Which pump is best?

Do you use a pump? Which one? Why do you like it and not the others?

I’m looking to get a pump again. I used to have minimed in 2004, but stopped using it & switched to pens.

I use Dexcom & love it. Thinking of going with omnipod because it works with Dexcom & it’s cordless (tubeless). Does it stick out too far?

Since you are interested in integration with the Dexcom, you should also take a look at the t-slim. My son uses it and loves it. He tried both the tslim and omnipod, but due to sports he went with the tslim.

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Tandem due to the Dexcom compatibility and the predictive software.
Check out Control IQ on the Tandem website.

It’s 14mm high, 52mm long by 40mm wide. It’s held on by a somewhat larger adhesive pad but that is attached only at the front (around the canula) and the back, so normally it sticks out away from the skin and it is possible to catch clothing, etc, underneath it and accidentally rip it off.

The only way to know if this is “too much” is to try it. Insulet will send you a free (non-working) one to try:

https://na.myomnipod.com/become-a-podder-demo-kit

Neither the current version (the “Dash” pods) nor the previous version (IRC “Eros” or UST400 pods) work in any meaningful sense with the Dexcom CGMs. The Tandem t:slim pump, as suggested by @Chris does allow direct integration of the Dexcom results with the controller; if Dexcom integration is important I suggest checking out both options, and being aware that more will probably emerge pretty soon:

Supposedly the next version of the Omnipod will have proper integration, but who knows when or if that will be available; it will certainly be a different system. Just to make the point, here is Dexcom’s press announcement from 12 years ago:

It says:

The PDM with DexCom technology will combine the functionality of both systems’ handheld receivers into one single handheld wireless device, eliminating the need for a separate receiver.

As of today 12 years later the Omnipod PDM cannot even download readings from the Dexcom sensors. There’s a lot of hot air here; don’t believe it will fly until you see it in the sky above you.

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Just to pile on to this - I’ve been using the tandem t2 slim for 3 years now and am very happy with it. They just released the control-iq approach which should deliver even greater control with computer assist.

Very effective device.

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I am interested in the tandem technology but here is my concern (maybe you experienced with it can shed some light)

I use WAY more bolus than basal. I think this is likely because I still have some residual ability to trickle out natural insulin that offsets basal needs thus offsets need for injected basal… however no ability to execute a natural “bolus”

I take about 15u of basal daily but frequently need more than that for a single meal with bolus insulin.

Every time I see a doctor they disapprove… I constantly hear “your basal dose should be approximately equal to your total daily bolus”

However… that’s just not my reality and it’s far from how it could possibly work for me. So my question for experienced users is: do you think the programming of the tandem pumps could accommodate this? Or are they programmed in such a way that their parameters would constantly be at odds with my ratios and requirements?

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If you run the pump in sleep mode 24/7 it doesn’t matter what you do. The pump will constantly be adjusting your basal rates to keep you between 110-120. All you do is bolus for meals, and the pump handles the rest. Too much meal bolus, it cuts basal rates, too little bolus, it ramps up the basal rates to bring you back to the 110-120 range.

If you don’t use sleep mode, you’ll be frustrated to no end with control-iq. The pump doesn’t do a damn thing until the BG is at 180, what it does do at that point is too little too late.

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Love that quote. Mine actually is, but what it actually is is the amount of insulin I need to remain approximately stable if I don’t eat, sleep and do not see any doctors for a week or so. I do run at about 12-15 IU basal + 12-15IU bolus per day when at home but them I’m doing a “lowish” carb diet.

Dang. I probably should have given up on tubeless last year and just went with t:slim, now I’m sitting here with a Mac trying to work out how to make my stock of Eros pods loop.

So… the loop setup definitely wants the basal to be entered, and loop wants it to be accurate (i.e. not something read out of a medical textbook published by Jonathan Swift). I can’t imagine that t:slim can ignore reality; so far as I can see the BasalIQ stuff just wouldn’t work if it did, so maybe the medical profession is about to be hauled in for an upgrade on what the correct basal rate is…

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As far as I can tell, the tandem is agnostic about basal rates or boluses – – you can have a very low basal rate, and bolus is up to 20 units I think. It’s just a tool and does not have an ideology or a recommended treatment.

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Clarification - the old pods (UST-400 version) do work with Loop and that is directly integrated with Dexcom CGM.

I know it’s not done that way from the manufacturer. But it can be integrated DIY, relatively easily.

If you have an IPhone and a computer, a couple hundred bucks gets it done.

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Yes, it’s true and the “old” pods are not discontinued; Insulet make them available both as medical devices and prescription items (they’ve repackaged them in 5 unit boxes for the prescription market.) But you get to learn a lot about computers, and buying stuff (like iPhones and Mac boxes) cheap, or not.

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