Hi everyone, new to this, I'm being switched to a pump next week and wanted to hear from others who have been in my situation. I'm a little apprehensive as it seems there's so much to learn. I'm getting a tandem tslim working with a dexcom g7. What do you wish you knew before you started on a pump. Any advice would be helpful. Thanks.
-
Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
Advice on Switching to a pump
- Thread starter Ryan_80
- Start date
I think the most important thing when you are feeling overwhelmed by your pump is that you can revert to MDI. I know some people taking pumping breaks at times.
This is one reason why you still need insulin pens or pen cartridges on your prescription, just like you still need test strips when you have a CGM.
The next most important thing for me is knowing what to do when the pump fails.
This is very very very rare but it can happen and, if it does, it will never happen at a convenient time.
How I prepare for this depends where I am and how long I am away from home. For example, I usually carry a syringe and my vial of fast acting insulin with me. If my pump fails, I can give myself insulin this way until I get home but need to remember to "basal". If I am away overnight, I take both my pens. I do not carry them with me all the time because I think it is a waste of insulin once it has been out of the fridge for too long and never used.
Finally, how to get supplies. Can you order on line, by phone or ... ?
This is one reason why you still need insulin pens or pen cartridges on your prescription, just like you still need test strips when you have a CGM.
The next most important thing for me is knowing what to do when the pump fails.
This is very very very rare but it can happen and, if it does, it will never happen at a convenient time.
How I prepare for this depends where I am and how long I am away from home. For example, I usually carry a syringe and my vial of fast acting insulin with me. If my pump fails, I can give myself insulin this way until I get home but need to remember to "basal". If I am away overnight, I take both my pens. I do not carry them with me all the time because I think it is a waste of insulin once it has been out of the fridge for too long and never used.
Finally, how to get supplies. Can you order on line, by phone or ... ?
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
I can’t really think of anything I’d wished I’d known beforehand. If I could go back in time to 20+ years ago when I was about to have my first pump, I think I’d tell myself not to be so nervous; that it would feel strange for the first few days; and then it would be even better than I’d expected.
It will be fine @Ryan_80 I notice you say your T Slim is ‘working with’ the G7. If you’re looping, the only thing I’d say is to make sure you know how to work your pump in manual. A pump is just another insulin delivery system. It’s important to know how that system works and how you can adjust things if needed.
It will be fine @Ryan_80 I notice you say your T Slim is ‘working with’ the G7. If you’re looping, the only thing I’d say is to make sure you know how to work your pump in manual. A pump is just another insulin delivery system. It’s important to know how that system works and how you can adjust things if needed.
PhoebeC
Well-Known Member
- Relationship to Diabetes
- Type 1
Same, there's nothing for me, for MDI to pump move.
I did my research, including reading a lot of the other posts and advice here, requested samples, read all the set up/user guides. MDI to pump went really smooth for me, a week in I felt so much better physically and mentally, and it was all really easy.
Do you use the G7 already?
Mine was only the change MDI to pump, not CGM too, that might have been different.
Do you research, and note down any questions to ask on set up day.
Looping is different, and didn't go as smooth for me. I wish I'd understood that it wasn't going to be as smooth as the previous change, or have as helpful impact on my life, that it would take time, to be patient and not let myself get upset.
Your medical team should tell you in advance but you likely won't need as much background insulin on set up day, as the pump will take over. You may take less insulin in advance.
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
It is very understandable being apprehensive about the switch but I was surprised at how easy it was, although there was quite a bit of work setting it up.
As others have said, you still need to have pens available just in case things go wrong. This is uncommon but if it happens you must be prepared. For my pump they get a replacement to me within 24 hours, but as @helli said the failures do not happen at the most convenient time (we were in a remote part of Wales and off grid, with no running water)
Once you have the basics set up don’t worry initially about the various extra options. Just get used to working it, which you will no doubt do very quickly. There are people on here who are also using the T-slim and they can answer questions that arise. I suspect that you will be looping but it is good to know how to use it in manual first as there will be times when the system puts you back in manual. If they ask you to do a week in manual first it is worth it, even if you are a bit impatient.
Let us know how it goes.
As others have said, you still need to have pens available just in case things go wrong. This is uncommon but if it happens you must be prepared. For my pump they get a replacement to me within 24 hours, but as @helli said the failures do not happen at the most convenient time (we were in a remote part of Wales and off grid, with no running water)
Once you have the basics set up don’t worry initially about the various extra options. Just get used to working it, which you will no doubt do very quickly. There are people on here who are also using the T-slim and they can answer questions that arise. I suspect that you will be looping but it is good to know how to use it in manual first as there will be times when the system puts you back in manual. If they ask you to do a week in manual first it is worth it, even if you are a bit impatient.
