Patch pump help

[Type1singlemum]

I have been T1 diabetic for 25 years now and I have had a Medtronic pump for the last 4 years. I am now able to have a cannula free pump (I’m very excited).

My choices are the Medtrum patch pump or the Roche solo pump.

Please please could anyone offer their advice / reviews / opinions on either? I’d like to get fellow diabetic’s reviews on them both?

I really like to hear from people actually using them for pros and cons before I make my decision?

Thank you so much I’m advance.

 

[everydayupsanddowns]

Welcome to the forum @T1D Girl

I'm not sure we have anyone on a Solo, but Medtrum was recently discussed here

Anyone on the Medtrum pump?

Just back on here after a while. I’ve been offered the chance of swapping to the Medtrum patch pump. Am currently using the Medtronic 640.Any views or opinions greatly received

forum.diabetes.org.uk

And forum member @helli is an enthusiastic user 🙂

 

[helli]

Thank you for the tag @everydayupsanddowns
My Medtrum (called “Patch”) is my second pump but my first tubeless one. I have had it for about 18 months when I was offered it as the CCG guinea pig.
My experience has been good but not perfect.
The positives are
+ small and discrete
+ very easy to manage. I am a “tweaker” and find it very easy to tweak or suspend my basal
+ I love the phone app. One less thing to carry around with me, especially as I now have Libre too.
+ set changes are easy, there is very little to put in the sharps box and all the packaging can be recycled.
+ the local team are fantastic. I was, initially, concerned because their uk presence is small. But this has become a huge advantage as I am on first name terms with them and they know my personal foibles.
+ they provide a spare temporary pump when you go away for holiday or business.

On the other hand
- the smallest bolus dose and variation for basal is 0.05 units. On my previous pump it was 0.025 units. As I am quite sensitive to insulin (I only half full the cartridge because I only use 90 units in 3 days), this has meant I needed extra basal steps during the night to alternate between two levels. It is not a huge problem once it is set up.
- I get more occlusion alerts than I did with my previous pump. This may be a generic patch pum issue but it is my only patch pump experience.
- I have had about 6 quality issues (patch and pump errors). The local team have replaced them every time, are incredibly responsive and always ask for details to investigate. Before the pandemic, we arranged a meet up in a local cafe to check there was nothing I was doing wrong but found nothing.

When I first trialled the pump, I thought it was a risk with so few in use in the UK. But, overall, I would say the risk was worth taking.
That said, I have no other patch pump to compare it with.

 

[daiseyc]

Hi! I've been using the Roche Solo Pump since May 2019. It's my first pump which I got on my 29th diaversary! I absolute love it. I needed a tubeless pump (small children and tubes... no thanks!) and I wanted to be able to remove it when necessary. The Solo wasn't available at my pump fair but Roche stated that if enough people were interested we could be a 'beta' testing group. I decided the solo was my best option despite having previously decided to go for the Omnipod. Being able to detach the pump means you don't lose precious insulin because of a bent cannula (though I've not had this happen often!) or if you need to change the site of your pump (I'm looking at you, high waisted jeans, when I've placed it in an awkward spot on my tummy!)
The main thing for me though is being able to bolus from the pump directly. I am ALWAYS losing my phone and I often have no idea where my PDM is, and its SO easy to bolus on the go when needed, discreetly too.
Happy to answer any questions across the board if needed 🙂

 

[everydayupsanddowns]

Glad you are getting on well with it @daiseyc

I think you may be our first Solo user

 

[InsulinPumpUser]

Hi! I've been using the Roche Solo Pump since May 2019. It's my first pump which I got on my 29th diaversary! I absolute love it. I needed a tubeless pump (small children and tubes... no thanks!) and I wanted to be able to remove it when necessary. The Solo wasn't available at my pump fair but Roche stated that if enough people were interested we could be a 'beta' testing group. I decided the solo was my best option despite having previously decided to go for the Omnipod. Being able to detach the pump means you don't lose precious insulin because of a bent cannula (though I've not had this happen often!) or if you need to change the site of your pump (I'm looking at you, high waisted jeans, when I've placed it in an awkward spot on my tummy!)
The main thing for me though is being able to bolus from the pump directly. I am ALWAYS losing my phone and I often have no idea where my PDM is, and its SO easy to bolus on the go when needed, discreetly too.
Happy to answer any questions across the board if needed 🙂

Does the infusion assembly have to be replaced every 72 hours as indicated here, https://www.diabettech.com/patch-pump/the-roche-accu-chek-solo-micropump-so-just-what-is-it/?

 

[trophywench]

But with any/all pumps it is NOT recommended to use a cannula for longer than 3 days, to avoid causing scar tissue - or pockets of unused insulin! - building up anywhere, hence 3 days is par for the course with a pump full stop, Though I need a new cannula every 2 days as insulin absorption gets iffy after that.

