New insulin pump options

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HannahB

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Relationship to Diabetes
Type 1
Hi
I have just been told I will be able to upgrade my insulin pump. I’m on Accu check insight at the moment. The new options are Medtronic, omnipod or tslim x2. The last one I hadn’t heard of before. I am excited for the change but also quite nervous and I’ve no idea which of these options would be best. Does anyone have any advice or would particularly recommend from experience of using one of these pumps? Any advice gratefully received
 
Well, the first thing I’d do is decide if I wanted a tubed pump or a patch pump. Then look at all the features of each pump and write down what’s important to you (eg remote control, ability to loop, batteries or needs recharging, insulin capacity, etc etc) and work from there. Also, look at the variety of sets and cannulas. The best pump will be ruined by crappy consumables. Don’t forget reliability of customer service too. I avoided Medtronic for that reason as I’d heard bad things about it.

YouTube is a good source of pump reviews too.
 
I dont think you should choose a pump on peoples reviews only by what they complain about on forums and the internet as they only right when they have problems not when they are happy with there pumps ,you should look on youtube and other sites who right unbiased reviews .
 
Very first thing is @HannahB - none of the 3 on offer use prefilled cartridges - the Insight was the sole one that ever has. Hence whatever you have - you will need to fill the reservoir of. Each Omnipod patch only lasts 3 days then has to be chucked and a new one stuck on/inserted, because the patch itself holds both the cannula and the insulin reservoir. The other 2 are conventional tubed pumps, each of which can be linked with a CGM - Medtronic have their own branded CGM whereas the Tslim uses Dexcom. But - one has a larger capacity reservoir than the other. Think the Tslim is about the same size as a pumpcart, whereas the Med is larger. Depends how handy you are at filling reservoirs and of course - how much insulin you happen to need daily.
 
In 4 days i am being shown a ypsomed and tandem which i asked to see after researching both to replace my medtronic 640g i did have the omnipod for 6 months but had numerous leeks from the cannula so they lent me the medtronic till i saw the endo and showed my interest in the ypsomed and tandem which inn future i will go closed loop with ether pump.
 
I am using the Medtronic 780 in closed loop with their sensors and transmitter. I found the switch over very difficult from my old combo, but I am now delighted that I made the switch, with
a TIR of around 80-90% most of the time
thinking far less about my diabetes,
far fewer hypos
sleeping and knowing that the pump will sort out any wobbles for me
and
with the new Guardian 4 sensors just one finger prick in a week.
 
trophywench said:
Very first thing is @HannahB - none of the 3 on offer use prefilled cartridges - the Insight was the sole one that ever has. Hence whatever you have - you will need to fill the reservoir of. Each Omnipod patch only lasts 3 days then has to be chucked and a new one stuck on/inserted, because the patch itself holds both the cannula and the insulin reservoir. The other 2 are conventional tubed pumps, each of which can be linked with a CGM - Medtronic have their own branded CGM whereas the Tslim uses Dexcom. But - one has a larger capacity reservoir than the other. Think the Tslim is about the same size as a pumpcart, whereas the Med is larger. Depends how handy you are at filling reservoirs and of course - how much insulin you happen to need daily.
Click to expand...

The D-Tron from years ago used normal pen cartridges not special cartridges - totally brilliant and very convenient! Then AccuChek bought up Disetronic and introduced the Insight, the only pump I’ve ever returned 🙄
 
I have never had a pump with pre-filled cartridges and never want one. I use far less than a cartridge between set changes so like the option to half fill a cartridge and not waste expensive insulin. I hate waste at the best of times but when the NHS is struggling so much, I feel it is negligent to waste tax payers’ money.
 
@helli With the D-Tron, the cartridges were glass so you could just carry on using them until they ran out. You just changed the sets. They were literally pen cartridges.
 
