IVF

[Lawra]

Hi everyone, I’m sure someone will be able to help me here ☺️

Basically my husband and I are going to be starting our IVF in the next 2(ish) months and thought about getting an insulin pump started ASAP, so I can make sure that my levels be as perfect as can be. My nurse recommended DANAi pump in pregnancy.

Has anyone been in this situation before? Doing IVF and had this particular pump?

I’ve never had a pump before so I have questions about it:
- where do you put it when you shower/swim etc and if you wear a dress? Or in bed sleeping or doing *things*
- how often do you change it?
- where is the most discreet place you can put it?
- is it an automated delivery system like the Omnipod?
- I am using Dexcom One+ does it link with this like it does with the Omnipod?

Sorry for the questions, but for someone that’s never had one, I’m just wondering so many things!

Thank you in advance ☺️

 

[Inka]

Hi @Lawra 🙂 I have a Dana i pump and love it! It’s tough and reliable. I haven’t had a single problem with it. It also comes with a good range of cannulas and the customer service is excellent.

To answer your questions, the pump is very small. You simply don’t notice it after a few days. I assume you’ll be looping with it, but even if you don’t loop it can be controlled by your phone.

You disconnect it for a shower (literally takes 2 seconds)
You don’t change the pump, you just change the cannula. I change my cannula every 3 days and the insulin reservoir every 6 days.
The pump is tiny so it’s very discreet anyway. I’ve found the best thing is a Hid-in belt. It’s very soft and goes around your waist. It’s not noticeable at all. You can also wear the pump on your thigh, eg, if you had a super-tight dress on.
Not sure what you mean but the Omnipod isn’t automated unless you loop with it. You can loop with the Dana i using CamAps, which is recommended for pregnancy, or you can use the pump alone, which is what I do.
No, it doesn’t link with the Dexcom One. If you loop, it links with the Dexcom G6.

Fab pump 🙂 In your position, I’d get it asap so you can get used to everything before your IVF. It’s not complicated at all, but, like every new thing, it takes a short time to get accustomed to it.

 

[Lawra]

Your reply is very helpful, thank you!

So, is the pump attached all the time, or do you only attach it to the cannula when eating etc? Other than showering/swimming etc. I do like to wear a little flared dress or little shorts in the summer ☺️

Oh, okay, my nurse recommended the DANA so I think I’d go with this one since this is what she recommended, I wonder if this would mean that she will change my sensor?

Im not sure about the Omnipod or what you mean by loop with it apparently, it will stop giving the insulin according to your levels???? I’m not sure. But it sounds like it would be easy to do and keep on track of etc. I’ve never had an insulin pump of any sort so this is all new to me - I’ve always used the pens ☺️

Thank you so much for your response and sorry for the questions!
-Laura

 

[Inka]

The pump is like a little pancreas - kind of! You wear it all the time (apart from showers, etc) and it releases tiny amounts of insulin every few minutes just like a working pancreas does. The pump only uses fast insulin just like a real pancreas. The tiny amounts it releases every few minutes are your basal and then when you eat you press some buttons on the pump or your phone and do a bolus.

Shorts and little dresses are fine. I’ve had a pump more than 20 years and have worn all sorts over that time! Tight things, loose clothes, skimpy clothes - lots! It’s never been a problem.

Looping is when you use an appropriate CGM with a pump in a kind of loop and the pump/loop algorithm makes decisions. Personally I think it’s overrated and have turned a loop down, but others like it. I’ve had 3 pregnancies and just used my pump myself, altering basal rates and meal ratios just like I did with injections.

The pump made insulin changes during pregnancy easy. It was also brilliant for labour and post-delivery. It will also be very helpful if/when you take IVF meds.

A Dana i pump is a better choice than an Omnipod IMO, for many reasons, and if you choose to have a pump I’d take your nurse’s advice and go for the Dana i 🙂

 

[Lawra]

Oh my gosh, you honestly made me feel so much better about getting one!

