…I know, the decision lies with me and I will be the one to make it. But any advice or experiences are good to hear.
I am a T1 and have been using injections since I was diagnosed 11 years ago. My last A1C (last week) was 6.6. My highest since I started treatment was 7. I have always felt that I was fine with taking 2 shots a day, and to be honest it doesn’t bother me. Then I saw the invite for the free trial pod from OmniPod and it got me thinking…
My biggest beef with Diabetes is the lows. I get them minimum 2 times a week, sometimes at night. I woke up with a 32 the other night, that is rather scary. I am a runner (I do half-marathons) and sometimes I do end a run on a low note. I guess I am wondering how much a pump would really help me with that. Perhaps a CGM would be more helpful at this point.
I also wonder if I hold off on the pump, is the technology going to finally get approved where we have a pump with a CGM built in? Then for sure I know that I would be on board.
You are doing really well with MDI - great job! Pumping does help with the lows, because you can adjust it on the fly (short acting insulin) and your body will respond pretty quickly. I have to be honest, 2 shots a day and great control sounds somewhat simple compared to all that we keep track of (batteries, site changes, etc). I don’t know much about the downside of your protocol though, perhaps you are on a fixed amount of carbs?
My daughter (14) is using the Omnipod and the dexcom. We love both. Dexcom is a life saver, I can’t imagine not having it, especially because with puberty/hormones and the swings this causes. My daughter started out using a Minimed pump, but now loves being tubeless with the Omnipod.
If I was interested in pumping, I would NOT wait for any advances in pump technology. The reality is the FDA takes an inordinate amount of time to approve these things. In spite of sales reps talking about new products being out “soon”, I do not believe the Omnipod has officially submitted the new design to the FDA. Minimed does have an integrated tubed pump and cgms right now, but their cgms system does not work well for many (we used it for 3 years). There are a lot of posts about this if you want to learn more.
You can call Omnipod and ask for a free trial of their system. I had my daughter wear the system for a week before we decided to switch. There is a bit of a learning curve with the pod, and doing a free trial also means when you make mistakes you aren’t using your own supplies. I would definitely wear it long enough to go through a site change.
I think Minimed and Animas will also do free trials if you ask for it.
I went from multiple injections a day to a pump 5 years ago. I was also having too many lows while injecting, but too many highs as well. Hardly ever got decent numbers. So I was given a pump. There is a bit of an adjustment period where you might have some lows still and somke highs as you’re working out the correct ratios and basal information, but once that’s dialed in, you’re good to go! I went from A1C’s in the 6 -7 range to consistant 4.8 - 5.5. What makes the pumps such a great tool in management is that you can give smaller doses with the pump than injections. Injections you can give as small as maybe a 1/2 a unit, but with the pump, you can go as low as 1/8 of a unit and even smaller, depending on the pump. It has better control. I had an Animas pump (no longer using pump due to switching health insurances - new insurance does not cover supplies). I do believe that Animas does have a loner pump program for people who are interested in their products. I do know they have excellent customer service and their reps are great! They did everything they could to try to help me before I had to make the decision to stop using their pump. They also make the transition from injections to pumping as easy as possible and have a wonderful support system for their customers. Good luck with your decision and know that whatever you decide to do, we’re all behind you!
Sounds like you are doing great! I went 36 years on 4-5 shots/day MDI before going on the Omnipod. Always had good A1cs, right around 6. I tried the Dexcom CGM before going on the pump and if I had to choose one or the other (pump vs CGM) I would choose the CGM, I also don’t recognize my lows and it has been a life saver. I only run a few miles so I find that the CGM isn’t able to give me an accurate reading because it’s so delayed but for half marathons it might be good.
Pros to a pump are (like already said)
you can dial in temporary basal rates so when you run you can try and minimize lows
smaller unit measurements are great plus you don’t have to eat as regularly
you don’t need to get out the needle/pen merchandise in public!
If you use it to it’s full advantage a pump can be wonderful but definitely more complicated and like anything there’s a learning curve. There are times with the Omnipod that I can’t get my BS down no matter what I do and other times I can’t keep it up and I have no clue as to why! I think there are a lot of variables when it comes to absorption rates in the different areas of placement plus the cannula can get kinked etc. I don’t know if this applies to other pumps as well but with MDI I KNOW if I take 3 units, I’m getting 3 units!
I am not interested in the tubed pumps so if the pod stops working for me I’ll probably go back to shots.
I would definitely give it a try if you can do a trial run. I know Omnipod will send a dummy pod to wear but was unaware that you can try an actual working unit, if that’s the case then do it! Good luck!
I love the pump. It helps me with the lows because you can reduce your basal or suspend the pump altogether when you’re working out so lows are a lot less frequent. And if you’re having a major hypo you can disconnect the pump and know you don’t have any extra background insulin working that may cause you to have a low later on. On injections once you inject that long-lasting insulin it’s out of your hands - it will work the same every time, even though you may not. The pump is beasically the background insulin which you can manipulate. Also, on the pump it’s much easier to bolus for slow absorbing carbs - you can spread the dose so that you get a percentage of it right away and the rest over a period of time, which is really handy.
