FUDiabetes

Something to be positive about!

So I had my first follow-up with my Endo yesterday and I feel the appointment went pretty well. He mentioned that my numbers were in a very good range, but due to occasional lows still happening in the morning… he’s under the impression that I might still be on too much Lantus. I am keeping a close eye on this, and as I stated to him - 12u is too little and 14u too much. I shall try and inject 13u just to see if that can make a good middle ground.

@Eric suggested that, due to my new journey into bolusing… since I am on Humalog, there is a 1/2 unit dosed Jr pen available. Ty lots Eric, my Endo thought this was a great idea and my mail order pharmacy already has the prescription under review - and covered.

Anyways, on to the best part of this visit. My endocrinologist had mentioned that not only will it be beneficial to get some information from the nutritionist next week, but that she is a pump extraordinaire! They want to look into getting me on a pump. So I’m not sure what the pros and cons here would be, if anyone has any input I am all ears! I would also love to know everyone’s experiences with pump vs. MDI. Also, what are your pump recommendations? I did some googling and so far my top choice seems to be Omnipod. Please share, share away! I have my appointment next Tuesday and would love to walk in with an idea of what I would like to push for.

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@Necroplasm congrats on the great visit! It’s always nice to get positive validation from your care team.

I was on MDI and had huge swings some possibly from stacking, and some because my Pancreas was failing but had not given up yet. When I switched to a pump within a few weeks my swings were not as large. When AID became available, I no longer got 30s and 40s as lows. I do get the rare 50 now, but that is an outlier and not every day. I no longer spend half my waking hours micro-managing my BGs, so I am a huge fan of AID pumps. Omnipod is slated to release it’s first commercial AID pump this year - the Omnipod 5 aka Horizon. There are user supported (read unofficial not commercially supported) Omnipod AID systems obtainable that many here at FUD are huge fans of. Tandem has Control IQ aka CIQ and Medtronic has the 670G and the upcoming 780G. Of the 3, the latter seems to have the most user antipathy here at FUD (and on other D blogs).

@Necroplasm if/when you decide to get a pump, just remember that the brand/model is your decision, not your care team’s or your insurance company’s. Depending on the pump, your recurring monthly costs might be a pharmacy benefit or DME which based on your insurance plan might be a determining factor for you. If you get a tubed pump, you are usually tethered to that pump for the next 4ish years so look at pumps that have upgradeable software and a form factor that works with your lifestyle. Tubeless pumps have a lower cost to entry price point, are tubeless (big benefit there!), but only offer 1 cannula style which might be a problem for some.

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This is why the Omnipod caught my eye. I’m a state certified care partner for the elderly, so I’m going with the safe assumption that being tethered (having tubing on my body) may not be the safest option for me as I am on the go a lot of the time and don’t always pay full attention. I would hate to snag that on anything, and in turn would be weary of IS malfunction/failure.

This is definitely a huge determining factor for me, being I struggled so hard to get my Dexcom supplies covered. That’s why I’m trying to take a deep dive into which pump I’d be advocating for… and if I choose the Omnipod, there’s a registration on the website to check insurance coverage and eligibility for a free trial. If I can be preemptive about it, I can have some of the information sorted out before I even see the nutritionist. That way I can tell her what I want, if that’s the course of action I will be taking.

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I have the Tandem pump, and in combination with the Dexcom CGM, it has almost completely prevented nighttime lows. I used to go low at least once a week while sleeping, and now it’s more like once every couple months. Daytime has been better too, but there are still highs and lows due to eating, exercise, sunspots, raccoons, etc.

So I’d suggest at least considering a pump+CGM combo that can increase and reduce insulin automatically. Maybe the Omnipod can do that; I don’t know much about it.

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From what I read, the Omnipod can’t work directly with the Dexcom. But you’re right, upon looking into it… it looks like the Tandem tslimx2 can work in combination. I will do some reading about this one. Thanks for the tip!

(Also, sorry about those raccoons running your sugars amuck. Gotta look out for those trash pandas :raccoon: )

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The Omnipod 5 (Horizon) which is scheduled to be released this year is an AID pump with integrated Dexcom. I’m looking at this pump myself.

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Yay! We taught your endo something! :grinning:

That is on the way. Should be available at the end of the year. Closed loop, auto basal adjustments, all of that stuff.

If you want to try the omnipod for free, we can arrange that. :wink: Soon as @elver is done. :joy:

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My wife made a video of my new little friend I met last week. It was so cute. Most animals take food with their mouth, but she was using her hands. She didn’t bit me or anything, she was very sweet.

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I think you will do great on a pump, do make sure you get comfortable with MDI and write down what was working for you, so that if/when the pump fails or you run out of supplies that you can remember how to do MDI. My son takes a month long pump break every year to keep his MDI skills up. My son uses a Tandem, but also looked at the Omnipod. I don’t think you can make a bad choice between these two. Do whatever is within your budget and feels right.

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Ooooh fancy! That would be life changing.

