Best Tubeless Pump

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Dogz

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Type 1
Hi - first post

I'm a T1 with c35yrs under the belt who is pretty well controlled but have now started experiencing rising blood sugars during the early hours (typically between 3-5am)

I've tweaked insulin and done all sorts of things but I can't get it sorted (Dawn Phenomenon)

I personally think a pump would help sort this issue so spoke to the pump consultant and was told I don't fit within the NICE criteria as my HBA1C is too good and I still get hypo symptoms although not as good as they once where

I'm desperate to get this sorted and get back to really good control during the night so am happy to self-fund a pump although I'm slightly annoyed that because I look after myself I'm disadvantaged

What are the best tubeless pumps on the market? I've looked at the Omnipod but it lacks integration with CGM which is ideally what I'm after but guess this will come in future releases.

I'm currently on Fiasp, Tresiba and Libre2 if this help

Any thoughts welcome
 
Are you based in the Uk?
I ask because my understanding is you need a doctor to approve a pump. I think this could be a private doctor but you can’t just go out and buy a pump plus supplies.
My (NHS) clinic do not offer Omnipod because, having to replace the pod every 3 days works out too expensive.

I was very lucky to be offered the Medtrum pump. I am currently using this with the Medtrum CGM. The CGM suspends the pump when my levels are low but does not increase basal when my levels are high.
I am happy with my pump but not sure whether it satisfies your definition of “best” as we all have different requirements.
 
Yes - UK based. It believe it needs to be authorised by your diabetic specialist and they need to confirm they are happy to support you with it. They offer the Omnipod so I can't see this being an issue but might be with other pumps
 
Dogz said:
I personally think a pump would help sort this issue so spoke to the pump consultant and was told I don't fit within the NICE criteria as my HBA1C is too good and I still get hypo symptoms although not as good as they once where
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Your consultant needs to reread the NICE guidelines.
 
I’ve been hearing rumours for a while that Omnipod are looking to release a new product which integrates with Libre so that might be worth keeping an eye on.

Hope you can continue to have the conversation with your consultant. As your hypo warning signs are “not as good as they were”, as Sue says I think it’s still worth asking again. I would suspect that you have made adaptations to your daily life to reduce your exposure to hypos, and that (as your warning signs have changed) you actively think about / worry about hypos or the risk of hypos frequently, because you never quite know when your BG might dip below 4.0?

NICE TA151 is the document which applies. The first criteria revolves around pumps and hypoglycaemia. Specifically when hypos become something that people worry about, which is termed ‘disabling hypoglycaemia’. Note that it’s not the hypos themselves that are necessarily disabling, it’s the effect they have on your quality life, and the amount of time you spend worrying about them / working around them.

“disabling hypoglycaemia is defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life”
 
Dogz said:
What are the best tubeless pumps on the market? I've looked at the Omnipod but it lacks integration with CGM which is ideally what I'm after but guess this will come in future releases.
Click to expand...

Hello again @Dogz

This thread came up in our virtual meetup today, when @Squirrel768 was describing his experiences with Android APS, Libre and Omnipod - might be worth you two connecting.

AAPS is the open source / unofficial version of a hybrid closed loop, which you have to build yourself.
 
I'll send a PM ... thanks Mike
 
Dogz said:
Hi - first post

I'm a T1 with c35yrs under the belt who is pretty well controlled but have now started experiencing rising blood sugars during the early hours (typically between 3-5am)

I've tweaked insulin and done all sorts of things but I can't get it sorted (Dawn Phenomenon)

I personally think a pump would help sort this issue so spoke to the pump consultant and was told I don't fit within the NICE criteria as my HBA1C is too good and I still get hypo symptoms although not as good as they once where
Click to expand...
Hi @Dogz. I agree, it sounds like you would benefit from the pump, and being able to set a basal profile to compensate for the DP rise. My DSN was ood - initially advised me what I needed to be doing to get the Libre, then didn't take a lot of persuading last year to put me forward for funding for a pump. Ended up on the Dash in December, and took a while getting the right numbers in the profiles. Then I started using the Android APS loop system - the initial version 2.8.2 didn't support the Dash, so I was running Open Loop, where it offered suggestions for me to manually input. When 3.0.0.1 came out, I upgraded to that at the beginning of April, as it included the Dash - and although still trying to tweak the profiles to fine tune things. Then of course, T1D decides to do something different!
 
My DSN was great and asked me all the 'right' questions eg D'you ever get concerned about having hypos, Jen? Well it's a constant worry Lin - how could it possibly ever not be, if you happen to drive? But you know me by now - no point on harping on about all the negatives that affect your life to the folk who know you, is there when I can't remove that worry - so I usually prefer to concentrate on the things I CAN change instead.
 
Hi "Dogz",
what you have written in your initial message that you are longterm T1D with your "Dawn-effect" in the morning should be marker for a pump in the NICE. I think it doesn't depend on your HBA1C only.

It may also depend on it how much time you invest in your Glucose-control to obtain such "good" HBA1C leveI. It took me at the beginning of my "Freestyle Libre life" quite some time and effort per day(Dense glucose reading, 1-2h analysis of the day, etc..) to obtain such a good glucose level. I went through a similar process 3 years ago to obtain my Omnipod-pump. The OMNIPOD Dash improved my working-life very much and comfortable.
PS: I am waiting for the upgrade (Omnipod 5 and Freestyle 3, which will have closed-loop capability)

You may should get an appointment with a full-time Diabetic specialist in your region, hospital outpatient, etc.. for your pump-project
to get a second opinion on it.
 
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Thanks everyone for your views and opinions.

I will read the NICE guidelines and retry with the hospital to be reconsidered for a pump. I’m going to look at the new Omnipod 5 as if it’s a closed loop system then it’s the best of both worlds

Squirrel768 - I will come back to you and everydayupsanddowns thanks for the intro

I’ll keep people updated as I make progress. Thanks All!
 
OmniPod 5 won’t be available here in the UK for a year or so. It is being used in the US but it hasn’t yet been approved for Europe - I think that was why anyway
 
RTI said:
PS: I am waiting for the upgrade (Omnipod 5 and Freestyle 3, which will have closed-loop capability)
Click to expand...
I'm waiting to hear whether the Horizon (Omnipod 5) will be loopable with Libre as I understand that Insulet and Abbott have signed an agreement, or whether it will only be looping with the Dexcom sensors (which is the current situation with the Tandem T-Slim pump) as the 'official' loop setup.

I get around the non-loopable Dash by using Libre 2, which feeds into Diabox making it real-time CGM, then passing the data to Android APS DIY loop system to connect with the Dash. So, not an official loop, but very effective in controlling the Dash in closed-loop mode! Downside is that it doesn't work out of the box like a commercial system, you have to build it following the instructions.
 
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