of the issues folks have with the Omnipod is that the angled cannula doesn't work very well with their bodies. And you can't change that.

Either way, I highly advise a pump. There's just no comparison. If you don't do the same exact thing every single day, a pump is really the way to go because you can adjust so easily.

Thanks for all of the advice. I really appreciate you sharing your experiences. I have met with the three pump reps. I wore the Omnipod demo for a day and didn’t really like it.
Right now I am leaning towards the Animas. All three that I looked at were similar as far a features, but the Animas seemed to fit me and what I am looking for. I am sure that I will have a bunch of questions once I start using it. Thanks again for your time.


I would respectfully suggest that while the empirical results may not seem very significant, the lifestyle results might be much greater (and more difficult to measure empirically).

For me (and other anecdotal responses here on TuD), the ability to fine tune the basal "on the fly" with the pump is pretty huge. My TDD over the last week has ranged from 19.3 to 35.2 with the average a bit under 29 units. I cannot imagine trying to do this on MDI - but this may be more of a comment on my own mental limitations ;)

I suggest you look at a few pumps and ask them to send you some samples. I was suprised to find that I am allergic to the adhesive of one and not another,

Also something I learned is that Both Animas and Medtronic will give you a loaner pump to try out.

Pumps are big investments, I think getting a loaner would be a good thing to do, or at least try out some of the different sets.

My sugars went from 6.9% consistantly to 5.8% just recently after I added CGM to my pump !

I would never go back to injections, Once in a while I switch off to give myself a break and there is just no comparison,

I have been on the Omnipod for more than 4 years. I waited for it to be available in my area as I did not want a traditional "tubed" pump. I have been very happy with it. I have had a couple of pod failures through the years, and I'll admit that initially I ripped one or two off my arm when the doorway jumped out at me, but nothing that would make me switch. I have no trouble with them "falling off" as others have complained. I truly like the system.

If you have any specific questions, I would be happy to answer them.