Replacement for my Animas pump?

[toddex]

I used Medtronic pumps for 20 years and tried their CGM several years ago. When I found the Dexcom CGM to be far superior (in my experience), I switched to the Animas pumps so the pump and CGM could be paired. With the recent announcement that Animas will no longer be producing pumps, I’d love input on what you all recommend as a replacement.

To be honest, I was very happy with Medtronic pumps and customer support and haven’t loved the interface of the Animas pump. I’ve heard good things about the T-slim.

[ClaudnDaye]

We only know the Insulet Omnipot @toddex, but we LOVE it. Tubeless, self-contained insulin capability and it’s easy to apply. We’re fans of the POD.

[Thomas]

There is a Tandem simulator which you can download to your phone and try out.

We are very happy with our Tandem t:slim X2 and Dexcom G5.

If you like Medtronic and Dexcom perhaps consider which is more important to you and that may give you some initial guidance as to direction?

[MaryPat]

Insulet Omnipot @toddex, but we LOVE it.

@toddex, the only significant limitation of the Omnipod, in my opinion, is the size of the reservoir. It works for my son, but it may be too small for those who consume high amounts of insulin. It can hold 200U for 3 days.

We tend to use pods a few hours longer, possibly 3 days + 4 hours average. Whatever you do, they stop working at 3 days + 8 hours.

[MaryPat]

We are very happy with our Tandem t:slim X2 and Dexcom G5.

@toddex, if you are interested at all in the t:slim, you might look into what @Thomas was writing about Tandem’s special offer to Animas users:

Insulin pumps: J&J Animas drops out

Tandem has what appears to be a really great offer for Animas pump users who may not appreciate being dumped on the doorstep of Medtronic. Tandem Diabetes Touch Simplicity Today Pump Access Program Details This offer is available for eligible Animas and Roche customers with pump warranties that expire on or before September 30, 2019. A one-time payment of $999 is due prior to the pump being shipped. Payment plans are not available. Offer available through March 31, 2018. Upon purchase of a ne…

@Thomas, what do you like and don’t like about the t:slim, as a long-time user?

[Thomas]

@MaryPat - Actually we are not long time users of the Tandem. We have only had it a short time. We previously were using the Animas Ping. We liked the Ping enough to run it a couple years past its warranty.

The major factor in picking a new pump was a pump which either currently worked or had publicly published intention of integrating with Dexcom.

Earlier this year we started on the Tandem t:slim X2 and of course continued using the Dexcom G5. Tandem had published three planned updates (their “Pipeline”). We were quite pleased that Tandem kept its word and and has delivered on the first update which was the X2/G5 integration. We wait for them to continue on their promise for the next two updates.

[MaryPat]

This a recent thread about 2017 pumps:

2017 pump choices: why did you pick yours?

@SLEE’s post on switching from Medtronic to Tandem reminded me what a hard choice it was for us to pick a pump, and how difficult it was to (a) understand the pros and cons and (b) figure out what was most important to us. I would have loved to know what other people’s choices were driven by. So here is how it went for us. Last December, we picked an Omnipod pump for my 12-year-old boy, after spending several months of investigations. My son is a young teenager in puberty who spends many hours …

[Beacher]

the only significant limitation of the Omnipod, in my opinion, is the size of the reservoir. It works for my son, but it may be too small for those who consume high amounts of insulin. It can hold 200U for 3 days.

That’s a good point, but it would be fairly rare, wouldn’t it? I think I take a lot of insulin (could be wrong – it’s just an impression I have from what people on various boards mention they take), but even if I’m pigging out on carbs or trending weirdly high, I rarely exceed 50U a day combined bolus/basal, and more like 30 to 35 when eating well but not low-carb. I fill with 175U and have not, in nearly a year on the pod, run short, and I always have sufficient in the reservoir when I hear the initial 3-day alert.

The concern with the reservoir is more often would you take enough insulin over three days, since you have to fill with at least 85U, which can mean wastage for those on small doses.

[Thomas]

That’s a good point, but it would be fairly rare, wouldn’t it

Somebody who has a degree of insulin resistance (whether T1 or T2) would possibly need higher amounts.

I have a T1 friend who takes very large amounts of insulin via pens. A pump would likely be a bad fit for him.

Our current pump, Tandem t:slim X2, holds a max of 300 units. The Tandem t:flex holds 480 units.

We typically put 250 units into our pump. This lets us easily split the 1000 units from the vial into four equal cartridge changes. We do not use all of the insulin but at this point that is not on our radar.

