Hi Everyone, Although I am not new to diabetes (type 1 for 20 years) I am looking for some advice on moving from injection pens to a pump, to help get better control of extreme fluctuations in sugar levels. I have done some initial research and I would prefer a patch pump. I have the option of a Roche Solo via the NHS in my Trust area however I also like the look of the Omnipod, which isn't on offer. I would consider self or part self funding (is this even possible?) for the right pump for me. I have also heard from a fellow local diabetic that at the start of 2022 we will be offered self adjusting insulin pumps, if this is the case I am wondering whether I hold out for a few months to see if I can get one of these, I believe I would be committing to a pump for 4 years via the NHS. Is anyone on a self adjusting pump or the Roche Solo that could offer further insights or anyone know the answer to some of the funding questions? I would really appreciate any input, it's not easy making these decisions!
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New here, needing pump advice
- Thread starter Vbop
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Inka
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- Type 1
Hi @Vbop 🙂 Have you been officially approved for a pump? I wasn’t entirely clear from what you wrote. I’ve had a pump 17+ years. I’ve never heard of anyone part-funding one, and I’d guess that’s not possible.
I prefer tubed pumps for flexibility so can’t comment on the Solo or Omnipod, I’m afraid. If by self-adjusting pumps you mean looping ones, I haven’t heard that. It’s the CGM part of the loop that’s the issue because they’ll rarely pay for that so I can’t see it happening in all honesty. @everydayupsanddowns might know more.
I prefer tubed pumps for flexibility so can’t comment on the Solo or Omnipod, I’m afraid. If by self-adjusting pumps you mean looping ones, I haven’t heard that. It’s the CGM part of the loop that’s the issue because they’ll rarely pay for that so I can’t see it happening in all honesty. @everydayupsanddowns might know more.
Inka
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Oh, well if you’ve got a Dexcom you’re laughing! What you need to do is look at the looping ability of each pump your clinic offers before deciding and see if they’d work with the Dexcom.
My pump is a DANA RS and would loop with a Dexcom if I could afford it.
If you do a search you might find mention of the Solo. It’s new and I’m struggling to think of anyone with it.
My pump is a DANA RS and would loop with a Dexcom if I could afford it.
If you do a search you might find mention of the Solo. It’s new and I’m struggling to think of anyone with it.
I have used both tubed and patch pumps, although none of the ones @Vbop mentions.
My preference is definitely patch but that has nothing to do with the tube. I was able to keep my tube out of the way so never caught it on a door handle.
I prefer my patch pump because it is smaller and more discrete.
The downside is needing a larger flat area to place a patch pump compared to the area needed for a cannula which the tube “swings off”.
There are a couple of different “self adjusting” pump options. There are the pumps that suspend basal when blood sugars get too low and those that adjust basal up and down according to your cgm readings.
My DSN is not a fan of the simpler option because most pumps (at least the Medtronic ones) suspend basal at quite a high level. If I remember correctly it is around 6.5mmol/l.
The ones that adjust basal up and down sound more interesting but I have read they are tempermental when “learning” and I see lots of questions about what to do when exercising which I do a lot of and turn off my basal.
My preference is definitely patch but that has nothing to do with the tube. I was able to keep my tube out of the way so never caught it on a door handle.
I prefer my patch pump because it is smaller and more discrete.
The downside is needing a larger flat area to place a patch pump compared to the area needed for a cannula which the tube “swings off”.
There are a couple of different “self adjusting” pump options. There are the pumps that suspend basal when blood sugars get too low and those that adjust basal up and down according to your cgm readings.
My DSN is not a fan of the simpler option because most pumps (at least the Medtronic ones) suspend basal at quite a high level. If I remember correctly it is around 6.5mmol/l.
The ones that adjust basal up and down sound more interesting but I have read they are tempermental when “learning” and I see lots of questions about what to do when exercising which I do a lot of and turn off my basal.
PattiEvans
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I belong to a FB group that encompasses all the Roche pumps i.e. the Combo, the Insight and the Solo. There seem to be quite a few moaning about the Solo, but quite often people only speak up to have a moan not to say how wonderful they find a product. I've been on the Roche Combo for 8 years and the tube is OK... but under certain circumstances I would prefer a tubeless pump. I may get one when this one runs out in November.
From talking to people on other mediums I understand that even if you fund your own pump the NHS will not fund the peripherals (which can be a very substantial monthly outlay). So best to get the pump on the NHS if, as your consultant seems to think, you do qualify.
From talking to people on other mediums I understand that even if you fund your own pump the NHS will not fund the peripherals (which can be a very substantial monthly outlay). So best to get the pump on the NHS if, as your consultant seems to think, you do qualify.
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Omnipod are planning to launch a new line with integration of CGM (which might be Libre I think?) but personally I wouldn’t delay starting because something is rumoured to be ‘out soon’. that could easily turn into 2years of waiting, by which time you’d be half way to your next pump!
The three commercial outfits offering ‘adjusting’ pumps are currently Medtronic MM670 and MM780, Tandem tslim and Medtrum A6.
Medtronic and Medtrum link with their own sensors, Tandem links with Dexcom G6.
There are also ‘open source’ options which you have to build yourself, including Loop, and AAPS.
The snazziest of these ‘hybrid closed loop’ systems offer predictive low glucose suspend (shutting off basal insulin if BG looks like it might drop low within 30 minutes), and also variations on an ‘auto mode’ where either basal, or small boluses can be added if BG is rising above the desired range.
They aren’t fully automatic... you still need to give them the right information about carbs, keep the sensors calibrated, and notify if you are doing exercise/activity etc etc... but I have found them a great help - even just with basal suspends.
The three commercial outfits offering ‘adjusting’ pumps are currently Medtronic MM670 and MM780, Tandem tslim and Medtrum A6.
Medtronic and Medtrum link with their own sensors, Tandem links with Dexcom G6.
There are also ‘open source’ options which you have to build yourself, including Loop, and AAPS.
The snazziest of these ‘hybrid closed loop’ systems offer predictive low glucose suspend (shutting off basal insulin if BG looks like it might drop low within 30 minutes), and also variations on an ‘auto mode’ where either basal, or small boluses can be added if BG is rising above the desired range.
They aren’t fully automatic... you still need to give them the right information about carbs, keep the sensors calibrated, and notify if you are doing exercise/activity etc etc... but I have found them a great help - even just with basal suspends.
SB2015
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- Type 1
I use the Medtronic 780 with their sensors. My pump with the cannulas is funded by the NHS and I self fund the sensors. The pump has three modes
With regard patch or tubed pumps, I have only ever had tubed pumps. The tubing has never caused a problem and I prefer the ‘smallness’ of the cannula and then being able to put the pump wherever I want.
there are pros and cons for each one as they all have their quirks.
Let us know what you choose to do.
- Manual mode without the sensors
- Manual mode with sensors which will give alerts in high and low
- Auto mode with the sensors where the pump talks to the sensor and makes adjustments to the basal every five minutes. The earlier pumps only gave the option of a target of 6.5 (I think). The 780 allows you to choose your target 5.5 or 6.5 and also to set a higher temporary target for exercise.
With regard patch or tubed pumps, I have only ever had tubed pumps. The tubing has never caused a problem and I prefer the ‘smallness’ of the cannula and then being able to put the pump wherever I want.
there are pros and cons for each one as they all have their quirks.
Let us know what you choose to do.
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