Pump vs. ICT

If this topic is still often discussed in the past, please let me know!
If not, let’s talk about, because I’m interested if prescriptioning a pump, and in the near future a (monohormonal) “closed loop system”, is the best solution for everybody.


By the way, I stopped looping 3 weeks ago, being suprised how smooth my BG looks now - neither loop nor pump.

I don’t think there is such a thing. It really depends on the person and their circumstances.


I think the better question would be is this the best solution for YOU.

I do NOT believe there is a single best solution for everybody.


I’d like to wait a bit with an answer, to see if all are coming to a similar reply.

There is no best solution for everybody - except a cure. I’m sure that would fit in well for everyone. Until that happens, each T1/T2 does what works FOR THEM, and YDMV is a very real thing. What works for our 5 year old son may not, and probably won’t, work for a friends 5 year old. Each person is different with different bodies, needs, other issues going on, environmental differences, etc., etc., And all of these things impact treatment decisions.


For me evidence that no one solution will works for everyone, you need look no further than the Medtronic 670 pump and Auto mode. For some people it is seen as a savior that helps keep them in a healthy range and a good A1c, and for others Auto mode was a nightmare problem that could not be overcome.

From my view, the difficulty of diabetes is that no two people are exactly alike. Excluding co-morbidities, each person will have a different amount of exogenous insulin being produced, each person has different alpha cell activity, each person has a different amount of variable insulin resistance, and of course each person reacts in subtly different ways to the insulin products available today. Add in sensor technology that works for some but not others, and you have a complicated recipe to try and solve universally. If someone is able to work that out, I would see a nobel in their future. Then add in co-morbidities and holy canolli that is a complicated problem.


You might have better luck asking folks what the best solution for them is.

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Are you following the this discussion? @FrederikDiabetics
You wrote in your first posts about using pendig pens. I’m interested in them. You got a recipe for it?

I agree with all of you; but I have to be more precise.
Here in Germany it seems we finally get the first hybrid closed-loop systems reimbursed by our health insurances: the 670G (don’t laugh) . It’s a hope for many of us who are not able or willing to build a (much better) DIY closed loop system.
But 1st I think it’s hazardous to give a HCL system to people who want to spent less, not more time for their diabetes (I suppose).
2nd: if there’s no time for pump instructions where should diabetes advisors take time for HCL instructions?
I think pumps alone and furthermore Hybrid Closed Loop systems might be helpful devises for some people who have massive problems with their diabetes; but they could be even dangerous for T1Ds who get only little help.
If you have found your well working diabetes treatment, don’t switch to a system which is allways more complicated and besides, could have more negative than positiv effects.

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Yes, we debated that in considerable detail. There are some outliers, but it would seem that for many people with A1c’s in the 7+ range, the 670 works pretty well assuming you can get the sensors to work for you. In the lower A1c ranges there were people who the 670 worked for, but it certainly wasn’t a large proportion of the population I heard discussing it.

We have hope for the Tandem closed loop algorithm due in the US in Q4, but if it doesn’t work well for us, we will just shut it off and hopefully re-enable Basal-IQ. Fingers crossed upgrading to the Closed Loop doesn’t remove Basal-IQ.

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I still have not heard what I would consider a definitive and authoritative answer on that.

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Everyone else has already said it, that there most likely won’t be a “one size fits all” solution, but I would like to reiterate that even if there were one, it certainly isn’t the 670G. And I think you understand that, @Wolf, but I’m not sure I agree with your breakdown exactly. It genuinely has nothing to do with how “bad” your diabetes is and much to do with your knowledge and understanding of the disease. I can understand your concern that this pump wouldn’t benefit people who don’t care to spend time on their disease, but that really is the group it does benefit. It’s the people who don’t know how to control their blood sugar who really see the most impressive results, and that is wonderful. However, for most who are in good control, regardless of how “bad” their diabetes is, the 670G can be maddening. Having watched what the 670G did as closely as I did, I have a hard time believing there will ever be an algorithm “smart” enough. In truth, it’s not a problem with the algorithm at all but in the disease. But we all already knew that.