Let us know how it goes.
A thought just came to my mind and figured I'd go ahead and ask. I use to be on levemir and was switched to tresiba because I have a high insulin load. My consultant said that I could still take a smaller does of background insulin so that the pump didn't have to inject as much. When the lady emailed me about my pump start date she gave me a reduction schedule for my background insulin and when I asked her about what my consultant said she seemed to act like no one ever takes background with the pump, even though I know a couple of friends in the US that take levemir and use the tandem tslim closed loop. Anyone else have experience with this?
Sally71
Well-Known Member
- Relationship to Diabetes
- Parent
Normally you don’t need to take long acting insulin with a pump, the pump gives teeny tiny doses of rapid acting every few minutes to act as your background, so you don’t need the long acting. I don’t know how it works if you have exceptionally high requirements, I guess you could take long acting as well if necessary, but I don’t happen to know anyone else who does that!
The biggest benefit of a pump is that it allows for variable background insulin which is gives by "pumping" fast acting insulin all the time. Therefore, it is very rare to inject background with a pump. The only reason I can think of is to use the injected as a constant minimum level and the pump to provide the variations on top. This may be necessary if you take a high insulin dose because most pumps only contain 200u (some allow 300u) and should last 3 days.
You mention you have a high insulin load would your TDD (total daily dose) push you over the maximum capacity of the T-Slim over 3 days?
My TDD is usually around 130-135 units, so would probably only last around 2 days, not sure if on a pump you can top up the insulin on day 2 or not. I do know that the tslim has a 330u reservoir.
martindt1606
Forum Host
- Relationship to Diabetes
- Type 3c
What type of infusion set are you going to use. I use tru-steel and these have to be changed every 48 hours - which isn't too out of line with your usage.
Good luck with the transition, take your time, be prepared to adjust your ratios, try to use all the functionality (sleep / exercise mode) and multiple profiles (i have a sick day profile and an exercise profile for specific activity).
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
People with pumps usually get all their basal from the pump, tricked in in tiny amounts day and night (all pumps use fast-acting insulin). BUT - and I think this is what you’re talking about @Ryan_80 , a few people use a regime where they get, say, 50% of their basal via the pump and 50% via an injection of long-acting insulin. It’s called the untethered regime.
Most people using this do so so they can stay disconnected from their pump longer (maybe because of their job or hobby); some do it to reduce the risk of DKA; some just prefer it. It seems you’re saying that you hope to do something similar - is that right?
Not sure which infusion set they will have me on yet. But if that is the case then yes it will probably work out. Thanks for the advice about the ratios and functionality.
Honestly I was just going off of what my consultant was saying because of the high insulin need. But lowering my risk of DKA is always a plus. Honestly just want whatever is going to work best. I feel completely lost as I feel like I have more questions than answers right now. Also seems like even in the same clinic the right hand and left hand don't know what the other is doing.
One thing most of us find is we need less insulin with a pump than MDI.
I think my TDD was reduced by about 15%.
My DSN helped with this at the start
I guess the DKA risk is when you don't notice that your pump is not working so you have no background insulin.
It is a risk that was hammered home when I first started pumping about 10 years ago.
Having 50% of your basal from injections ensures you have some background insulin.
However, now CGMs with high (and low) alarms are common, is this as relevant/necessary. I would hope I would notice the alarm from my pump and/or the alarm from my CGM plus my own "off" feeling from being high.
Having that 50% background just in case feels like adding a second belt to your trousers as well as the braces.
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
I think some people are more prone to DKA than others @helli Also, some find it useful when ill when ketones are a risk, sometimes even at normal sugars. I read about the regime a number of years ago. I don’t remember all the examples, but a couple were: a woman who spent a lot of time on the beach each day; and a young man who was prone to DKA and wanted the back up of some long-acting insulin. It worked very well for him. I don’t remember the numbers but it greatly cut his occurrence of DKA (hadn’t had it in X number of years since starting the pump). He already had a CGM (he was American) but it was the addition of some long-acting insulin that solved his issue.
Hi Ryan - best thing that ever happened to me! Please don't be afraid, all new things can make us anxious but there really is no need to worry. The only downside to be mindful of is if something goes wrong with the pump - which is very rare - because you will be using only one type of insulin in the pump - if there's a problem you will potentially react very quickly. So always have a back up plan. I always have a syringe in my diabetic bag alongside insulin and pump cannulas etc. This really is a just incase option. I have a Medtronic pump and the support team are absolutely brilliant at answering any questions and address issues promptly. Don't forget a pump is the way forward and we're lucky to have one so enjoy this new freedom the new system will give you and people are always on here to give you help or comfort whenever you need it.