I'm on my way to getting a pump...

[Teapot99]

Hi everybody,

I haven't messaged for a little bit but I still like to come back on here and see what everybody is up to. I hope you're all doing well?

I have been speaking to my DSN about pumps, I am waiting for my DSN to return from holiday next week to speak to me about pumps and which one would suit me better. I originally wanted to go with the Omnipod 5, I have heard great things about it but I have heard that it isn't very 'forgiving' if I don't work out my carbs correctly and they have said I may end up taking too much insulin (over 200 units over the 3 days - which I don't completely believe as I am on low doses) so the Omnipod 5 won't hold the amount that I need. My diabetes team have said that they will help me work out my average to see if it is viable as I don't want to pay for more pumps that I should need!

One of the other pumps that have been suggested to me is the Medtronic Minimed 780g System. I was, at the start of my pump journey, very against cannula pumps (v.s. 'cannula-less (Omnipod 5)) as I don't want to feel attached to anything. I have heard that it is better at over correcting though but it does mean that I may have to change from the Libre 2+ sensor to a Dexcom in order to have this pump. So I have a few questions for my pump friends!

1. For anybody that has a pump - Did you find the transition easy to go from pens to pump? I am worried that I will be stressed by the change.

2. For anybody that has the Medtronic Minimed 780g System - How are you getting on with it? Is it easier to use than expected? How have your glucose levels been since being on the pump, have you seen positive changes?

3. For anybody that has changed from a Libre 2 or Libre 2+ sensor - Was the change quite easy?

My hospital have said that they can actually put me in contact with some specific pump users so they can speak to me about how they use it and the transition of going over to a pump which I will likely take them up on.

 

[PhoebeC]

1. For anybody that has a pump - Did you find the transition easy to go from pens to pump? I am worried that I will be stressed by the change.

2. For anybody that has the Medtronic Minimed 780g System - How are you getting on with it? Is it easier to use than expected? How have your glucose levels been since being on the pump, have you seen positive changes?

3. For anybody that has changed from a Libre 2 or Libre 2+ sensor - Was the change quite easy?

1. Very easy, I couldn’t believe how smooth and how much within a few days life was easier and better TIR

3. There’s no difference at all really. It’s the same user experience. I had no issues with the libre 2 + until I tried to connect with the Omnipod 5

 

[Teapot99]

1. Very easy, I couldn’t believe how smooth and how much within a few days life was easier and better TIR

3. There’s no difference at all really. It’s the same user experience. I had no issues with the libre 2 + until I tried to connect with the Omnipod 5

Thank you Phoebe, I know we chatted about a few bits before so thank you for reaching out. I hope you’re doing well

 

[SB2015]

2. For anybody that has the Medtronic Minimed 780g System - How are you getting on with it? Is it easier to use than expected? How have your glucose levels been since being on the pump, have you seen positive changes?

Hi @Teapot99

2. I have been using the 780 looping with their own sensors for over 5 years. I had already been on a pump for many years before using this one, and was used to do the decision making and adjustments myself, so it took me a bit of time to get used to trusting the pump to make those decisions for me. Now very happy to trust it and love thinking a lot less about my Diabetes. The looping gives me a TIR which is usually in the 80’s but often in the 90s.

3. For the 780 you have to use their own sensors: either Guardian 4 or Simplera Sync (I switched to the Simplera is a lot easier to apply and I find it more reliable but both good. ) I am content to rely on the sensor to make decisions for me about basal. The pump and sensor check in with each other every 5 min and adjust as necessary.

1. The switch from MDI to my original pump was a big step, and I was very nervous on the first day but I quickly saw the benefits: adjustable basal hour by hour, increasing flexibility to exercise by turning basal down an hour before, various profiles for illness, exercise, weekends, … being able to deliver my bolus in a variety of ways (when I tried to spli this on MDI I so often forgot the second half.)

With regard to being ‘tethered’ to a pump I find the tubed pumps fine. I am hardly aware of the cannulas and often have to search for where it is. I use a 60 cm tube and that is long enough to let me move the pump around and tuck it away where I want to according to what I am wearing. I disconnect for swimming and bathing, and otherwise just have it attached. In bed I can let it roam free and it does not cause any issues.

Happy to answer any questions that come to your mind.

 

[Inka]

The worry before the switch was far worse than the actual switch. I got used to the pump and cannula in a couple of days. Good luck @Teapot99

 

[trophywench]

If you don't want to 'feel attached' to a pump, I fail to understand how having an Omnipod stuck to you is better than a cannula since tubed pump cannulas are far far smaller than an Omnipod. Yes you have the tubing which trails to wherever you stash the pump. I usually wear separates so trousers/shorts/skirts so have to make sure they have pockets - but that's hardly onerous.

