So, I have started compiling a workbook of features for pumps to bring with us during our pump class that we will be attending next week but I also wanted to ping the TuD community to see what “questions” I should ask during this class? Looking for any relevant questions that should have impact on the decision we will be making for our 2 year old son. Some questions I’ve considered include:
(Note: I know some of these questions are Insurance related and will need to be addressed with them, but I’m hoping whoever is teaching the Pump class will have some additional information.)
What is the lowest Bolus dosage increment?
Does my Insurance cover X pump and supplies that will be used?
What is the “out of pocket” cost for said pump / supplies.
How obstructive (large, bulky, wires dangling) is the Pump?
Dos it come with a CGM Meter, or does it connect with a CGM (preferably our G5)?
Does the pump have the ability to create different “profiles” for different events or occasions (different insulin dosing), or “temporary” basil rates?
Does the pump come with a remote control for remote boluses?
Is it waterproof / water resistant?
Will the pump company upgrade my pump at a discount (or for free) when newer technology is available?
Any questions anyone could help me think of would be much appreciated. Again, questions should be pertinent to a 2 year old toddler. I realize adults may have additional (or different) considerations…such as …how much insulin can the pump hold? In my case…the container size isn’t really that relevant because he uses such small doses at this point in his life, we won’t have issues with this.
A helpful tip for when first starting out. Ask your physician to write the rx to say changing infusion site and reservoir every 2-3 days. So even if you are changing it every 3😉 It gives you an emergency cache of supplies. You can’t just go to the pharmacy and get more. Also the biggest learning curve is getting these sets in correctly. So at first the change out can be more than planned. Good luck, you will love pumping!
I’d advise against letting integration with CGM be a factor in deciding which pump to get for your son. Advances in CGM technology far outpace those in pump technology and many folks are “stuck” with an older version of Dexcom. Some companies are working on new iterations of their pump that will allow for CGM upgrades, but they’re not available yet.
A great many of your questions can be answered here:
Thanks everyone! I’ll be making notes when I get home! I’m just afraid the Insurance will give us problems after having just been approved for the CGM a couple months ago…how that will settle with them if we go to a pump that doesn’t actually utilize the CGM in some capacity?
No, that’s not what I’m asking. I’m asking…will I be penalized for getting a Dexcom G5 CGM and then requesting to turn it back in, or whatever I would need to do with that CGM if I went with a pump that integrated with some other CGM?
You have the G5. You most likely won’t get insurance to cover another CGM system until your year is up.
It’s doubtful the cost questions will be answered at a pump class. Those are better suited to the insurance dept of the pump/CGM companies. You can ask to have benefits run without obligation. They do it all the time.
For a 2 year old, I would be concerned with remote bolusing capabilities, basal/bolus increments & IOB. Visibility of the screen is also important. The number of button pushes has never been a big deal for me, or for my daughter.
The way I see it is I’m really going to have a very limited selection of pumps to choose from because the most important part at his age is to be able to receive the .025 insulin injections instead of the .5 he currently receives. I don’t believe there are many pumps that allow for such small dosages increments.
yeah, you have to put more weight on certain things that are the most important to you. I began pumping around 1989-90 when you couldn’t detach the infusion sets for bathing and swimming. Waterproof was a major factor for me since I was doing a lot of water sports. So I resisted until my endo showed me a picture of the Disetronic HTron. Ihave stuck with them (Now made by Roche as the Accu-chek) because their customer service to me has always been stellar.
The only two CGM systems available in the U.S. are Dexcom and Medtronic’s Enlite. The overwhelmingly vast majority of PWDs (including physicians with diabetes who utilize a CGM) choose Dexcom.
That being said, if you choose a Medtronic pump, I have read that you cannot purchase it without their Enlite CGM. However, most people I know that use a Medtronic pump have discontinued using the Enlite CGM and instead use the Dexcom CGM due to better accuracy, improved sensor longevity, and more comfortable insertion.
also it’s not exactly an injection. In the case of the Accu-check, you program each hour of the day to give you so much insulin per hour, given in microdoses every 3 minutes. so like right now, I’m getting a .5/unit over the course of 3-4:00PM. My TDD is about 17units/day
I’m still trying to figure out the basal vs the bolus insulin with the pump. As I understand it, the need for the bolus is gone with the pump…So I don’t know how the bolus would be compensated for for the “fast acting” insulin. Right now, he gets 1 unit of Lantis (basal) in the morning and two units in the evening because of his high night time BGs.
He gets Humolog (bolus) injections in different quantities during the day for each meal. For every 20 - 30 carbs he gets .5 dose of Humolog.
I need the ability to administer less than that .5 bolus because it creates huge spikes up and down when he eats and uses the full .5 dose.
Hope that makes sense…So much about the pump is still foreign.