So, first, I’m a 33 year old adult that is newly diagnosed. A few weeks ago I was hospitalized in DKA and then diagnosed with type 1. I went in thinking I had the flu only to have my whole life change. It’s been a bit of a struggle adjusting, accepting. At any rate, I’ve been looking into CGM and pumps. From reading posts here is seems like the Medtronic CGM can be really unreliable, painful, and is currently out of stock. I think I’ve made the decision to go with the Dexcom but I can’t make up my mind on the pump. I’m a little apprehensive of the units with tubing. My big concern is sleeping, I’m kind of a crazy sleeper that normally sleeps on my side and i’m wondering if having this attached to me at all times will create an issue for me or if I might accidentally rip it out while sleeping? For that reason I like the Omnipod. That being said I really like that the t:slim is updateable and that with that unit I could have the option of closed loop later this year. I do also like that the Dexcom automatically communicates with the pump. I’m not a super decisive personality to begin with and knowing that this will be, at minimum, a 4 year investment makes it that much harder. I’d really appreciate any feedback from folks that have used one or both machines to help me make this decision a little easier. Thanks in advance!
@Lonardh hi Amanda,
CGM - some people are fine on the medtronic CGM, some aren’t. the ones who aren’t will surely be more vocal about it.
Some are fine on the Dex… some aren’t the thing is that CGM simply are not going to work for everybody.
all pumps are essentially the same. pick the one you like, even if it’s because of the screen the color or the cool controller. seriously. it also helps to find out in advance which pump your insurance provider covers better as pumping is very expensive compared to MDI.
I didn’t like the pod because (and this is an opinion) I figure that with a completely disposable pump battery and infusion set, the instrumentation (such as the pressure sensors and motor sensors) have to be throwaway too. that scares me because it’s these sensors that can indicate occlusion and internal problems. the other reason was sleep - with the hockey puck glued to you (and I prefer my upper butt) there’s no way to sleep on it. with the “pager” you clip it anywhere and you can actually sleep on your infusion set…
again - that’s just my bit. if you call Insulet or go to their website they will send you an empty pod you can glue it to your backside or arm and sleep with it… for free! best to try before you buy!
I actually just did that earlier today! I didn’t know that was an option until I was fooling around on their site.
Thank you for replying, I definitely appreciate your insight! I feel so overwhelmed by everything still.
@Lonardh Amanda - its gong to take a while before you get used to the idea of being your own primary care physician. “Think Like a Pancreas” a really good book for all things type 1. if you can get a CDE (certified Diabetes Educator) on your medical team it would be very helpful especially in figuring out how to make diabetes fit into your life and not the other way around!
Hi Amanda @Lonardh,
Welcome! Yes, you have choices, and at this point in your lifelong career with TypeOne Diabetes you should listen carefully to your health care team - well, you are probably just beginning establishing relations to assist you with diabetes management.
For a comprehensive buyer’s guide of all pumps and CGM, and other diabetes related stuff, I suggest that you look at the current issue [March / April 2018] of Diabetes Forecast Magazine the publication of the American Diabetes Association; online at diabetes.org . No one size fits all, and I’d suggest that you don’t jump in to pumps too quickly - a really good endocrinologist and diabetes care educators will tell you the appropriate time.
Disclaimer: I have been a Reader’s Panel member for Diabetes Forecast and did editing [my last official duty] on the issue I’m recommending.
Thankfully, I was set up with the CDE and endo before leaving the hospital. I only started looking into pumps when my endo recommended I talk with the CDE about them. He seemed to think I would have an easier time of it with the pump and I think he might be right. Plus, with the hospitalization I’ve met my deductible with this insurance so they wanted to go ahead and process that claim. I think I may be switching jobs in the next couple of months as well, which means new insurance. If my current insurance pays out for a machine and I switch am I still locked into that machine for the warranty period? Or will a new insurance pay for a new machine? Not that I’m trying to get multiple machines I’m just worried that I’ll choose wrong and hate it. I had seen the recommendation on other posts about the Think Like a Pancreas book so i’ll Definitely check that out as well as the publication in the magazine mentioned. Thank you guys!