 

[PhoebeC]

If you don't want to 'feel attached' to a pump, I fail to understand how having an Omnipod stuck to you is better than a cannula since tubed pump cannulas are far far smaller than an Omnipod. Yes you have the tubing which trails to wherever you stash the pump. I usually wear separates so trousers/shorts/skirts so have to make sure they have pockets - but that's hardly onerous.

Yeah the Omnipod is chunky. I would say get the sample pod and give that a go.

@SB2015 I miss the profiles I had on the dash, discussed with my DSN yesterday about having them on the Omnipod 5 to use for match days, and my period etc. I might need to turn off the HCL for these days.

@Teapot99 I don’t understand why they said you would use 200 units if you are on small amounts. I normally fill mine with 150 units now and that’s lasts. Do you know your daily amounts now?
I believe pumps reduce most people’s insulin amounts. But if they know what you’re on then maybe they are right.

 

[mrsnnm]

Im still in that limbo phase of whether to get a pump or not. Im definitely keeping my options open but I'd say definitely do some more research over which pump would be best suited to you. Even though the omnipod has no tubing i think compared to the other pumps, it is quite a chunky device. Maybe ask your team if you can speak to a range of people on different pumps to get an idea that way?

 

[everydayupsanddowns]

Good luck choosing your pump @Teapot99

I’ve been using a pump for well over a decade now, and have only ever used the 180u reservoirs, so like @PhoebeC I can’t understand why 200u is being felt to be not enough for 3 days if you are on anywhere around 1:10 unless you are eating like 400g carbs a day 😱

Medtronic have their own sensors (either G4 or the new Simpleras) so if you are looking to use the MM780G as a hybrid loop you would have to use theirs. Otherwise you could non-loop and stick with Libre (but I’d say that would limit the benefit of the pump based on my experience).

I’ve never fancied the idea of a tubeless pump, so can’t help with that one. I did wear a dummy pod at a conference once. OK on my arm, but quite a lump (and that’s where I usually wear my sensors).

The algorithm on the MM780G works really well for me. I reckon I’ve added somewhere around 10% to my TIR from my first hybrid loop. So now I almost ‘expect’ to be running around 90% TIR, which is crazy really. The biggest benefit of the MM780G for me is the freeing up of head space. I am much happier to just let it do its thing, and feel I have to tweak and fiddle far less often. As long as I keep giving it the information it needs, it keeps things pottering along.

The only snag is things like illness, where it takes a few days to catch up with increased insulin need on the way in, and the takes a few days to taper everything back down again on the way out. I wish there was an ‘illness’ setting I could use to alert the pump that my body is having a bit of a strop.

 

[helli]

I thought it might be helpful to share my experience of pumping.
To start with, I have only done "manual pumping" with no HCL.

My first pump was a tubey pump. This was an Animas pump which is no longer available.
I loved the freedom it gave me with the ability to give small boluses and change my basal.
But, I found it large and "too obvious" for me - it was as if my diabetes was on display all the time.
When I explained this to my DSN, she told me about someone wearing one at their wedding. But the bride's dress was designed with a huge bow to hide the pump!
And, I have bony hips so with the pump clipped to my belt, I was getting bruises if I carried a bag.
When Animas pulled out of the pump business, I was initially offered a Medtronic. I forget which one but it was even bigger than my Animas.
I did a bit of research at the time and Animas was the smallest but it was not available at my clinic as they said it was too expensive.

However, there was a new kid on the block looking for guinea pigs to try out their patch pump.
This was Medrum who I have been with since.
They are not common and their HCL is not approved in the UK so I would not recommend them.
However, I have much preferred having a patch pump. It cannot move but that is not a problem because I can stick it where I want rather than where I have something to clip it to or hide in a pump belt.
I don't have to detach to have a shower (the time at which my FoTF is most prolific). I can't detach it for the gym but I can suspend the basal rate so that is good enough.
I still use my abdomen for my pump - my arms are not suitable.
It is smaller than the Omnipod so I can't comment on how bulky that would be but I have seen the Medtronic 780 and think it looks large (and old-fashioned).

That said, what is the most important thing - appearances or diabetes management?
At my last diabetes review, we were talking about HCL and OmniPod vs Medtronic was bought up.
Omnipod was described as "very gentle" which means that my HBA1c is likely to go up because it corrects slowly and the target BG is higher than I use.

Currently, I am not interested in HCL because I do not think insulin works fast enough for me and my days differ so much. I may be exercising (at short notice) one day and stuck in long stressful meetings the next. These things require basal changes which I can make quicker than the pump can notice.

 

[Teapot99]

Hi @Teapot99

2. I have been using the 780 looping with their own sensors for over 5 years. I had already been on a pump for many years before using this one, and was used to do the decision making and adjustments myself, so it took me a bit of time to get used to trusting the pump to make those decisions for me. Now very happy to trust it and love thinking a lot less about my Diabetes. The looping gives me a TIR which is usually in the 80’s but often in the 90s.