I like the MiniMed pump/CGM combo a lot. I got this stuff called FlexFix Opsite tape that has worked to hold the CGM on most of the time. I’m training for my first marathon (100911…) and have had a few pullouts of the infusion sets on 17+ mile runs. It’s a work in progress but I’m sure that the tape and planning will make that work. I have found it very useful for running. I was involved in a strenuous martial arts program but moved for work and switched to running a year or so after I got the pump. I got the CGM a week before my first 1/2 marathon and was bummed it fell out 3 or 4 miles into the race (too bouncy while I was listening to “Mogwai Fear Satan” really loudly?) and I lost the data. Race #2, I’d ordered the flexfix and it stayed in and I had a good race BG wise. It’s not always perfect but for me, a disaster is usually low 200s which isn’t that much of a disaster?
Can I ask what type of insulin you are on? With only two shots a day as a Type1 I am guessing it is a 70/30 mix. This could be leading to the lows. If you don’t mind shots you could switch to something like lantus/humalog.
I myself stayed on MDI for 14 years before getting the OmniPod and I will never go back.
Sure you can ask! I mix NovoLog and Novolin. I take 10 long and 2 short before breakfast, 4 long and 2 short before dinner. The lows usually happen when the long acting kicks in, if I am late with my snack or didn’t have enough carbs with dinner. Or, well, sometimes for no reason as we all know.
LOL at the Mowai Fear Satan!! I would be fascinated to see how my sugars do on a 2 hour run. So far all my races have been hypoglycemia free, I am very anal about taking GU every 3-4 miles, even if I am feeling strong. Thanks for the feedback!!
I used to have way more carbs but lately it seems like 8-12G of carb (1/2 GU?) seem to produce really stable BG. Then again you look a lot faster than I do so maybe you’re burning a lot more than I am?
When I got my pump either the doctor or the MiniMed sales nurse mentioned that Novolin (NPH?) which I’d been taking had only a 53% chance of peaking when it was supposed to so it could go earlier or later or way earlier or ??? Particularly after I’d enjoyed the smoother and more predictable basal w/ the pump, it explained a lot of the irregularities I’d blamed on my own mistakes, blunders, etc.
I just put my dummy pod on this evening… I am like you, I am not interested in a tubed pump. With all this great input from you wonderful people I am leaning toward going with just the CGM for now…but I am still in the early decision process. Thanks!
You have had a lot of pros about the pump, so I will give you a view from the other side! I have been diabetic 27 3/4 years. I started on the pump at the end of last June. I had nothing but a lot of site problems. In the beginning, I was apparently allergic to Teflon so had to change to the steel sets (that won’t be an option for you if you end up going with the pod). Even after I switched to the steel sets, I was lucky to get 48 hours out of a site – I seem to build up scar tissue pretty fast even rotating the sites. On MDI, I have my problems but with the pump, I was literally seeing 200 every other day because of site problems.
In January, I started getting a lot of bubbles which also created BS problems. After about a week and going thru all kinds of things Animas wanted me to try, they changed the pump out. Two months later, that pump also started spitting out bubbles and was making a strange noise. That one they changed out with a refurbished pump – I did not realize that my insurance company could pay $6k for a pump and they could replace it with a refurbished on. While I battled with Animas for 2 weeks, I was back on MDI and my BS was really good. At that point, I decided pumping was not worth it and decided to stick with MDI.
I think part of the problem with the first pump was it was spitting out insulin inconsistently. I did not know until a day or say after they changed it out that there was supposed to be 16 units of insulin left in the cartridge. My cartridge would be bone dry. I also had a lot of lows with the first pump. Overnight was never consistent with the pump – I would go either low or high. Overnight is usually consistent for me on MDI. When I would go shopping with the pump, I would always end up low (with both pumps). I would cut back my basal and still crash. I rarely have a low while shopping on MDI. I had my first A1c in the 6s in over 3 years while on the pump. I do better on MDI.
I would definitely get a CGMS first. I have a Dexcom (currently need sensors though) and it really does make life better!
WOT but 16U is a HUGE amount for it to be “off” or inconsistent? I’ve never run into anything like that. Right before my pump died, it seemed to be running more heavy handed than usual but I changed from 11-12G/ U to 13G/U and it seemed to clear it up. It was hard to tell and I never bothered MiniMed to ask them what was wrong. At the time, I was also increasing my running mileage or maybe the consistency of my mileage so I figured “oh well, maybe something’s up w/ that…”. Then it blew up and the 13G/U wasn’t enough, I turned it back to 11 and it seems to be working fine. I’ll never know what was up with it for sure but it was off like a smidgin, not 16U!!
