I need advice about a pump and CGM


(Chelsea) #1

My son is 7 and has been diagnosed for 6.5 years. At the beginning of August we decided to switch to the TSlim and Dexcom G5. We’ve had so many issues with the whole system. It is very frustrating and I’m not sure what to do. We have only made it a handful of times the full 3 days between sensor changes. For example I changed his site today and his sugar is currently at 380. It only seems to work part of the time which is more frustrating than not at all. (Yes I’ve adjusted Bolus numbers numerous times). We have also had 2 infections from infusion set sites. Did anyone else have a rough time getting started and if so how did you handle it. Any advice would be greatly appreciated. I can see small glimpses of this being wonderful but so far the bad is out weighing the good.


(joe) #2

@chelseahyland hi Chelsea

starting a pumps and a cgm may be asking a lot. in my opinion, starting on a pump for the first time took all of my attention, for months. The first month I thought I was going to throw my pump out a window. now that it’s set right it has become much more of a background thing.

the most common side effects of a pump that I have seen are; infusion set site infections, irritations, inflammation, scarring, and (and this is my favorite) low blood sugar. the list is here if you want to see it https://www.tandemdiabetes.com/important-safety-information

so while starting a pump is a big deal, so is starting a CGM. sensor locations, reactions, a sense of sensor lag, sensor calibrations, alarms, communication between the sensor and the pump are all complications to an already complicated system. The fact is that all CGM are inaccurate, they all need careful calibrations, and they are years away from replacing a finger stick blood meter. The CGM will simply not work on some people.

okay on to the advice: breathe, take it slower. concentrate on the pump. get the book “Pumping insulin” and read it. wait until the pump and all the pump things are secondary and you are comfortable and feel like you are in control… then start the CGM. this isn’t a race. book yourself 6 months on just pump stuff and basal tuning.

once I got to a more comfortable point, using a pump became a great tool and a great decision. I have better control, more flexibility, and I can withstand more schedule (activity and meal) inconsistencies on a daily basis.

good luck!


(Larry1) #3

he may be having a reaction to the adhesive on the inserter if it was a skin infection. I use the Dexcom G5 Mobile and an Animas One Touch Ping and have had little to no problems with the two but you have to realize they aree not paired, I must enter values manually into the G5 Mobile. I have heard similar problems with the new Medtronics units that are paired and frequently do not work properly. enought said about that, were the infections skin related or worse? You can call and or email Dexcom and the TSlim companies. After ifinally got through ti ?Dexcom they were very helpful and replaced the original receiver unit that came with the CGM. However, i also agree with @chelseahyland
in that it can be challenging with just a pump and add a CGM too, quite a bit to learn all at once. I had my pump for quite a few years before i got my CGM. This is the best part of her reply - "
@chelseahyland hi Chelsea

starting a pumps and a cgm may be asking a lot. in my opinion, starting on a pump for the first time took all of my attention, for months. The first month I thought I was going to throw my pump out a window. now that it’s set right it has become much more of a background thing.

the most common side effects of a pump that I have seen are; infusion set site infections, irritations, inflammation, scarring, and (and this is my favorite) low blood sugar. the list is here if you want to see it https://www.tandemdiabetes.com/important-safety-information

so while starting a pump is a big deal, so is starting a CGM. sensor locations, reactions, a sense of sensor lag, sensor calibrations, alarms, communication between the sensor and the pump are all complications to an already complicated system. The fact is that all CGM are inaccurate, they all need careful calibrations, and they are years away from replacing a finger stick blood meter. The CGM will simply not work on some people.


(timothyputman) #4

Hi Chelsea,

Father of an 11 year old, diagnosed 10 years. It seems everybody’s different and you have to find what works for you. We’ve used Dexcom CGMs for about 7 years, and a Medtronic pump for about 3. Dexcom is a gamechanger for us, and my recommendation is to start with the CGM first. The feedback it provides is priceless, plus peace of mind, plus more lifestyle flexibility because more people are comfortable taking care of a T1D when they can see the blood sugar numbers all the time. The Dexcom is , for us, super accurate and dependable. More accurate than finger sticks most of the time. We tried the CGM that pairs with the medtronic pump and it didn’t work for us.

The pump has been a chanllenge for us. It helps us to change every 48 hours, no matter what - we don’t wait for sites to go bad and struggle with bad numbers for hours. it IS much more convenient than shots, but as far as control, we actually did better with shots and CGM than with just the pump or even pump and cgm.


(Trippa) #5

Chelsea, we used the MiniMed Paradigm for four years and just switched over to the 670G. The best change we ever made was actually changing the infusion set type. For Tandem I would highly recommend the TruSteel 90 degree set over the other 30 degree angled sets. When we switched (using the Medtronic equivalents) we found significantly fewer “bad sets” or delivery issues and my son says these sets are much more comfortable. I don’t know which kind you are currently using, but this may help if you are using the AutoSoft or VariSoft types.
I agree with the Larry and Joe about getting the pump down to a science before trying to add the CGM to the mix. We tried the CGM for a while and my son didn’t like the additional set. He is 14 and was diagnosed 5 years ago and the pump has made management much easier on him and us. He maintains a sub-7 A1C at every appointment so we must be doing something right.