I am about to start using an insulin pump after 10 years on MDI. I’m interested in getting feedback from all you pump aficionados out there as to what I can expect, learning curves, issues etc. I have been on a CGM for 10 years - currently using Dexcom G7. I admit to being a little apprehensive so I appreciate all your thoughts.
4 Likes
I forgot to mention I will be using the Tandem Mobi pump
I’ve only used Omnipods, so I don’t have any great insights about the Mobi. The number one thing in my opinion for any pump is to dial in your basal program(s) as solidly as possible. That should be the building block you can go back to and rely on when/if the Mobi is not doing it’s Auto-mode thing to your satisfaction. I use the Omnipod on “Auto mode” most of the time, probably 75-80%. But whenever I switch into “Manual mode” (which is the basal program that I entered into the pump) I always feel pretty confident that I know how that basal will work for me. It’s a nice feeling and it took a lot of trial and error to get there.
4 Likes
It’s kind of funny how I started using a pump nearly 3 years ago. I was interested but did not think I would be covered under Medicare as aa type 2. I had a conversation with my endo and told him I leaned towards the Tandem X-2 with C-IQ. I liked that it was intergrated with the Dexccm G6 which I had been using for several years.
Well he put the order in and just before Christmas a box appeared at my house with pump and supplies. There is a 30 day grace period which expired before I could get training. Thankfully I liked the pump.
I did spend that month wearing the pump with a piece of string trimmer line to mimic the tube and infusing site. My trainer thought that was pretty clever.
We set the basal, units/g carb and correction the same as my MDI. The basal rate was fine as C-IQ will adjust up or down based on Dexcom data.
Both U/g and correction had to be tweaked. On MDI I had an HbA1c of 5.5% with the pump it was 6.0% flat for a year. Then I returned to the mid 5% range.
Since then I had chemo, surgery and immunotherapy all of which has caused BG instability. I wouldn’t call me brittle but definitely not my former normal.
This pump is the best fit for me. I fudge the U/g a bit by either overriding the recommended or increasing grams of carbohydrate higher. I tend now to get a postprandial spike 3 hours after eating and will do corrections higher than the correction factor set in the pump.
One thing you will have to learn is which infusion sets are best for you. Hopefully your trainer will give you samples of all the types available.
The MOBI if I understand correctly does not use the cartridge with a bag like the X2, but more like a motorized syringe type reservoir like Medtronic. Some find this easier to fill.
You will need to get used to the new normal, but will find the 3 day cycle an improvement over doing MDI every day.
4 Likes
This is very important (and I confess that I’m a bit lax about this).
Because infusion sites can “go bad” so that you’re not getting sufficient (or any) insulin, it’s important to have an alternative insulin source available (I use a half-unit insulin pen). I experienced this problem this morning—BG starting climbing by 10s out of the blue—and dosed with my pen before I changed my Omnipod. I also gave myself a small bolus with the pump to boost the basal dosing. (Thanks, @Eric!)
Remember…”when in doubt, change it out”!
5 Likes
That is a rule of thumb we can all get behind! There are always some Murphy’s Law issues at play with infusion sites. With the recent heat waves I experienced a variety of pod failures on 6 pods over 45 days. Another good rule of thumb is to always have a syringe and fast acting insulin (or pen and tips) handy to get back under control if the pump infusion site is in doubt or has failed.
5 Likes
Good luck with your first pump! 
Your trainer should give you plenty of good info! Some other tips:
- Beware of doorknobs – my #1 way to rip out a perfectly good infusion site.
- Limit scar tissue by rotating your infusion sites and trying to stay on the replacement schedule.
- If your site hurts, you notice bleeding, or you rub the site and can smell insulin, then it’s probably time to change early! Same thing if you notice a BG rise out of nowhere or unresponsive highs – like @CatLady said, “when in doubt, change it out!”
- I’d recommend getting used to the pump without using the AID system (Control IQ) if possible. Especially while figuring out the right basal rates. Once basal rates are solid, then Control IQ will be able to work with more accurate info! (When you get there, beware that Control IQ will auto-bolus when it thinks you’re going to go high. The number of times I’ve treated a low only to have the “sudden rise” be bolused back down into another low is a lil infuriating. One day I’ll write a letter to Tandem.
)
4 Likes
Thank you all so much for your feedback. I really appreciate them all!! Wow it’s clear there is such a lot to learn!! From all your comments, it’s obvious this device will take some time to master. Hopefully in a few weeks - after I’ve completed all my training sessions - I will be a little more knowledgeable and confident in its use.
6 Likes
@funk I hesitated to respond because others here use Tandem’s, and I’m on Omnipod Dash. Regardless, I think you’ll find pumping quite freeing when compared to MDI. I could go back, even prep to every time I take a trip, but I don’t think I’d like it. As with most things new, you’ll probably stress over the details of filling, placement, etc. But after awhile it becomes the norm. The one thing I don’t care for is the waste stream involved with the consumables (infusion sets, tubes, the pumps themselves with Dash, applicator, etc.); it would be great if the manufacturers could find a way to re-cycle the plastics more. Best of luck and, please, let us know what you think of the MOBI!
4 Likes
There are many youtube videos by Tandem and users you might find useful. Here is one example.
3 Likes