Hello to whoever is reading. I just joined the community for support and answers that I can’t seem to find anywhere else. I was diagnosed about two years ago with a A1C of 14.2 on 3/13/22. With the help of Toujeo and Humalog I was down to 7.4 in July of last year. I tried the Omnipod 5 system to maintain this target but I experienced low sugar levels way too often. I had support from my local rep but I gave up on it. Now that my A1C is up to 8.9 I feel I need to use a pump at this point. My doctor is adamant on the Medtronic brand but I’m hesitant on what I should choose. If anyone has any recommendations I would appreciate it. Thanks.
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I am not a big fan of Medtronic.
There are really only 3 commercial pumps - Medtronic, Omnipod, and Tandem.
With Omnipod Dash, you can use Loop, which is a do-it-yourself pump. You can create your own basal and correction setup.
If that is too much to attempt, the Tandem is an easy thing to try.
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I appreciate your help. To be honest I’m not a huge fan of a tube system it just seems like a lot, which is why I did end up trying the Omnipod 5 initially. I did like it but waking up every night for a week with my sugar at 50 kind of threw me off. I just like how the Medtronic has the CGM built in honestly. Plus the transmitter is good for a year.
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@frostydankbud First, welcome to FUD! You’ve found a good group of people that will offer and seek advice and comment freely!
Pump choice is a personal thing, dependent on your choice of size, tubed or not, type insulin used (some are only “certified” to work with particular insulins, though some here will contend other insulin’s work fine), how much effort you want to put in (ala Loop or iAPS, I’ve used both), if you want a black box approach (i.e. whether you know what the algorithm is), and what CGM (presuming you have one) is used, etc. It also depends on what your insurance will cover (unless your independently wealthy) and where in the world you live.
Some people swear by Tandem T:slim X2, some by Omnipod (I use Dash), others use Medtronic…others swear at them! If you can give us some more info on your preferences and coverage, there will be people here that can provide advice and assistance. One thing I would point out: This is YOUR decision, not your doc’s; don’t be “talked into” a system you don’t like. Get advice here, but do your own research as well as YOU will live with the result and once chosen, most insurances wont cover another choice until the “warranty” period on your first choice expires.
I use Dexcom G6 (looking at the G7) and Omnipod Dash with Loop (though I’m currently trying iAPS) as a DIY AID system. If you’re interested, I can describe it in detail.
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Did you only try it for a week? My understanding is that the algorithm takes a little while (several pods) to figure you out.
Also, did you set your overnight target higher in order to try to avoid overnight lows?
I think I’ve read here that you can also use Activity mode overnight, which reduces the basal automatically.
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With any pump, whether tubed or tubeless there won’t be a magic button that can be pressed to fix BGs. Any system takes rigor and experimentation as you tweak settings to get the kind of management you want, and need. Excessive lows are often resulting from high basal rates or too aggressive of an ISF but these things take testing and tweaking to get correctly set.
I wouldn’t give up on any system because of lows or highs because any system is going to depend on correct settings to operate and manage your BGs correctly.
So, instead of looking to replace one system for another, i recommend you spend a good amount of time learning about all the settings and doing the various tests to determine what YOUR settings should be.
Once you have a firm understanding of what your settings should be without a pump, that can serve as a basis for pump management (which will require additional changes as you get comfortable with the pump.). But having that solid foundation is critical.
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Another option is Tandem mobi.
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The problem is, while the various pumps available, comparison is the classic apples vs strawberries.
There are 3 companies manufacturing about 5 different pump types. Islet has the OminPod Dash and 5 patch pumps lacking tubes. Both have their pros and cons. Many loopers like the Dash because it can be controlled with self built open source software. The 5 is more automatic and works with Dexcom sensor and iirc FreeStyle Libre.
Medtronic has their new signature tubed pump and sensor. Some users have good results while others not so much. There have been issues with the Medtronic sensors.