@Lonardh hi Amanda,
If you are using a company sponsored insurance now, and you switch to a different company, and also a different insurance provider, then they might start your deductible at zero and it will be like your first pump.
If you switch companies but the insurance provider is the same… the deductible may not carry but I’d be willing to bet that they would want you to stick with the pump until the end or warranty. More importantly, some companies cover diabetes differently than others, some have different deductibles and different “formulary” (whatever drug, medical product, or machine) they like best.
Yes, the warranty is on the PUMP, the insurance company has nothing to do with it once you receive it. Ask whichever company you want to start trying if you can return it if you find it doesn’t work right for you. I’m pretty sure Omnipod will do that for a new customer within a reasonable time frame, possibly as much as 3 months according to something I saw elsewhere, but check with them in any case.
You have to understand that taking back a rejected pump is the best thing they can do for public relations: no company wants unhappy customers complaining on the Internet!
Besides which, where do you think they get pumps to replace bad units with?
I have the Tslim with Dexcom. I recommend. The greatest invention since the wheel. I’ve had several pumps and this is the best by far. Wish you the best.
I recently made the move to the Omnipod and Dexcom 3 months ago and I’m happy.
I went with Omnipod primarily because I didn’t like the idea of being hooked up with a tube. I like the system so far and forget that I’m wearing it, even when sleeping. I too was worried about sleep since I can be restless, but I barely notice it.
I got a demo kit before opting in and that was helpful when making my decision. I’d recommend that if you’re not sure.
Hi Amanda. Thought I would throw in my opinion, too. I was on a Medtronic, tubed, pump for 17 years and changed to the Omnipod pump and Dexcom G5 CGM a little over a year ago. I totally love the Omnipod. I hated having to unhook from the Medtronic to take showers and really got sick of the tubing. Also, the automatic inserter for the Medtronic infusion set was regularly getting stuck. I have been diabetic for over 50 years and have never been happier with the insulin part of my care since I changed to the Omnipod. I also like the Dexcom CGM and I have read recently that Omnipod is working with them to connect the two systems. I don’t mind waiting since I absolutely do not want to go back to the tubing!!! Hope you are happy with whatever you choose.
I have worn an Omnipod for 7 years and it has changed my daily quality of life! One thing is that it is tubeless and wireless and can be worn 24-7, changing the pod on average every 3 days. You can sleep in it and swim in it etc. The pod is quite small and makes it easy to wear all types of clothes. Getting ready to add a Dexcom this year to get an even tighter control on my BS.
Good luck to you!
I have used both tSlim and Dexcom. I have also used two other pumps with tubing. I sleep on my stomach, my back, and either side, as I have to keep moving in order to prevent arthritis pain. None of my pumps has been a problem. I put it in a pouch around my waist and keep the pump in the small of my back most of the time. I never notice no matter what side I am sleeping on. But with a waist pouch, you can also rotate the pump around your waist to the opposite side from which you are sleeping on. The pouch cushions it, and I use an elastic waist band that I can slide up and down my torso depending on where the infusion set might be inserted.
As to the pump, tSlim is the smallest. And I liked it best when I could use the tSlim with the Dexcom so I didn’t have to carry around two objects at once. (I put them in my pockets normally.)
As I recall, each of my pumps came with a clip-on case, although I didn’t care for them myself. I’m a “rotisserie sleeper” so instead I tuck my T-slim in my waistband or pocket if I have one - in that case I just have to remember to grab it when I invariably get up to use the bathroom overnight.
I had thought about the Omnipod once, and got a sample of to try, but I decided against it because I didn’t want to have to use a remote to control it: I was afraid I might forget it, then I’d be stuck!
I also use a T-slim CGM which I love. I keep it in a Vera Bradley ID around my bed post overnight.
I’m using Tslim as well and like it slot, but considering Omnipod. I’ve never had issues with the tubing while sleeping and I’m a roller. I just lay it on the bed and it follows me around. I love my CGM as well… almost more important than pumping in my opinion. Another excellent read Dr Bernstein Diabetes Solution. He also has a lot of podcasts on Utube called Dr Bernstein’s Diabetes University. Both he and author of think like a pancreas follow a ketogenic diet. Look into that as well. I went from 8.1 to 6.6 A1C after starting it and only been 6 months. Good luck! Reach out anytime.
