Medical devices

Hey! I was recently diagnosed T1D a few months ago. Ever since I have been having extreme high numbers and extreme lows and I’m having difficulty managing. I’ve been talking to my doctors about going on a pump and a meter implant. As a community I was hoping I could get some opinions on these kinds of devices. Such as cost, accuracy, maintenance, etc. thank you everyone for your help!

Hi @Katyarvt Katya, there was only 1 fully implantable pump I read about and I don’t think it was approved yet, were you interested in the more standard pumps like Medtronic, Tandem, or the Insulet omnipod? There’s plenty of people on here that pump.

Most typical CGM are sensors that just pierce your skin but there is an implantable version called Eversense, but it’s pretty new and doesn’t integrate with pumps yet only meaning the Eversense is not currently part of any closed loop pump systems such as the Tandem/Dexcom or the Medtronic 670g/Guardian as 2 examples.

A good way to learn is to make appointments directly with Medtronic or Tandem and have the sales reps do their thing and show you how each work and to contact your insurance for estimates of out of pocket costs.

Good luck.

Hi Katya @Katyarvt as @Joe said you have choices and the way for you to decide if a pump is your right for you is discussion with your medical care team and then meet personally with the pump and CGM manufacture representatives - consider your lifestyle and cost. All pumps have minimal maintenance requirements but the infusion-set changing differs. Insulet OmniPod is a one piece throw-away.

In addition to the suppliers Joe mentioned, there is also an inhaled insulin - Afrezza - which does not use a pump and the insulin does not require refrigeration. Currently a friend of mine, 20+ years living with TypeOne, is hiking the 2,000+ mile Appalachian Trail and is now past the 1,400 mile mark while depending on Afrezza inhaled insulin and the implanted Senseonics Eversense CGM - both well suited for active, rough lifestyle. Prior to the inhaled and implanted devices, he used a standard pump and CGM; I’m waiting for him to return next month and hear his “diabetes report”.

Katya @Katyarvt what I didn’t mention earlier is your extreme “highs” and “lows”. Being newly diagnosed these swings can be expected while you and your body adjusts to a new, different life; you may also be in a “honeymoon” phase where on occasion your pancreas will resume making insulin.

BG Readings are really nothing more than markers from which you make decisions about insulin dosing - both background insulin dose and meal-time bolus insulin. For example if three hours following a particular meal you have a high reading, you may need more bolus insulin for the number of carbohydrates you had at that meal - or possibly, you didn’t count all the carbs you ate. Your medical care team can give you pointers on calculating insulin doses and carb-counting.

The cost of insulin pumps is high - but for many the cost can be off-set by insurance. The pump [and CGM] manufacturer representative can usually do the “leg-work” to get you the lowest out-of-pocket cost. After you get the pump, you will have the on-going expense of infusion-sets which need changing about every three days.

You are entering the world of diabetes at a time when technology is helping us a lot. By implantable, I assume you are talking about Continuous Glucose Monitoring Systems, which can provide a blood glucose reading every 5 minutes. That much data can be overwhelming even to an experienced diabetic, UNLESS it is paired with an insulin pump that can use the data automatically. That is a game changer. For right now, I suggest you take a long look at the Tandem t:slim X2 insulin pump, paired with the highly accurate Dexcom G6 CGMS. This combo, especially when Tandem releases its Control IQ software update shortly, will help smooth out your highs and lows with its automated adjustments to insulin doses. It isn’t magic, but it helps a lot. And it won’t become obsolete overnight, because the software can be updated. Medtronic still does not have that capability. Good luck with your decision!