Tandem has the X2 with C-IQ pump that can use both the Dexcom and the FreeStyle sensors. (If I am wrong on the sensors please correct me.) The C-IQ algorithm works well for some others not so much… This is the pump that I use. Tandem has also released a new smaller pump, MOBI, that uses a short tube infusion set and has the added bonus of a USB-C charging connector. Both have built in rechargeable batteries.
Again there are pros and cons to both pumps.
I chose the Tandem X2 because I figured that I would knock the OmniPod off because I am clumsy. The reputation of the Medtronic sensors steered me away, right or wrong. The MOBI wasn’t available and the X2 connected well to the Dexcom G6 which I was already using. The tubes never bothered me much. My biggest complaint about the tubes is they have a tendency to retain their tight curls. Would like the tubes to be more straight.
Don’t expect perfect. I like having some control over the pump and am apprehensive of anything approaching fully automatic.
- CGM sensors can be in error.
- I am T2DM with varying insulin resistance. Being able to stop, reduce basal and do override corrections is a big plus for me.
This comparison of the Medtronic and Tandem pumps may be helpful…
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Tubes are definitely manageable. I used Medtronic for years and now have had Tandem for about 6 years - I LOVE IT. (I also tried Omnipod and hated it.)
It seems like a lot of docs really push Medtronic for no apparent reason, other than it is what they are familiar with. Keep doing digging on what people like and don’t like, and make up your own mind. You have 30 days (at least) to try a pump, and if you aren’t happy, the manufacturer will take it back.
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I too used tubes for years and didn’t really have a problem. Tubeless is nice for a variety of reasons, but also causes problems with the large pod always attached to you.
For me I’d consider:
Ability to offer therapy needed, by which I mean infusion sets, insulin, sensors, etc. If the infusion set or sensor doesn’t work for you there no point in getting the pump.
Convenience and user experience. This is what eventually drove me away from medtronic after years of using their pumps. The new UX had so many unnecessary checks and extra button presses it drove me crazy. Def demo the pump if you can.
Form factor. Tube vs tubeless, size, touchscreen. This stuff can matter but for me was a lot easier to live with than some of the earlier stuff mentioned. For instance I always forgot my PDM on omnipod, so switching to a phone app made it a lot more convenient.
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Hello everyone - I haven’t posted for a while because I haven’t had much to say, but it’s always interesting to discuss the pros and cons of different pumps. @frostydankbud good luck! I am waiting to hear any user reports on the tandem mobi. That one looks pretty good to me.
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Every pumper has strong thoughts! 
I’ve got the Tandem t:slim X2.
I chose to go with Tandem primarily because of the ability to update the software. When I switched from the Animus (may it RIP), it felt so sci-fi and forward thinking! There have been good UI quality of life updates over the years in addition to bigger updates like Control IQ. I have loved Tandem’s customer service as well.
It hasn’t been absolutely perfect of course. I’m working out the kinks with Control IQ for the first time. I really wish I could customize my BG target for the algorithm. And I’ve found it frustrating when CIQ automatically boluses right after a low treatment because I’m “rising fast” (duh, of course I am). I can totally see why some people prefer the DIY systems. But, besides that, I’ve generally really liked Tandem.
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Not quite sure what you mean. Omnipod and Tandem also communicate directly with the CGM — no relay from another device or anything.
Knowing that would probably help in using Omnipod 5, but, it’s worth noting, Omnipod 5 interestingly doesn’t much care what your settings are. You can’t do a fix like: going low at night? Lower nighttime basal or correction factor or whatever.
I think both Tandem and Medtronic would let you fix that one problem (the nighttime lows) with the help of your doctor pretty easily. I think it could be fixed with the Omnipod, too, but it would be less straightforward.
I also think, generally, that having a lot of knowledge of your diabetes would certainly make pump management better, but I don’t think it’s a prerequisite for using a pump for people who may not be as systematic in their approach to things.
My two cents are that the Tandem mobi might give you two things you’re looking for: not much tubing/ reduced nighttime insulin to prevent lows.
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