Okay, looping makes sense. I’ll be happy to try anything with regards to DANA, just as long as my levels stay in good control - or even just help me to maintain control etc. so I’ll still need to keep injecting with my background insulin, I’ll just essentially have an external pancreas to work quicker for me

Thank you so much!

 

[Inka]

The pump will do both your basal and your boluses using only one insulin, eg Novorapid or another fast insulin. You won’t need any injections at all. The pump does it all, either with your input or automatically with a loop @Lawra

 

[rebrascora]

No, you don't use background (basal) insulin at all. The pump delivers tiny amounts of fast acting insulin every few minutes day and night to replace what your long acting insulin does. If you have it looped with a sensor, then the pump and sensor talk to each other and if your levels are going too high, the pump delivers a bit more insulin to bring it down and if they are going too low, it reduces or stops insulin delivery until your levels are stable.
You just have to tell it how much insulin you need for meals and learn how to adjust the basal profile which is how much insulin it delivers per hour at different times of the day to replace your long acting insulin..... So you might need very little at 2am in the morning but quite a bit more at 7am when you get up etc. You can program the pump to deliver different amounts of insulin at different times of the day according to what you think your body needs.

 

[Lawra]

Ok that’s helpful, thank you.

I think I’d rather do as a loop, so it’s easier for me. So, for example, I have Levemir for background morning and night and then Lyumjev as fast acting - but these would come in one in the pump, is that right?

I’m sure my nurse will talk me through anyway - but I’ve bit the bullet and sent her an email asking for it, so it’s a waiting game now on her response ☺️
Thank you guys

 

[rebrascora]

I think it might be worth while doing some background research whilst you wait. You Tube can be great for tutorial videos and if you know that it will be a DANA pump there may be some videos of people showing how that particular pump works and how to fill the reservoir and how to apply the cannulas etc. and that may give you a better insight into the way insulin pumps work. They are not just "plug and play" so the more understanding you have of them, the better your experience should be.

 

[Inka]

Ok that’s helpful, thank you.

I think I’d rather do as a loop, so it’s easier for me. So, for example, I have Levemir for background morning and night and then Lyumjev as fast acting - but these would come in one in the pump, is that right?

I’m sure my nurse will talk me through anyway - but I’ve bit the bullet and sent her an email asking for it, so it’s a waiting game now on her response ☺️
Thank you guys

No, not quite right. Read what I wrote above. The pump ONLY uses fast insulin. This is just normal fast insulin (eg Novorapid) NOT a mix of Novorapid and Levemir or whatever. There is no slow insulin involved WHATSOEVER.

The fast insulin is released by the pump in a tiny trickle day and night. This acts as a basal because it controls your blood sugar day and night but is NOT a slow insulin - just a fast insulin trickled out every few minutes which acts like a basal but better because it’s more finely tuned to your body’s needs. Then when you want to eat, you count your carbs and bolus on the pump which then gives you a bigger amount of the SAME fast insulin.

TLDR - pumps ONLY use one type of insulin: fast/rapid insulin eg Novorapid, Humalog, Fiasp, etc

 

[trophywench]

Your DSN won't hang around - they are all (or they should be all!) prioritising getting pregnant ladies (and certain other adults) on to HCL pumps asap. At my clinic there were 4 ladies starting ours on the same day at the same time - me because my existing non closed loop pump had reached the end of its contract, another lady who was sight impaired and the other two were both in early pregnancy - no men starting with us that day. Only the sight impaired lady did not have her husband/partner with them, to learn as they learned. As my husband has to come with me anyway since I no longer drive so can't get there otherwise, he came in with me (though as it happened I managed to get em to make me a coffee during the process but he didn't cos it was whilst I was out of the training room having a loo break, hence he stayed where he was so as to try not to disrupt the proceedings for anyone else. First time I've managed that)

I've had a few probs since with the new to me system cos it was 'all change' even though I've been pumping for donkeys ages now. I have found the pump phone helpline absolutely excellent. Different pump so can't comment about the Dana one - back to you, @Inka .