FUDiabetes

New pump/cgm

Hi I’m new to this forum. I’m looking for info on cgm/pump combos. Which ones people use & why do you like them.

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Welcome to FUD @2maus! Interesting question, however it is a little bit of a tough question to ask since we don’t know where you are in the world and what options are available. I will say that the two most used pump/CGM combo’s on this board are the Omnipod/Dexcom G6 and the Tandem Tslim/Dexcom G6. A third, less popular option is the Medronic 670/770 pump/Guardian CGM system. Finally there are also people using various other pumps that are available in different locations in the world.

The biggest differentiator between the Omnipod/Tandem and the rest is the Dexcom G6 CGM system which is superior in our collective experience to the Medtronic Guardian system.

For people whose insurance or location won’t allow the Dexcom system, the Libre system is a close second, and I would guess would be judged superior to the Medtronic Guardian system in ease of use and accuracy. The problem is that the Libre doesn’t integrate into pumps or looping systems as easily as the Dexcom.

Others will chime in shortly I am sure.

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Thanks

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And right now this combo is a DIY option with the “old style” Eros pods.

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Check availability of CGMs first; you are not likely to find you have much of a choice. The Libre system seems to be the only one that is paid for in the UK; I think some people use Dexcom stuff but they pay themselves and that’s quite a big bill. Libre isn’t “continuous” but you can get readings immediately so it works with a pump. A true CGM gives you rise/fall rates and that can be extraordinarily valuable when working out pump corrections. Not true; see [1] at the end.

Pumps are determined entirely by your lifestyle. If you are very active then you might want to consider just using a CGM and staying with MDI; pumps fail and sometimes detecting the failure is difficult. I use the Omnipod Dash system and mine failed today; my BG was 178mg/dl (10mmol/L) after strenuous exercise but my blood ketones were at 0.6mmol/L, oops; I’m back on MDI until I have stopped the strenuous exercise and am doing something less damaging to my pump.

If you can, trial the pump first; then you have no investment and can go back to MDI or try a different pump if it isn’t working out. It is extraordinarily difficult to predict how a particular pump will work if you haven’t used any pump yet. There certainly is no answer to the question, “What is the best pump?”

Different pumps are available in different countries and they are all very different in design and affordances. If you spend a lot of time in the water that will be a major consideration; this is half of the reason I use the Omnipod, the other half is that I live in the US and when I started using it it was the only waterproof choice. The lifestyle issues will almost certainly leave you with no choice, so then you work back sacrificing some considerations in favour of what you hope will be the benefit of using the pump…

When I started out I used the Omnipod and the Dexcom G4. This did not work - the G4 errored out after 24 hours and it invariably did so in the middle of the night while I was asleep; I sent it back and asked for a refund. I stuck with the Omnipod and it was great; it was a pump so I could basal and bolus to my requirements of the day and it was waterproof so I got this without having to unhook myself before getting into the water.

When the G6 was introduced by Dexcom I tried CGM again and this time I got something that I could use; something that worked for me. It’s most definitely not necessary to do pump and CGM at the same time and it may be counterproductive. Both the Omnipod and Dexcom are annoying, but I’ve adapted to those annoyances and can benefit from both. Having both of these mediocre pieces of medicine dumped on me at once could easily make me give up on all of it, so my personal view is that it is better to start with one (CGM or pump) then, if that works, proceed to the next step and if it doesn’t drop the first and try the second.

[1] I updated the post because I was wrong about the FreeStyle Libre 14-day system; it is monitoring continuously, so it is possible to obtain rise/fall rates and therefore get the data that I regard as necessary for pump bolusing.

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