 

[InsulinPumpUser]

But with any/all pumps it is NOT recommended to use a cannula for longer than 3 days, to avoid causing scar tissue - or pockets of unused insulin! - building up anywhere, hence 3 days is par for the course with a pump full stop, Though I need a new cannula every 2 days as insulin absorption gets iffy after that.

I was thinking that sometimes I have 4 days between set changes and this pump still functions fine with that. Sometimes it isn’t possible for me to complete a set change exactly 3 days after the previous one.

 

[Inka]

I was thinking that sometimes I have 4 days between set changes and this pump still functions fine with that. Sometimes it isn’t possible for me to complete a set change exactly 3 days after the previous one.

I get you. I do sometimes leave my cannula in a few hours longer eg overnight which works out close to 4 days. I do try not to do it though and it’s only an occasional thing.

If you want that flexibility, a tubed pump would give you that. You could leave the cannula in as long as you wanted (at your own risk), use the reservoir/cartridge as long as you wanted, etc

 

[helli]

When I had a tubed pump, I would occasionally have 4 days between set changes.
With a patched pump, as a larger area of the pump is attached to my skin, I find it becomes more irritating and, after 3 days, I am used pleased to give a different part of my body a go.
I use Cavilon to protect my skin and the irritation is not so great that I want to rip the pump off but enough that I am happy to change.
My days are not always the same but the time taken to change a set is so small that it does not have a great impact if my set change day is one where I need to be getting up earlier because of travelling (when that was an option).

 

[daiseyc]

Does the infusion assembly have to be replaced every 72 hours as indicated here, https://www.diabettech.com/patch-pump/the-roche-accu-chek-solo-micropump-so-just-what-is-it/?

With any pump you are recommended to replace every 3 days? The good thing about the solo (as opposed to say the omnipod) is that you can replace the insulin reservoir and the cannula assembly separately rather than ditching the whole thing. Depending on how much insulin you fill the reservoir with (200u is the max) and how much insulin you use, would also make a difference!

 

[InsulinPumpUser]

I get you. I do sometimes leave my cannula in a few hours longer eg overnight which works out close to 4 days. I do try not to do it though and it’s only an occasional thing.

If you want that flexibility, a tubed pump would give you that. You could leave the cannula in as long as you wanted (at your own risk), use the reservoir/cartridge as long as you wanted, etc

I think the thought of tubeless is swaying me as I normally do a set change every 3 days any way but it is just that I do not want to have to do it exactly every 72 hours. With my current pump it could be a few hours earlier or later and it still works fine.

 

[InsulinPumpUser]

When I had a tubed pump, I would occasionally have 4 days between set changes.
With a patched pump, as a larger area of the pump is attached to my skin, I find it becomes more irritating and, after 3 days, I am used pleased to give a different part of my body a go.
I use Cavilon to protect my skin and the irritation is not so great that I want to rip the pump off but enough that I am happy to change.
My days are not always the same but the time taken to change a set is so small that it does not have a great impact if my set change day is one where I need to be getting up earlier because of travelling (when that was an option).

Although I have sensitive skin I have managed to keep the Omnipod on my arm since Friday afternoon but sometimes my arm gets extremely itching with the Freestyle Libre sensors.

 

[InsulinPumpUser]

With any pump you are recommended to replace every 3 days? The good thing about the solo (as opposed to say the omnipod) is that you can replace the insulin reservoir and the cannula assembly separately rather than ditching the whole thing. Depending on how much insulin you fill the reservoir with (200u is the max) and how much insulin you use, would also make a difference!

I am just a little concerned that if I have to do a set change exactly every 72 hours that what would happen if I couldn't, for example I slept in, I was travelling, the clocks went forward or back and I forgot to change my alarm to waken me as I normally do my set changes before breakfast?

When on holidays and you do not know the exact carb content of the food you are eating it is less hassle to take an extra day out of the set change rather than guessing wrong and then thinking the set change didn't work correctly.

Perhaps others have a way around knowing that a set change was successful on holidays?!?! I would be interested to hear if they do, it would make holidays easier, if we ever get them again due to covid,

 

[helli]

When on holidays and you do not know the exact carb content of the food you are eating it is less hassle to take an extra day out of the set change rather than guessing wrong and then thinking the set change didn't work correctly.

Can you explain what you mean?
Why does the bolus affect how long between pump changes?
If you are referring to using up all the insulin, this is lower priority than changing your pump site.

Regardless of holidays, I never eat a consistent number of carbs per day - sometimes it could be less than 100g another day it could be more than 200g.
Bolus is not the only thing that changes - one day I could be doing a lot of exercise so suspend my basal for a couple of hours then reduce it and, another day, could be spent slobbing in front of the telly with a cold which means I need to increase my basal.

