Pump decision for newly diagnosed 14yo with ADHD

Parenting a D-Child New Child Dx
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Hello all,

Kiddo was diagnosed T1D about 6 months ago at 13. We’re still coming to terms with it. Without going into too much personal detail for him, he’s dealt with other mental and physical health issues all his life including surgery at a young age, another autoimmune condition (thankfully symptom free now) and significant ADHD/anxiety/depression. This diagnosis was a real kick in the gut for a kid who was already struggling.

I’m reaching out for the collective wisdom of the community on how to support him and give him agency in his choices. He is interested in choosing an insulin pump and we’ve tentatively narrowed it down to the T-Slim or the Mobi, mainly due to the Control IQ algorithm. The threads about this seem to be a few years old so I hope bringing this back up is OK.

Tslim - I like:

  • Can still use if (when) he loses his phone or it’s out of battery, or if his phone is in downtime or confiscated (it’s a trigger to stop phone time for nonpreferred but necessary life tasks)
  • Hopefully harder to lose than a phone b/c it’s connected to his body with a tube. He would misplace his own head if it wasn’t stuck on.

Don’t like:

  • Bigger, bulkier, harder to play basketball with - what if the tubing snags or is ripped off? What if he loses the tslim itself?

Mobi - we like:

  • smaller, maybe tubeless soon
  • shorter tube, less likely to be caught/snagged?
  • Attached to his body so he can’t lose it

Don’t like

  • phone required - phone permissions are a hot button issue and family link controls don’t make it easy to navigate this. Also, he’s going to misplace his phone or the battery will be dead. We have a separate standalone receiver for the Dexcom G7 for this purpose, but what would he do to control the Mobi?

Another piece that I’m trying to find more information on is just how much executive function is needed for each approach. Currently we’re not logging anything in the Dexcom app because he has enough executive function to calculate carbs for his meals/snacks but just can’t take the extra steps to log his carbs and insulin (and doesn’t want me hovering over him to ask “how many carbs was that? What did you dose? Did you correct?”). How easy is the Tslim interface or Mobi app to use, and do either of them have a lower barrier / less clicking?

Thanks in advance for any thoughts.

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@Squirrel Welcome to the community. It appears you are doing a good job of thinking through the pros and cons.

I am a T:Slim user who while not a 13 year old am still quite active at 76.

When my pump warranty expired Tandem was pushing the MOBI hard. I stayed with the T:Slim because of:

  1. MOBI requires a phone to operate. T:Slim’s phone app is more limited than the MOBI as the one active thing you can do is bolus.
  2. I was having to use more than 200u in 3 days because of prednisone.

I still remember the high activity of a teenaged boy having been one and raised 4. I know that Basketball has some contact even though it is supposed to be a no contact sport.

This is a problem with all pumps whether patch type or tubed. A pump held to the body with adhesive can be pull off.

My solution to an athlete using a T:Slim pump is to use a belt worn under clothes. I use an “invisible belt” which is elastic and I can clip my pump to it. This one I just found looks better.

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It’s from glucolgy. I don’t have any personal experience with this product. It just looks good to me.

One other bit of advice on the T:Slim. The bluetooth signal is received on the front. This means the front of the pump should not face the body. Early on after getting my pump I tried spibelt which has a zipper iirc pouch for excess tubing and the pump. The problem I had was the pump would turn around in the pouch losing signal from the CGM.

Good luck to you and your son.

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