If I were you and your insurance will pay for it, I would get the new Medtronic 670g pump and CGM. I don’t think the T-slim closed loop will be out till later 2019. I was on and older Medtronic CGM for about 10 years and got totally sick of both its inaccuracy and their customer service blaming me in so many words. Now that was the one that came with the Medronic 530g pump. The 670g came with a newer CGM which my doc says is pretty accurate. I understand the new 670g closed loop pump and CGM, is tested as very accurate, but I have not used it. It maintains glucose between 100 and 120 except for post-meal peaks which shoot up to maybe 160 before coming quickly back down. Not shabby.
The closed loop pump works well if you accurately input the meal carbs. Future pumps should be able to respond to any food amounts you eat within reason. If food stays in the stomach longer control will be less accurate. And of course exercise is a big factor. You will learn your own body and its response to different inputs.
The hardest part of control is the protein and fat content. The protein affects the glucose levels beginning about an hour after eating, as do complex carbohydrates. The fat hits about 2 to 3 hours after eating, at least for me. I have been working with doing things like temporary elevated basal to handle the fat and a square wave bolus to handle the protein, leaving the instant bolus to handle fast carbs. Working well as long as I have an accurate CGM, which w/o doubt is the Dexcom. When I switched to it, my A1c went from 7.5 to 6.5. As with any sensor, it needs about a day to get “wetted in,” after which the Dexcom nails the glucose, so much so that I rely on it for pumping. I only check myself about 2-3 times a day. I put on a new sensor to get wetted in a day before I change over from my prior sensor. That reduces the needed calibration period. My 530g expires in 3 months and I may wait till Dexcom or Omnipod comes out with closed loop; haven’t decided. I could try the 670g for a month and if happy will keep it.
I am okay with tubing. I use only my arms and belly, since they are the most accurate, at least for this overweight person. I put my shirt on after installing the sensor on my arm which keeps it out of sight and doesn’t get in my way. For my stomach I use the shortest tube. Pump is on my belt on the same side as the sensor. I tuck excess tubing into my pants.
When the new super-fast acting Fiasp insulin is okayed for pumps, we should be able to drive post-meal peaks out of existence with pump use. My doc swears by it.
The nice thing is this: whatever pump you buy with insurance supposedly includes a 30-day money back guarantee. That means you want to learn all you can about a pump and CGM before buying it. Ask for literature, downloads, etc.
Hi! My name is Gabrielle and I’ve had diabetes for almost 10 years and have had experience with pumps, CGMs, injections, and all the fun stuff that goes with it lol. One thing is that I’ve used a pump for about 5 years and it only ripped out twice… I wouldn’t worry about that too much. If you have other questions feel free to ask me
I was in a study way back in the 80’s where we were the “guinea pigs” who had the opportunity to wear the pumps and be in an experimental group to change diabetic treatment plans. I’ve been wearing a pump since 1990 and have always worn a Medtronic/Minimed pump. They have fabulous customer service and I have been 100% satisfied. You’ll need to figure out how to sleep with it. In the beginning I used the longer tubing and put it under the pillow next to me until my cat chewed through it in the middle of the night! I now use the shorter tubing and hook it onto the band of my underwear. ( I did have to try several brands before I found one that had a stronger waistband than others…I chose Jockey bikini and they work well for a pump user! It stays put and I am a side sleeper. I don’t even notice it being there. I also have a Dexcom after attending a session with CGM wearers and the preference seemed to be Dexcom over Medtronic.
I hope this helps! Feel free to reach out if you have further questions.
PS My daughter uses a TSlim and a Dexcom and seems to like it. She used to have a Medtronic but liked the techie features of the TSlim as a teenager. Recently I asked if she likes it better since it’s time to upgrade. She said she does not prefer one over the other but she doesn’t like the syringe filling features of the TSlim.