As previously discussed, the change does not have to be "exactly 72 hours". You have an 8 hour buffer so you can have a lie in one day. For example, I usually change my pump before breakfast at around 8am. Yesterday, I changed my pump at 4pm.
I was not a complete couch potato - I didn't lie in until 4pm. I had a bike ride so delayed my shower and pump change until afterwards. The point is, the extra 8 hours gives me the flexibility.

This 72 hours seems to be a major concern for you.
If it was completely rigid patch pumpers would all be changing our pumps every 2 days to avoid the risk of missing the cut off and that would be a waste. The lifetime of a pod allows for lie ins and clock changes and travel, including travel to a different timezone

 

[InsulinPumpUser]

Can you explain what you mean?
Why does the bolus affect how long between pump changes?
If you are referring to using up all the insulin, this is lower priority than changing your pump site.

Regardless of holidays, I never eat a consistent number of carbs per day - sometimes it could be less than 100g another day it could be more than 200g.
Bolus is not the only thing that changes - one day I could be doing a lot of exercise so suspend my basal for a couple of hours then reduce it and, another day, could be spent slobbing in front of the telly with a cold which means I need to increase my basal.

As previously discussed, the change does not have to be "exactly 72 hours". You have an 8 hour buffer so you can have a lie in one day. For example, I usually change my pump before breakfast at around 8am. Yesterday, I changed my pump at 4pm.
I was not a complete couch potato - I didn't lie in until 4pm. I had a bike ride so delayed my shower and pump change until afterwards. The point is, the extra 8 hours gives me the flexibility.

This 72 hours seems to be a major concern for you.
If it was completely rigid patch pumpers would all be changing our pumps every 2 days to avoid the risk of missing the cut off and that would be a waste. The lifetime of a pod allows for lie ins and clock changes and travel, including travel to a different timezone

In order to know my set change has worked properly I need to consume carbs and bolus. If my readings are high well then I know my set change has not worked and I need to complete another set change. Using all of the insulin is not a concern for me as I am very sensitive to insulin and only use just over a total of 20 units daily.

 

[helli]

In order to know my set change has worked properly I need to consume carbs and bolus. If my readings are high well then I know my set change has not worked and I need to complete another set change. Using all of the insulin is not a concern for me as I am very sensitive to insulin and only use just over a total of 20 units daily.

If I understand correctly, you eat something of fixed carbs after changing your pump, bolus and test to ensure the ump is working correctly.
This is not something I do and I don't understand why a patch pump would make any difference to a tubed pump in this regard. But if it is part of your pump changing strategy, why not take a pack of muesli bars or something pre-packed that you know the carb content of with you on holiday? If you go for a week, you only need to take 4 bars - one for each set change and one spare. Compared to the pump paraphernalia you take with you, this will have little impact on your luggage.
Actually, I always take some food like bars with me when I travel and have been doing so since before I had diabetes. I find it gives me a peace of mind that I have something with me if I am unable to get to a restaurant or a meeting overruns (most of my travel is for work rather than holidays).

 

[InsulinPumpUser]

If I understand correctly, you eat something of fixed carbs after changing your pump, bolus and test to ensure the ump is working correctly.
This is not something I do and I don't understand why a patch pump would make any difference to a tubed pump in this regard. But if it is part of your pump changing strategy, why not take a pack of muesli bars or something pre-packed that you know the carb content of with you on holiday? If you go for a week, you only need to take 4 bars - one for each set change and one spare. Compared to the pump paraphernalia you take with you, this will have little impact on your luggage.
Actually, I always take some food like bars with me when I travel and have been doing so since before I had diabetes. I find it gives me a peace of mind that I have something with me if I am unable to get to a restaurant or a meeting overruns (most of my travel is for work rather than holidays).

"If I understand correctly, you eat something of fixed carbs after changing your pump, bolus and test to ensure the ump is working correctly." Your understanding is correct. That is what the nurse said we had to do when I was first put on a pump.

Can I ask, if it is not rude, how you know when your set change has worked?

Thank you for your suggestion of muesli bars.

 

[helli]

Can I ask, if it is not rude, how you know when your set change has worked?

I have been pumping for 5 years and trust my pump. If it is not working it beeps at me.
Maybe I am lucky that I have no absorption problems.

 

[Inka]

I think the thought of tubeless is swaying me as I normally do a set change every 3 days any way but it is just that I do not want to have to do it exactly every 72 hours. With my current pump it could be a few hours earlier or later and it still works fine.

That makes sense. If that’s an important criterion for you, then it’s crucial to be 100% sure the pump you choose fulfills it. I don’t want a patch pump but if I did I’d want similar flexibility over the 72 hour thing just like you. For me flexibility is crucial. The pump works for me, I don’t work for it.