After 20+ years I am finally going to test a few insulin pumps. My main concern is the tubing and where the heck I will place the pump - my waistband, my leg, what happens when I wear a dress, etc...
First off I am testing the Snap and the T-Slim. I do have a Dex and I love it but I'm not thrilled with the Vibe so I am depending upon future integration with other pumps and upgrading. T-Slim would not tell me any info bout whether they will offer an upgrade with the t-slim G4.
I like the idea of tubeless pump, Omnipod, but insurance hassles and what I've read about issues have me discouraged.
The Snap looks like the simplest pump but it's length is a bit disconcerting especially after you look at the T-slim but I don't want to be ruled by aesthetics only.
Just reading on how to use a pump and all the calculations and such, I'm a bit anxious, I already spend so much time on my diabetes and then to add more complicated math!
I have just started on insulin on the tslim, they don't allow you to test it before purchasing it as far as I know.
I selected it due to safety of the reservoir/boluses which only allows small amounts of insulin accessible to you at one time. I chose the 23 " tubing and I'm wearing it on my hips, stomach so far with insets there too. I'm finding it a bit difficult to conceal the tubing under my clothes- I was going to post a question about this, hopefully someone else will tell us how to do that.
I'm keeping it in a passport waist band so far over my pants/skirt so that way it is easy to use the bathroom. I plan to get a spi belt soon or something from pumpwear. I chose the shorter tubing because I was told there is 1 unit of insulin per 3 inches of tubing so just in case your tubing is damaged in some way and any insulin gets into you, not possible according to tandem due to gravity and pressure, it would be a smaller dose. Plus less tubing to deal with, but then you can't wear it on your arm or legs prolly either.
As far as the math etc. your endo is going to manage everything for you until they figure out how you react to the change. They will decide your pump settings for i:c ratio, correction factor, bg target and insulin duration. First you train on saline for 1-2 weeks to get used to using it and how to change the cartridge, change sets and so on.
When you start on insulin, your basal insulin will be automatically reduced by 25% probably and you will do a few days of basal testing to adjust things. My basal was automatically reduced from 9 to 7 units which amounted to .3 units per hour. You will use the carb setting, you enter carbs and it tells you how much to bolus, so you don't have to figure anything out at first if you don't want to.
The omni pod offers a free trial with saline I think, so you might want to try that first to see if you like it.
I think that most of the pumps have a 30 day return policy but you have to sign up and go through all the insurance mumbo jumbo and "declare" you "want" the pump and then your doctor has to say you "need" the pump before you can play with one. A local buddy arranged a meeting with the TSlim salesman so I got to play with one but, for me, playing would really need to involve trying it out.
I didn't do any research, my doc said "we do Medtronic" so I got Medtronic and, despite all of the online aspersions, have had really great experiences with them. It's worked great for me and, I'm so used to it, I'm not sure I'd like to switch. I'd also be concerned about one with a fancier screen, like the Vibe, that I'm not sure I could read or not, given the constant bifocal-type of issues I'm dealing with.
Hi Linny and good luck ahead of time on your decision to make a change after 20 years! Most people are very happy they did and love their pumps. Also, most people say that the tubing, which they worried about the most quickly became a non-issue. I have heard that time and again! I have a Ping which has a meter/remote so I can wear it wherever I want and not worry about taking it out to bolus. Most commonly I wear it clipped to the waistband of my pants or skirts on the side. Sometimes, if I'm wearing a clingy top I will hook it to the middle of my bra. For dresses I clip it to tights, underpants or wear sleep shorts with sundresses. I sleep by hooking it to sleep shorts in summer and thermals in winter. I bought a spibelt but found I rarely use it; we are all different, you just have to see what works for you. I actually prefer the longer tubing, the 43". The reason is it has a lot more flexibility that way and I feel less tethered. I can put it down to get dressed without it tugging on me. I can slide it around to either side or the back for wearing or when I sleep. I just kind of tuck the tubing in my waist usually though personally if some shows I don't really care. I'm kind of proud of it and love explaining it to people who always think it's amazing!
It IS a learning curve, and takes awhile before you get all the doses where you want them so be patient. I was put on saline for the first week and though some people hate that it gave me the opportunity to play with buttons and settings before I had to rely on it for my insulin. I read every word of the manual and referred back when needed. The hardest part for me was the infusion sets as I have terrible eye-hand coordination, but I read the directions over for a couple weeks until it became routine. I highly recommend you request a variety of types of infusion sets and see which works best for you. I switched to the metal sets which I now swear by (no problems with kinking and can remove them if they get uncomfortable, move them to a new spot and tape it down.
Congrats, meee; I know this has been a long time coming for you! Zoe
Thanks, Zoe - all of that is reassuring! My Diabetes Ed person says she'll start with trying out the Snap, one week just to see how it feels and the next week with saline. I really like the size of the T-slim but I really like the idea of the insulin cartridge of the Snap. Decisions, decisions!
Just started on my first pump, a t:slim, two months ago after a dozen years of MDI. Very happy! Tubing isn’t an issue. Spibelt is key, makes pump totally independent of clothing.
Thanks Zoe, it sure is.. hope it works out well for me... I don't mind the tubing showing if I'm just walking around in public but I don't want it showing when I teach so I will have to figure out something for that. I use longer shirts to pull over it but somehow it pops out if they're not long enough, plus I really don't like wearing the waste band things under my clothes because they are visible there and it looks weird, but maybe with a hole cut into them or with one built in it will be easier. Also, sleeping is a pain, I don't wear anything to clip it on and I have to pick it up to go to the bathroom- it is also falling out of the passport thing at night- not sure how, lol. I keep in there next to me so I don't lie on the tubing,
Hi Linny - Good luck with your pump search. Be aware that Asante will not do the four-week trial with Medicare. I don't know if you're that age yet, but that's the deal for Medicare.
I'll echo Zoe's preference for the 43 inch tubing. We all have our preferences. I like to clip my pump to my belt. When using an abdomen site and "taking care of bathroom business," it's nice to have all 43 inches to keep from tugging at the site. I also find this tubing length good for dressing and sleeping. You want to try a few lengths to see which one you prefer. I tried the 23 inch length one time and quickly found it unworkable. Some prefer that length.
I haven't worn clothes to sleep in for years, Meee, but I tried the "under the pillow" thing at first and ended up with me and my cat wrapped in tubing, so now I do the sleep shorts/thermals thing and it's fine.
I announce to my students the first day that I'm Type 1 and tell them it probably will have no effect, but I may need to test/take glucose tablets.