[MaryPat]

That’s a good point, but it would be fairly rare, wouldn’t it?

I wouldn’t know, but have always assumed that it would be too little for many larger people. My son weighs 140 lbs, and uses about 30-35U of TDD in sports seasons, but 45-50 when he does no sports at all (the month of August for us), and he can hit 70 when he is sick. Also, we don’t eat low-carb but we definitely don’t eat high carb.

So I thought that a 200 lb sedentary male who is a bit insulin resistant, or who eats normal carb meals, would not have enough of 200U for 3 days.

[Beacher]

True enough! So maybe I’ve been wrong in thinking I take a lot of insulin. It would actually be interesting to see what people’s total daily dose is. Maybe I’m normal after all (in that regard, anyway ).

[Thomas]

Maybe I’m normal after all

I try telling myself that everyday. So far it has not (apparently) helped.

[Eric]

So I thought that a 200 lb sedentary male who is a bit insulin resistant, or who eats normal carb meals, would not have enough of 200U for 3 days.

For something like that, the easy fix is just to get a prescription written for using a pod every 2 days instead of every 3.

Or if someone wanted to, they could just use U-200 and adjust the dosing. I know, it’s not approved for that yet, but the math is not hard. If someone wanted to, they could do that, despite the fact it is not “sanctioned” by the FDA or Pump Czars.

[toddex]

Thanks Thomas and MaryPat. The Dexcom is definitely more important to me and for that reason I won’t switch back to Medtronic. I tried their newest CGM and still far preferred the Dexcom. I would love to know more about pros/cons of Tslim in your experience. Have you tried other pumps to compare? I always see Tslim with Dexcom G5, is it possible to use G4? I don’t want to switch to G5 as my understanding is the transmitter only lasts 90 days whereas I get around a year out of my G4. Financially smart but dirty change on Dexcom’s part, in my opinion. It’s difficult to get a new transmitter through insurance when mine quits, so I can’t imagine having to do it 4x a year instead of once. Anyone else out there used multiple pumps that could offer some comparisons?

[Sam]

Some people take a lot of insulin… like several hundred units a day. Generally if they’re taking doses that large the pump provides very little potential benefit to begin with because they’re not doing or benefitting from things like micro bolus etc… so I suspect dexcom is just designing to its target audience of people who don’t require hundreds of units each day… although people who use a ton could use the on omnipod, like Eric says by just changing it every 2 days or even every day. At some point I would think it becomes more hassle than it’s worth

[mikep]

@toddex I’ve used both Medtronic and Omnipod pumps. I don’t use a pump now, but I used the OmniPod for years and if i ever went back, I’d use an OP no questions asked. Pump reservoir was plenty for me and I eat a decent amount of carbs on any given day. The tubeless nature of the OP can’t be replaced IMHO. I wore a Medtronic pump for years and not having to worry about tubing at work, playing/coaching sports, on a plane and really pretty much anywhere else, was awesome.

I’d at least give it a try.

[mikep]

How much do other pumps (t:slim, Medtronic) hold? Sorry, I remember 300u but that was a long time ago.

[Thomas]

I always see Tslim with Dexcom G5, is it possible to use G4?

The G4 and G5 are not interchangeable due to the transmission differences.
The Tandem t:slim connected to the G4.
The Tandem t:slim X2 connects to the G5 and will presumably connect to the G6.

I do not believe you can purchase the t:slim from Tandem anymore. The new updates that Tandem is working on for the X2 will require the G5 for the next update (suspend) and the G6 for the following update (hybrid closed loop).

X2 insulin cartridge is 300 units.

Tandem has another pump the t:flex that holds 480 units but currently not integrated with a cgm. I think I read they are coming out with another version of the t:flex that will connect to the cgm but not positive on that one.

[Millz]

I’ve been pumping for just under 3 months and have been loading my Pod with 155 units. On average I have about 10 units or less remaining at the end of the 3 day window. Only once have I run out.

[toddex]

Thanks, mikep. Curious, why you currently aren’t using a pump. I can’t imagine going back to injections after being on a pump. I’ll explore the omnipod. I do get annoyed with tubing when I sleep, getting tangled up in it, but other than that haven’t minded it and wonder if having a larger item attached to me would be even more annoying. I generally use 35-40 units daily, so the reservoir size isn’t an issue. Is it annoying to be required to change the pump at the three day mark regardless of whether it’s empty? I generally go 4-5 days before changing infusion sites with no problems. Did the omnipod ever cause issues because you couldn’t remove it? Like for sports, etc. I also scuba occasionally and assume it would have to be removed if going that deep below water.