3. For the 780 you have to use their own sensors: either Guardian 4 or Simplera Sync (I switched to the Simplera is a lot easier to apply and I find it more reliable but both good. ) I am content to rely on the sensor to make decisions for me about basal. The pump and sensor check in with each other every 5 min and adjust as necessary.

1. The switch from MDI to my original pump was a big step, and I was very nervous on the first day but I quickly saw the benefits: adjustable basal hour by hour, increasing flexibility to exercise by turning basal down an hour before, various profiles for illness, exercise, weekends, … being able to deliver my bolus in a variety of ways (when I tried to spli this on MDI I so often forgot the second half.)

With regard to being ‘tethered’ to a pump I find the tubed pumps fine. I am hardly aware of the cannulas and often have to search for where it is. I use a 60 cm tube and that is long enough to let me move the pump around and tuck it away where I want to according to what I am wearing. I disconnect for swimming and bathing, and otherwise just have it attached. In bed I can let it roam free and it does not cause any issues.

Happy to answer any questions that come to your mind.

Hi @SB2015 thank you for replying!

2. That's really great to hear, it's nice to see that it has helped you with improving your blood sugar levels as this is really want I need to do

3. That's really interesting so thank you, I'm waiting to hear what they say about my CGM as my DSN have only brushed over it and not really gone into a lot of detail about it, but I am looking forward to hearing about what they say

1. I'm happy that it has different profiles for different activities, etc. Makes me feel a lot less nervous about it. I split most of my meal doses as it turns out that I eat a lot of complex carbs! I didn't realise that, I think that's why, before carb counting, I used have a lot of dips in my blood glucose after eating lunch and dinner and that would be why. Sometimes at the moment I'm not even having to do the second half of my dose sometimes - which I find strange but I guess that's heat and anxiety related stuff? Can you Split the doses on the 780?

That's good to hear too so thank you. I've heard they're quite slim and it's not too noticeable either. Is it hard to re-connect once it has been disconnected? And do you have to tell the pump it's being disconnected? What is the process if the cannula gets pulled out by accident? Sorry for all of the questions!

 

[Teapot99]

The worry before the switch was far worse than the actual switch. I got used to the pump and cannula in a couple of days. Good luck @Teapot99

@Inka Thank you! Makes me feel a lot better about it 🙂

 

[Teapot99]

If you don't want to 'feel attached' to a pump, I fail to understand how having an Omnipod stuck to you is better than a cannula since tubed pump cannulas are far far smaller than an Omnipod. Yes you have the tubing which trails to wherever you stash the pump. I usually wear separates so trousers/shorts/skirts so have to make sure they have pockets - but that's hardly onerous.

@trophywench it was more the fact I would be 'connected' with the cannula as I am a clumsy person and feel like I might rip it out! I've been told it's difficult to do and can just happen randomly too

 

[Teapot99]

Yeah the Omnipod is chunky. I would say get the sample pod and give that a go.

@SB2015 I miss the profiles I had on the dash, discussed with my DSN yesterday about having them on the Omnipod 5 to use for match days, and my period etc. I might need to turn off the HCL for these days.

@Teapot99 I don’t understand why they said you would use 200 units if you are on small amounts. I normally fill mine with 150 units now and that’s lasts. Do you know your daily amounts now?
I believe pumps reduce most people’s insulin amounts. But if they know what you’re on then maybe they are right.

@PhoebeC thank you! Yes I did give the Omnipod 5 tester a go a few months before I started my carb counting and I think I liked it, seemed similar to the Libre 2 + sensor but chunkier as everybody has said

Edit: I have been doing about 8 units or so max per each meal so I don't think that's bad or would be over the limit? I think maybe they're saying that to see if I can get onto the 780 instead because it will keep me 'more' in check with corrections etc?

 

[Teapot99]

Im still in that limbo phase of whether to get a pump or not. Im definitely keeping my options open but I'd say definitely do some more research over which pump would be best suited to you. Even though the omnipod has no tubing i think compared to the other pumps, it is quite a chunky device. Maybe ask your team if you can speak to a range of people on different pumps to get an idea that way?

@mrsnnm Funnily enough, I was actually suggested talking to other people with the pumps so I am really considering it to see. Everybody here is helping too so thank you all

 

[helli]

@trophywench it was more the fact I would be 'connected' with the cannula as I am a clumsy person and feel like I might rip it out! I've been told it's difficult to do and can just happen randomly too

It is definitely difficult to rip out a cannula. And, if you think you are more clumsy than most, you can tape down the tubing to reduce the risk.
I don't know about "randomly" ripping out a cannula. The worst case I can imagine is the glue loosening in the hot weather. But I have heard more examples of this happening with a OmniPod. Remember, the OmniPod still has a cannula it is just not on the end of a tube.
One of the reasons I avoid putting my patch pump on my arm is because I am more likely to knock it there but it is a common place for many.

