I Need a Pump. But I Don't Know Where to Begin!

Technology & Management
#1

Hi there! I’ve been a diabetic for 46 years, and I’m just now deciding to use a pump. (I know: Welcome to the 21st Century.) I’m a bit nervous about switching, but I need to make the transition as my blood sugars have been bouncing all over the place in the last year or so.

Anyway, is there a pump with CGM capabilities I should start with? I’m a bit tech illiterate, so the simpler, the better. What do you recommend?

Also, after the pump is acquired, what are the supplies I need to have refilled/restocked? Where do you get the insulin for the pump?

Any help you can provide would be greatly appreciated! Happy holidays, everyone!

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#2

Hi @JTwithJD. It’s great to hear you are considering upgrading to a pump! When people start thinking about it they probably broach the epic with their endo first but you’ll find lots of help here. I use Tandem’s T-Slim pump which works with Dexcom’s CGM to adjust for high and low glucose levels using a program called Control IQ. There is another program called Basal IQ that adjusts for lows only. From what I’ve seen on this forum is say most people use CIQ but if you want to look into them discuss the details and benefits of each with your doctor. If you use CIQ right now there is no way to go back to BIQ. I’ve heard a few regrets about that.
Medtronic makes s pump with its own CGM. There are lots of opinions about one vs the other here on the forum and I don’t want to influence you so I encourage you research for yourself - here and elsewhere - what user opinions are. I used to use Minimed (Medtronic) pumps but switched to Tandem before trying Medtronic’s CGM. The pump itself was great but I liked Tandem’s slimmer profile. I’m very happy with the Dexcom CGM and how it works with my Tandem pump to adjust, but that still relies on the user having good settings in place (your doctor will help you with that) and inputting carbs, etc.
I suggest you call your doctor to express your interest and they can get you started and let you know what you need to know to get the most out of the technology.
As for supplies: I’ve always gotten mine from an online supplier - they send the cartridges that holds the insulin, the infusion sets that transfer the insulin from the pump to your body (there are different types), and the needles and syringes to fill the cartridges. The insulin itself I get from my local pharmacy although in the play I’ve gotten it through mail order as well. If course your doctor will need to give you a prescription for those items and the pump. Their office may know what supplier works with your insurance if you have trouble finding it in your documentation. You can expect to go through some training before you start - either with your DNE or a rep from the company you choose. I believe they are the ones that will handle things with your insurance when placing the order.
I hope this helps and gives you something to start on. Definitely contact your doctor to express your interest!

#3

@JTwithJD Hi J.D., and Welcome to the JDRF TypeOneNation Forum! Only 46 years without a pump? Just about like me, I began with a pump in my 47th year, and now I’m happy using my fourth pump.

Keep in mind, that a pump will NOT, by itself “fix” your bouncing blood sugar - a pump is only as good as the data you feed into it. As the accountants are know to say GIGO - garbage in, garbage out. That said, the pump with continuous glucose monitoring system I’m currently using is almost fully automated - it is known as an iAIDs, an Integrated Automated Insulin Delivery system. It is the Tandem t-Slim x2 pump paired with a Dexcom G6 continuous monitor, and is controlled by the Control IQ [CIQ] algorithm. Three different physician prescriptions are needed for use of this system.

I suggest that tour tour the Tandem [tandemdiabetes.com] and the DexCom [dexcom.com] websites and learn for yourself what these devices might do for you. Both of these companies post really good videos demonstrating capabilities, there are also many user videos available on the web.

Supplies; yes in addition to the pump [the Tandem insulin infusion pump is actually a sophisticated, rather expensive computer], you will need infusion sets - the piece you stick into your body and change out at least every three days, and insulin cartridges which you fill and replace when you change infusion set. You can get insulin from your usual supplier; pumps require Rapid-Acting [not Fast-acting] Insulin formulation such as Humalog or Novolog.

Continuous Glucose Monitoring [CGM] system requires a Receiver /Reader and sensors that you implant in your body, and change out periodically. The DexCom G6 must be changed every ten days. I use my Tandem t-Slim pump as my primary CGM receiver.

Good luck with your search. This is a change that will need to be approved by your attending physician.

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#4

Wow! Congratulations! I’ve been a pump using for years, starting with Medtronic and then adding in the very-easy-to-use Libre cgm. In my opinion, this is a great entry level cgm to use with a Medtronic pump (which won’t communicate with the state-of-the-art Dexcom cgm), but if you have never pumped before, why not start with the best?It will be a learning curve no matter where you start. This year I switched to the Tslim pump with Dexcom cgm. I started with Basal IQ (as required by my insurance) and then quickly moved to Control IQ. I have zero regrets, knowing I am getting the very best technology has to offer at this time. As has been pointed out, it won’t smooth out all your highs and lows, but it sure does help. This forum has also been extremely helpful to me throughout the process. There always seems to be someone else who has experienced whatever problem I encounter and who is willing to offer their wisdom. Don’t hesitate to reach out! Good luck.

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#5

I have to add, I keep a Freestyle on hand as a backup. I’ve found my Dexcom to be very reliable but it’s always good to have a “Plan B” in place. If you haven’t used a CGM the Freestyle might be a good place to start. It doesn’t have all the bells and whistles of a Dexcom so it could be a good way to ease in. It had its own receiver and I think it will connect with your phone but I’m not sure about that.
Dexcom can also be used with its own receiver or a phone. No pump needed for either of these so you could stay on CGM alone if you wish.

#6

You’ve gotten terrific advice already, so mostly I’ll just add encouragement. My daughter was diagnosed at 6, and stayed old-school until this year (she’s 12 now, which I still can’t get over :slightly_smiling_face:). But when her numbers started fluctuating like mad overnight, and our endo said hormone surges and growth spurts happen when you sleep (and your body doesn’t send you a memo about which nights, either, so it’s not like you can adjust your injections accordingly), we took the plunge.

Tandem tslimx2 with Control IQ paired with the Dexcom G6 for us, too. It’s great. I mean, it still sucks to have diabetes, but the pump that talks to the CGM is a great tool. It really has helped. She can stay asleep, and the pump works to correct her BG, and she can stay asleep. Did I mention she can stay asleep? And so can I. :slightly_smiling_face:

The substantive advice I guess I can add is to manage your expectations. There IS a learning curve, and you’re going to need to be patient and attentive and resilient. Expect challenges, and approach them like the outstanding problem-solver I’m sure you are.

And let us know how it goes, would you?

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#7

@JTwithJD,

What the above commenters have shared is good. Pay attention to @Dennis, & @wadawabbit, their words are true and can be trusted as wise and sage advice.

My only add on is old style pumps are just an extended insulin injection, a wee bit over time with good clocks.

New closed loop pumps, like the Tandem X2 with Control IQ technology, a pump with CIQ software watching a CGM & dosing insulin based on the way software reads the glucose level is a whole new ballgame.

Think of flying a single engine private plane compared to watching the autopilot on a 500 seat commercial airliner making an automated landing by instruments and GPS.

Welcome to a new world.