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That is honestly the cutest raccoon I have ever seen! New pet?? :laughing:

Honestly I may be able to deal with omnipod not directly connecting until the new one comes out! I think it’s safer for me to go tubeless in the long-run, for I am theeee clumsiest person imaginable and I know I’ll snag it on relatively everything possible. This is making me feel stronger about my leaning towards it, I’m going to stay out of the reviews because a lot of users had a negative experience with Omni.

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That’s solid advice, ty. I do have a planner I’ve been writing my meals, doses, and pertinent BG numbers throughout the day. I will continue this practice until I get pumpified so I have a reference to go back to. A month out of the year with MDI sounds like a good way to refresh your memory and give your body a break from the pump. I am noting this down as a practice I can use in the future once I get set up.

I was very excited (and only a little bit nervous) when my Endo said the nutritionist/DE could set me up with a pump next week. I just had an instant reaction of “wow this could really help further along my diabetes management and take away some stress” which is much needed at the moment. I will definitely keep all of you updated as to how this plays out.

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Do remember to keep your prescription for long acting valid, and always keep some long acting around for emergencies and on all of your trips. Nothing is quite so painful is being away from home for a few days and having to keep injecting fast acting insulin every couple of hours because you don’t have access to basal insulin.

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Absolutely. I’ll be sure to keep my 'beetus pack that I bought stocked for my backpack. Never know if a site fails either! Good to have backup.

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It’s common to anticipate that the tubing snags on things. It turns out not to be an issue for adult pumpers, as far as I can tell. For me it’s about as common as snagging my shirt on something and getting a tear. I wear the pump on my waistband and keep the tubing tucked in so there’s really nothing sticking out. I knew of a couple guys who put the pump in their pants pocket and made a kind of buttonhole in the top inside part of the pocket, so the tubing threaded from the pocket to inside; nothing at all exposed or visible outside. Some women wear the pump in or on their bra, so again no exposed tube. That will become more practical with the t:slim later this year when it becomes possible to bolus from the phone without touching the pump at all.

Although I prefer running LOOP with my old medtronic pump, if I were choosing a new pump now there’s a good chance I’d pick the t:slim because Control-IQ works satisfactorily now (it does an excellent job of keeping the BG steady all night, and it’s not bad during the daytime) and the new version should be even better. The old omnipods are loopable, but I don’t know how long they will be available and whether they’ll be covered by my insurance going forward. And the forthcoming hybrid closed loop version of the omnipod is their “first release” so who knows. I mean, it should be ok, but there’s something nice about not getting the first version of anything. The infusion sets for tubed pumps are small and can be put in lots of places where a pod might not be so convenient. And there are several kinds of infusion sets, which may be a plus.

I hope I’ve confused the issue enough that you don’t settle on a choice early, just to avoid the pain of having to look into it. Tubed pumpers generally like that style. Podders generally like their pods. Both kinds have their quirks, so it’s just a matter of finding which is more comfortable for you. From my point of view, Control-IQ and the forthcoming bolusing from the phone are kind of a thumb on the scale in favor of the t:slim.

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This is all excellent information to be receiving. I have done a little bit of research on the tslim this morning. I’ll keep weighing out the pros and cons of both so that I have an idea of what to discuss at my visit next week. I do like that the the tslim can combo with the Dexcom. I know the omnipod might do that later on, but you’re right, the first gen of anything may not be the greatest. Definitely a couple of contenders fighting in the ring lol.

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If you want to read up on Loop, check here: LoopDocs . Several of us have been doing this for a year or more. Horizon keeps slipping on release date and last I heard won’t be until Q1 2022. Not sure how customizable it will be either since it will be FDA approved. I know myself I like to set mine at a goal of 100 for example. Unsure if you can go that low with the upcoming Horizon.

It looks daunting at first, but it’s not that bad if you follow the directions.

One thing though is that you have to use the Omnipod EROS pods not the newer DASH pods.

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I am a Tandem user and a big fan. But I do get the tubing snagged occasionally. I have the pump in my pocket and sometimes the tubing will be out and will snag on stuff like the pulls on kitchen drawers. I should be more careful.

Also, sometimes the pump will drop and the tubing acts like a tether, which is mildly distressing. It has only pulled out of the site once in 4 years. But tubing is a bit of a bother.

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No, it’s greatly comforting. It tends to prevent the pump from smashing on the floor. My pump has been saved by the tubing. Because of the way I tuck the tubing into my pants the falling pump doesn’t pull on the infusion set, it just takes up some of the slack hanging down inside the leg of my pants.

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@Necroplasm Thanks for starting this thread. All the feedback is useful. I’m also considering a pump and set to talk my Endo on it at a scheduled Sep appt. Already talked with Omnipod folks who said it would be covered fully with them supplying the PDM and Tricare providing the pods. Haven’t spoken to Tandem as yet. The tubeless part of Omnipod is a definite plus.

Ref the Omnipod 5: The rep I spoke with indicated the 5 is due out end of the year, but CMS and Tricare may take a while to include in their formulary/approval process. Anyone know more on this?

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