FUDiabetes

Pump Decision

Hi all,

I got good news this morning that I am signed up for the first pump education class in June to transition my 8 year old son (dx about 6 months ago) to a pump. First class will be just information on all the pump options, etc, but after that we can decide and move forward with a pump.

So I wanted to reach out and get input/information/considerations on the different pumps. The decision basically comes down between the Omnipod or Tandem, and fortunately our insurance will cover either, so there should be no issues there.

If you use a pump, or your child uses a pump, any feed back on the pros and cons to that pump, anything I should consider or quirk I may not have ever thought of, would be so greatly appreciated.

I realize it will be another transition, and likely some bumpy weeks as we change from MDI to a pump, and yet another learning curve, but the impression I get is that it will eventually make our lives much easier.

I’ll leave it at that! Thanks!!

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We selected Omnipod primarily because we didn’t want Liam to be tethered down by tubes that, at his age, would have most certainly been snagged all the time, and forced many unwanted change-outs. There were other smaller reasons but that was the primary reason.

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No child to speak of.
But I feel that the Tandem pump would offer better control when paired up with the Dexcom G6.
The tubes will be a factor for a young one (they are for us older children as well :wink: )
But he could learn to get used to them.
The Omnipod can still get knocked off, but would still be a great option for a young child.
I wouldn’t overlook the huge quality of life given by Tandem’s current logic on their pumps to keep us in range! I feel this is one of the biggest changes I have seen.

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Liam knocks off one, on average, once every two months. Not bad at all and we don’t use Tegaderm or anything else.

Omnipod + Omniloop + G6 = great quality of life as well. We just finished our Endo visit yesterday and Liam has a 5.6% A1C and over the past 90 days, he’s been low/severe low < 1%. Loop is some work getting dialed in, but once dialed in, I can’t think of any way to improve Liam’s control/quality of life.

There are many options and they can all be great quality of life, but it’s all in which direction you want to go and whether you care about “approved” looping methods and other management things, or if you’re comfortable as I am with DIY methods since current approved mechanisms don’t yet exist.

Over the years there have been many threads that have delved into the pros/cons that each person/methodology have found in their chosen path.

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It takes a few months to get the hang of pumping. Best advice ever, “If in doubt, change it out”. That is because in addition to everything else you will have a new mechanism of failure (the set or omnipod site). When starting, my other recommendation is when you have an unexplained high treat it with an injection and then troubleshoot the problem.

As for the choice, you can make no wrong decision here, I would go with what your son feels best about and don’t be afraid to ask for each of the systems to trial at home with water to see which one he likes best. This is really a preference item. My son chose the Tandem and has been pumping for more than 5 years. We tried the Omnipod and my son didn’t like it as much.

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Yes, there are looping options for the omnipod and people seem to be happy with how it works as well.
But like you said, not sure how everyone is with the DIY approach.
I think most systems going forward that can do any real looping or corrections with a good working CGM will work great. Just need to figure out which works for both child and parents.

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People are extremely opinionated on this. :grinning:

Ultimately the most important thing is for you to check them both out and ask a lot of questions. And hopefully the people in your doctor’s office won’t try to sway you either way.

Of course the pump reps will try to sway you, but you already know they are salesmen!

And please make sure your son is involved in the decision. I know he’s young, but he is the one that has to wear it.

See if you can get an extended test of them both - like for several days. Like you can fill it with saline and actually have your son wear them each for a few days and do the bolusing and everything. Just looking at brochure’s is not the same thing!

I am happy to answer any specific questions about my pump because I think I know it really well.

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Tandem doesn’t give the test/trail units, but your Dr might.

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Our doctors office happily provided a demo pump to trial for a few days. Tandem’s official stance may be they don’t provide them, but the local rep should if they want more business.

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Couldn’t agree more!
I wish Tandem did more in this area.
That being said, I think most Drs will have something you can try out. Even if it doesn’t really work, just having a real experience of something new attached to your body 24/7 is invaluable.

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Wonderful, thanks for the tip! It wouldn’t have occurred to me to ask for a demo h go or a few days. That’s great.

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I heartily endorse this advice, no matter what pump you choose!

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It’s important to know which CGM you want to use. I personally would let my cgm preference drive my pump decision vs having the pump drive your CGM decision.

Can you elaborate a bit on why this is important?

I would go with the Tandem if your child is large enough. It has a program that automatically adjusts insulin. We use Omnipod and Loop because my child does not meet the minimum weight requirements of the Tandem algorithm, but fine tuning the settings in Loop takes a lot more work. And your child will have to remember more stuff to carry everywhere – a phone needs to be near your kid at all times, as well as a little extra microcomputer (called a RileyLink or OrangeLink) to take data from the sensor and use it to calculate instructions for the pump. With the Tandem, you have just one thing, and it’s attached to your kid.

The Tandem ControlIQ algorithm tends to be AWESOME for teens and less ideal for smaller kids. The minimum weight they recommend it for is 55 lbs.

That’s just my two cents though. The plus with the Omnipod is that it’s waterproof so you don’t have to disconnect when bathing or swimming. Another downside with Omnipod is you need to fill it with at least 50 to 80 units and it lasts for 72 hours, so if you’re using a lot less insulin than that you might wind up wasting some. The Tandem also requires some insulin wasteage though; I think it’s around 30 units?

Anyways, someone who has used the Tandem for longer (we have used that one for just a week in a clinical trial) can weigh in.

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for what it’s worth, Samson knocks off his Omnipod sites about as often as he knocked out his infusion sites with his tubed pump, which is to say about once or twice a month. I think it has to do with activity, they are both equally knock-offable in our experience.

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Full usable time is 80 hours. 72 regular + 8 extended hours.

Also, the extra insulin is extactable if you really really need to conserve. We’ve extracted and re-used insulin on many occasions without any issues.

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I think what @jim26 was trying to say is that some pumps work with the Dexcom G6 and some, like Medtronic, have their own CGM. So if you like the Dexcom G6, that narrows your pump choices a bit.

I personally use the Dexcom G6 and the Omnipod using Loop and absolutely LOVE both. The G6 is the gold standard of CGMs and I like the omnipod because it is all self contained and no tubes to worry about. It is also reall easy to fill. Omnipod support is also excellent and has no problem replacing bad pods.

I would also recommend a trial like the others have suggested if your MD can work something out. Most insurances won’t let you get a new pump for at least 3 years, so choose wisely!

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Thank you! I think this is great info (I wasn’t sure actually!) for anyone making a decision about pump/cgm to know and now that you explained it it makes perfectg sense!

We have been on Dexcom since December. I have no experience with any other CGM, but overall I’m very happy with the Dexcom and wouldn’t want to be without. And I’ve never had issues getting a replacement sensor or transmitter (our first one died in 6 weeks!), so I’m happy with their customer service as well, so far at least.

Because of that, I realize that narrows our choice pretty much between Tandem and Omnipod.

Thank you all for the input so far!

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