Wednesday, December 19, 2012

Question for Type 1 Diabetics about Pumps & Continuous Glucose Monitors

Friends, I’m crowdsourcing a question.
I’m going to put a lot of narrative below, but my basic questions are:
 1)      What pump do you use?
       a.       Why?
2)      What infusion set do you use?
3)      Plastic or metal cannula/needle?
4)      Have you ever had problems with insulin leaking, the cannula or needle pulling out, or any other non-standard response?
5)      Do you use a Continuous Glucose Monitoring system?
       a.       If so, which one?
       b.      What are the pros and cons of that system?
If you feel you can answer those questions without any more info feel free. You can respond with comments, you can email me at, find me on FaceBook as Jules Shore (same picture) or via Twitter @7shores.

Now for that background: My wife, hereafter known as Mrs, has been a Type 1 Diabetic for 51 years. Hold your applause please, it doesn’t mean she’s done everything right. On the contrary, she’ll be the first to tell you she isn’t a good diabetic. She has exceeded all expectations of doctors. 20 years ago when we got married, she was expected to live about 5 years. It’s 20 years later and she’s slowed down some, but she’s still ticking.

Mrs works in a Doctor’s office (Family Practice). About two years ago a Medtronic pump salesperson approached the Dr to get him to recommend pumps for patients needing that type of therapy. The Dr wore a pump for two weeks with saline in the reservoir to get a feel for it. At the same time, they recruited Mrs to try pump therapy too. Of course, she had a real live pump full of insulin. That went well so they added on some other incentives and Mrs became a pumper at the cost of $1500.

Up until that time, our Primary Care Physician was following her diabetes. Mostly that meant checking the A1c and keeping up with prescription needs. They didn’t want to follow her use of the pump, so they really forced us to get an Endocrinologist.

When we signed up with the Endo, she already had a pump and supplies, so there wasn’t any discussion of which pump to use. Within a few months, they were pushing the CGMS integrated with the Medtronic paradigm pump that Mrs is using.

Mrs’ control has been great on the pump, but frankly it hasn’t been the easiest change to make. She had a lot of problems with the first Infusion sets she used. They had a needle inside a plastic cannula. After insertion, you pull the needle out and an internal valve is supposed to keep the insulin from coming out the hole. That didn’t work for us, after a number of instances of changing the infusion set while on the phone with Medtronic customer support, we resorted to covering the hole with tape. On a following visit to the Endo, we were put in touch with a different Medtronic salesperson. They may call them case worker or similar title, but I call a spade a spade. She switched Mrs to the Sure-T infusion set. That model has a needle stay in the whole time, so there is no hole for leakage. Unfortunately it has a smaller patch of adhesive and Mrs has pulled needles out on occasion. We reinsert it and cover it with band aids or tape and change at the next expected change.

Mrs also tried the Glucose monitor system from Medtronic that integrates with her pump. Frankly it was a pain in the ass. (My blog; my rules.) She couldn’t take any of the IV covers they wanted her to use. Tegaderm works fine in the hospital, but after three days around the sensor she’d be all red and bumpy at the edges. Without a cover, the sensor adhesive would sweat off before 3 days were up. In addition, she’d have to check her BG 8 times a day to keep the sensor calibrated.

Thru Twitter contacts, I’ve discovered there are other brands of pumps and also CGMs that aren’t integrated with the pump. So I’m looking for some feedback from real users about their equipment; good, bad, or ugly. I can do research all day long, but none of that is as valuable as the info I can get from real users. Feel free to pass this around via any social media to all of the Type 1 pumpers you know.
 If there are any other sugestions, feel free to share those too. It seems strange to be newbies at the process 51 years into a disease, but it is true that we are newbie pumpers compared to some of you.

Thank you,

1 comment:

  1. I was on Disetronic pumps from the mid nineties, then had to go Minimed in early 2006. I used their CGMS as well. At first it was pretty cool, caught a few trends and I was able to get some levels sorted out.

    In 20010, they replaced my Minimed 722 with the Revel (723) Still used CGMS for a time, but I noticed I started to have more irritation with the sensors, a LOT of inaccuracies, (Sensor says 167, but fingerstick said 88....HUH?) and I kept getting higher BG values than what they should have been

    After a cataract operation, my distance vision was amazing, but I could not read so well anymore. I couldn't see my pump screen without the use of a jeweler's loupe to do the most basic things.

    I then saw a touch-screen insulin pump over the summer, from the Tandem Diabetes company, called the "T:Slim". I asked for a demo and they sent a rep out. I got to play with the pump for some time as he sat there, answering my questions and guiding me when I needed it. No high-pressure, no "Used car salesman" stuff. I applied for one.

    My insurance turned me down, so I appealed based on my eyesight and Maximus Federal appeals overturned the denial. YAY!!!

    Since hooking up to the T:Slim pump, day before Thanksgiving, I have had to lower my basal rates across the board, only upping my insulin to CHO ratio from 1:6, to 1:5g CHO. I don't have a CGMS anymore, Ironically my OneCare Medicare/Medicaid paid for MM's CGMS, but is not going for the G4 Dexcom Why, I guess I will never know, but it may be MM's ability to work with stubborn insurers ... Dexcom G4 is "New" so... well, never mind. My BG's are amazing and my last A1c is at 6.5%!!

    I do think the T:Slim will become more popular when the T:Connect software becomes available in the new year. I've been religious about logging, but I think the software will be a big help in this.

    I've been IDDM for 28 years and at 56 and I guess what could be called a Tech-Geek, This T:Slim has been oddly amazing. I can see the thing to use it, I think it is delivering insulin in a slightly different manner, because my Glucose levels are very responsive to the boluses and any basal changes I've made.

    Ask about the T:Slim. It has been extremely good for me, but you're right. You need to see, hold and try one to believe it.