 

[Teapot99]

Good luck choosing your pump @Teapot99

I’ve been using a pump for well over a decade now, and have only ever used the 180u reservoirs, so like @PhoebeC I can’t understand why 200u is being felt to be not enough for 3 days if you are on anywhere around 1:10 unless you are eating like 400g carbs a day 😱

Medtronic have their own sensors (either G4 or the new Simpleras) so if you are looking to use the MM780G as a hybrid loop you would have to use theirs. Otherwise you could non-loop and stick with Libre (but I’d say that would limit the benefit of the pump based on my experience).

I’ve never fancied the idea of a tubeless pump, so can’t help with that one. I did wear a dummy pod at a conference once. OK on my arm, but quite a lump (and that’s where I usually wear my sensors).

The algorithm on the MM780G works really well for me. I reckon I’ve added somewhere around 10% to my TIR from my first hybrid loop. So now I almost ‘expect’ to be running around 90% TIR, which is crazy really. The biggest benefit of the MM780G for me is the freeing up of head space. I am much happier to just let it do its thing, and feel I have to tweak and fiddle far less often. As long as I keep giving it the information it needs, it keeps things pottering along.

The only snag is things like illness, where it takes a few days to catch up with increased insulin need on the way in, and the takes a few days to taper everything back down again on the way out. I wish there was an ‘illness’ setting I could use to alert the pump that my body is having a bit of a strop.

Hi @everydayupsanddowns thank you for your message,

Yes that's exactly what I thought. I am on between 1:8, 1:9 and 1:10 depending on the day and weather or my stress levels so I do think what they're saying is a bit strange. I am running high though, so maybe they're saying it in relation to needing corrections too? I am definitely not eating that many carbs!

Okay thank you for that information. I will likely have to change sensor then but I guess they are all the same really? It's just getting used to it, I struggled when first using the libre because of the change but I love it now!

Yeah I understand that, I think I will likely get the cannula pod if the hospital think it will keep me in range more? Is it right that they can set the ranges that your blood sugar levels should be on the pump? Just as my bloods have been running higher for years (through being a teenager, etc) and I don't want to go straight down to 5-8 if I can help it as I don't want to feel rough! (If that makes sense)

Oh wow that is really good! I cannot wait to feel like I have some head space back, I think that has been a struggle for me. Yes I am currently always putting carbs into my libre so I know I should be on top of all of that!

Okay that is good to know, I am a bit worried about that but I know I will message on here if it comes to it. Thank you for your message!

 

[SB2015]

Can you Split the doses on the 780?

That's good to hear too so thank you. I've heard they're quite slim and it's not too noticeable either. Is it hard to re-connect once it has been disconnected? And do you have to tell the pump it's being disconnected? What is the process if the cannula gets pulled out by accident? Sorry for all of the questions

No problem with any number of questions @Teapot99
Splits
When looping I no longer split my doses. I tend to do the first part and a bit more, and the automated system deals with rest using the autocorrections. If it looks like I am going to get higher than I would like I will check in and do a correction bolus which is calculated by the system. For the first time in years Pizza is back on our menu, and I am happier to go out for curry, both of which caused problems for me on MDI
Connecting and disconnecting
Both of these are easy. Do ask them to show you a cannula and the tubing.
When I have a quick shower I don’t bother to tell the pump that I have disconnected. I tend to shower just after doing a bolus for breakfast. On the pump it borrows some basal and adds it into the bolus (previously referred to as a super bolus by some) so there is always. Small gap in basal delivery just after a bolus. So I am not going to be missing any insulin at this time ( I have been known to go and shower before the delivery of bolus is finished - ooops. The dressing gown gets the bolus instead!!!)
If I have a bath or go swimming I disconnect and I am going to be off the pump for a while, so I tell the pump and suspend delivery (for the awkward questions - we do the same during intercourse) . I just have to remember to reconnect and start delivery again. The pump alarms every 20 minutes whilst it is in suspension.
Replacing a cannula
If a cannula gets pulled out by accident, you will soon notice as your levels will rise with a steep rise as you will have no basal insulin, and you will soon get an alarm and advice to check your connection. (This happened to me recently. I went back into manual doing corrections myself as it was a while before I realised that my cannula looked okay but I had pulled it enough to lift out the fine Teflon needle and not noticed):
Looping
If the looping is in any doubt it will ask for a BG and warn you that you need to take over and work in manual. If the cannula gets pulled out you just put another one in and fill the cannula. Very straightforward.

Ask any questions that arise. Your concerns sound very similar to those that I had.