I hate and loathe filling reservoirs! I'd been on MDI so long I'd entirely forgotten how bloody hard it is to get rid of air bubbles in any type of syringe, and therefore also pump reservoirs. I cannot 'flick' very hard - it hurts. Have to remember to get a stainless steel knife with a weighty handle out of the drawer in the kitchen, so it just adds to the ruddy palaver of changing cartridges. Hardly a thing you can do in 5 minutes ever, in view of having to get the insulin out before you need to do it.
 
trophywench said:
I hate and loathe filling reservoirs! I'd been on MDI so long I'd entirely forgotten how bloody hard it is to get rid of air bubbles in any type of syringe, and therefore also pump reservoirs. I cannot 'flick' very hard - it hurts. Have to remember to get a stainless steel knife with a weighty handle out of the drawer in the kitchen, so it just adds to the ruddy palaver of changing cartridges. Hardly a thing you can do in 5 minutes ever, in view of having to get the insulin out before you need to do it.
Click to expand...

Insulin at room temp you shouldn't get many air bubbles, I don't & been filling pods for last 9 years.
 
Until I had the medtronic pump I never had air bubbles in any of the previous pumps. Even though medtronic have been told time and time again there is a design fault with their cartridges which is causing the air bubbles they still choose to do nothing about it. (Plunger is where the air is getting in and it's a simple fix)
Once my 4 years is up I hope never to see another medtronic again.
 
nonethewiser said:
Insulin at room temp you shouldn't get many air bubbles, I don't & been filling pods for last 9 years.
Click to expand...
Have to say, I think I'm just not as dexterous as I once was, cos my first Combo I didn't seem to have that trouble, and used to tell @Pattidevans I didn't know how she got so many air bubbles in hers, she must be doing summat wrong. Of course - I now apologise! - better late than never ....

I also used to be able to see the insulin going along priming the tubing. I can't now, so just have to wait till it drips out the end ...
 
Happy to answer any questions you have on the tSlim.

I have been running the tSlim with self-funded sensors since late Summer 2020, and I think the combination of Tandem and G6 is probably the best kit I’ve ever had to help me juggle my BG levels.

Average of 93% of time spent between 3.9-10mmol/L over the past 90 days, with only 5 days below 80% Time in Range (and 4 of them when I ran out of sensors!)
 
I started on a pump in December. I was offered Medtronic 640 (rejected that because it was old technology) and they weren't offering the 780 at that time. Omnipod (interested as being tubeless). There was another couple, which I wasn't interested in. I was thinking of the t-slim, but although I liaised with the team and the local rep to try and get this, the team were given a training session, but not provided with one for me to see, and arranging to get one would have been another 2 or 3 months. In the end I went for the Omnipod Dash. Downside was that there were no official options for looping with it, However, as I wanted to get started I went with that one. Been very pleased with it, had some pod failures for various reasons ranging from trying to set a temp basal while I was out dog walking (it had problems communicating with the pod - ending up with a 'screamer' and no option other than th deactivate the pod - strange that it did this OK, when I was not talking to the pod!) and one that was dislodged by around 30 Kg of puppy-assistance! The other thing with the tandem was being restricted to the Dexcom sensors, which I wouldn't be able to get funding for - and self-funding would be 10% of my income!

Since April, I have been using a DIY loop (Android APS) but this does involve carefully following the step by step instructions to set up the software and build the app - and of course, there is no technical support from Insulet, only from within the online groups and forums, so it has to be approached with caution. I'm also using another 3rd-party app that reads the bluetooth signals from the Libre 2 and shows the results in real time, making it effectively a full CGM sensor, which Abbott didn't implement in their own app. That feeds the readings into the APS loop. So, it is possible, but certainly not as easy as a commercial system.
 
Thanks so much everyone for taking the time to reply. I’m just taking in all the responses and making notes before my meeting with the different reps. Your comments and watch outs have been so helpful
 
everydayupsanddowns said:
Happy to answer any questions you have on the tSlim.

I have been running the tSlim with self-funded sensors since late Summer 2020, and I think the combination of Tandem and G6 is probably the best kit I’ve ever had to help me juggle my BG levels.

