Should I Pump or CGMS or Both?

Hi All;

I have TD1 since almost 28 years ; and am planning to switch to a pump.

Can anyone give me some advise / describe experience as I am questioning if I should first try the CGMS before switching to the pump…

Can you manage your BS with Intensified Insulin Therapy & CGMS alone?
Or do you suggest to just switch to the Pump…

I am abit scared of being connected to wires all day… used to have a test pump in 2000.

On the other way I don’t see any other way around it… after 28 years I need to take serious action to improve my BS to the better.

How much does the CGMS system cost & how much do the supplies cost…
How much do you spend on the Pump…

In case I switch to the Pump ; only Medtronic is available in my country.

In my case going on the pump made a HUGE difference in my control. Going on CGMS made a NICE improvement. Together, they’re awesome, but to me, the pump was a bigger benefit.

Out of pocket expenses:
Approx. $600 for the Dexcom and $35/sensor (they last a week)
Approx. $6000 (I think) for the pump and $250 or so per month.

… but insurance has covered all of mine. I wouldn’t have tried either without insurance, HOWEVER I’d try hard to keep both if I lost insurance.

Thanks for the advice ; fixed a meeting with Medtronic to test the Pump … lets see how it goes.

I’m going to jump in here and voice my support for a CGMS over a pump. I considered a pump, but I dealt with the same issue as you, not wanting to be tethered all day long. When the CGMS came out, I thought it was a good compromise. You still have to have something attached to your belly all day, but at least it’s wireless (I should throw in that there is a wireless pump out there now too). But now that I’m using a CGMS I really think they are more usefull than a pump.

With a CGMS, you really understand what is happening with your blood sugar, so it makes it much easier to control it. You know when you’re starting to go low, so you eat something. You know your blood sugar is going high, so you skip that second helping. Knowing whether my blood suger is rising or falling and by how much also affects how much insulin I give myself before meals. I can also sleep more soundly at night, knowing that if I started going low, my CGMS would sound the alarm and wake me up.

To me, a pump is convienent. It makes it easier to give yourself insulin. So, it’s only going to help your A1C if you used to eat a bunch of carbs without bolusing. I usually do no more than four shots a day, plus one shot of Lantus, and my last 2 A1C’s were 5.9 and 6.1. So, you can do just fine with only a CGMS.

Now, the downside to a CGMS is a lot of health plans don’t cover them like they do a pump. I only get 50% coverage. I use a Dexcom Seven Plus. Sensors usually last me 11 to 14 days and they’re $60 each. ( the transmitter was a few hundred and lasts at least a year, the receiver was 4 or 5 hundred and should last a few years). Dexcom offered a free two week trial. I’d check it out a CGMS before you make a decision.

Why chose one over the other. I use a CGMS pump. I use the CGMS feature (wear the sensor/transmittor) one week each month, so that I can check on trends and make small adjustments to my pumping therapy. This has dropped my A1C1 #'s. :-)!!

The pump is way more expensive than MDI, but at least insurance covers the bulk of it. CGMS is a whole other story. Few insurance companies cover it - but SOME do. The nice thing about having the CGMS with a pump is that, if your pump infusion site fails, and your BG’s start shooting way up, quickly (something that never happens with injections) your CGMS will alert you to this fact. Both the pump and CGMS require discipline and diligence on the part of the wearer. Neither item is a panacea, though both can help immensely (especially in terms of being able to set variable basal rates during the night.)

I had the same issue as you when I decided to switch to the pump from MDI about 2 years ago. I wanted both, but because the CGMs back then weren’t as accurate as they are now, I decided to try the pump first. Also, I didn’t feel comfortable going on two new devices at the same time.

That being said, I went on the pump first. I saw a huge improvement in A1C (I went from 8something to the high 6’s in a year). However, even being on the pump did not reduce my nighttime hypoglycemia episodes, so about 5 months ago, my endo decided to put me on a CGM. That brought my A1C even lower, going from a 6.5 to 6.3 to finally a 6.0 in about 6 months.

As for being connected to wires, my pump is wireless (OmniPod), and so is the DexCom, so I really don’t have any issues there. I’m glad you’re trying one out though, because then you know for sure how you’ll like/dislike being tethered!

As for out of pocket costs, I have very good insurance with the University of Pennsylvania. The DexCom was like $200 to start, and each box of sensors costs me $10. The OmniPod was paid for by my previous employer; my OOP costs for the PDM were about $200 as well. A box of pods costs me about $100 each now.

Good luck with your decision!

Hello Hayaa, Insulet and Desxcom has signed a partnership to have Pod patch pump and Desxcom Seven sensor integrated into a unique PDM (portable data management).

Actually you can have the 2 patches but they are remoted wireless controlled by 2 differents devices.

Here in Italy we hae only one people who use them, a kid of 11 who does agonistic swim and hem and parents end Doctor ensure that he lives very but very well.

Hope those informations are useful.

Hello

Biago