Average of 93% of time spent between 3.9-10mmol/L over the past 90 days, with only 5 days below 80% Time in Range (and 4 of them when I ran out of sensors!)
Click to expand...
Hi, many thanks, that would be really useful if you would be happy to share how you have found tslim. I liked the look of Medtronic but the pump is quite a lot larger than the insight. Most important is that I want to get the best tech available but if tslim is as good but so much smaller then that’s something I just want to look in to.
 
HannahB said:
Hi, many thanks, that would be really useful if you would be happy to share how you have found tslim. I liked the look of Medtronic but the pump is quite a lot larger than the insight. Most important is that I want to get the best tech available but if tslim is as good but so much smaller then that’s something I just want to look in to.
Click to expand...

I really like the tSlim.

I had run the Medtronic MM640G for 4 years and had got on really well with it, but there were the inevitable minor irritations with the user interface (everyone will have different ones). Plus I wasn’t finding the G3 sensors suited me so well, and they were needing quite a bit of calibration - more than the enlites had for me, which I think is unusual.

The 640 was always a bit of an ugly spud, and as someone who only ever half fills a reservoir for 3 days the decision to only make them with the ‘sticky up bit’ for the bigger reservoir always irritated me more than was strictly necessary.

The form factor, big colour touchscreen, and smaller overall size of the tSlim was very attractive, plus it linked to Dexcom which had a brilliant reputation and at the time was the only mainstream CGM I hadn’t tried.

Another thing that attracted me was the ability to update the pump software during the life of the pump, via a download (something Medtronic had always promised was about to be available soon), so that while I started with Basal IQ (suspend only), my tSlim has now been upgraded to Control IQ (hybrid closed loop) without having to wait 4 years for new hardware.

There are a few moans and irritations, as there always will be, but the tSlim with the Dexcom G6 that I am currently self-funding, does actually mean I can hand over some of my diabetes thinking to the pump, and it takes up a bit less brain space.

If you think it would be helpful, there is a downloadable emulator app which allows you to explore the menu system on the tSlim on your smartphone to have a bit of a play with it and see how things are laid out.

Good luck with your decision 🙂
 
everydayupsanddowns said:
I really like the tSlim.

I had run the Medtronic MM640G for 4 years and had got on really well with it, but there were the inevitable minor irritations with the user interface (everyone will have different ones). Plus I wasn’t finding the G3 sensors suited me so well, and they were needing quite a bit of calibration - more than the enlites had for me, which I think is unusual.

The 640 was always a bit of an ugly spud, and as someone who only ever half fills a reservoir for 3 days the decision to only make them with the ‘sticky up bit’ for the bigger reservoir always irritated me more than was strictly necessary.

The form factor, big colour touchscreen, and smaller overall size of the tSlim was very attractive, plus it linked to Dexcom which had a brilliant reputation and at the time was the only mainstream CGM I hadn’t tried.

Another thing that attracted me was the ability to update the pump software during the life of the pump, via a download (something Medtronic had always promised was about to be available soon), so that while I started with Basal IQ (suspend only), my tSlim has now been upgraded to Control IQ (hybrid closed loop) without having to wait 4 years for new hardware.

There are a few moans and irritations, as there always will be, but the tSlim with the Dexcom G6 that I am currently self-funding, does actually mean I can hand over some of my diabetes thinking to the pump, and it takes up a bit less brain space.

If you think it would be helpful, there is a downloadable emulator app which allows you to explore the menu system on the tSlim on your smartphone to have a bit of a play with it and see how things are laid out.

Good luck with your decision 🙂
Click to expand...
That is so helpful - thank you.
One more question! Does tslim have a handset or do you have to do all your bolus on the pump itself? I understand that you can’t use your phone to programme the pump as you can with Medtronic?
 
HannahB said:
That is so helpful - thank you.
One more question! Does tslim have a handset or do you have to do all your bolus on the pump itself? I understand that you can’t use your phone to programme the pump as you can with Medtronic?
Click to expand...

A smartphone app to control the tSlim is apparently on the “soon” list… which could mean anything from 6 months to 6 years!
 
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