I’m about to move onto a pump, the wifes ok with it now I’ve just got to choose one!
As an electronics engineer I despise the throwaway nature of the omnipod, I also doubt the stickyness of it and I don’t like the idea of an automated needle insertion. I do however like the remote.
The animas 2020, well I like the look of the pump but I’m hoping the new ping will be available for the remote, but I’m suspicious of one touch test strips (paranoia is a perfectly healthy symptom of diabetes, right?)
My favorite option is the accu-check combo, I’ve used their products for 16 years & may have become a fanboi, but that pumps old & I have heard complaints about it. Basically if it looks old now, how’s it going to look in 4 years time!
And then there’s all the accessories like infusion sets, should the availability of a particular set influence my choice? Will a pump function ok with insulin in the sun on holiday?
Basically, can you old hands at this give me some sagely helpful advice as to what things should be influencing me and what’s good?
At the moment & given the current financial climate I can’t see CGM being an option in the next few years.
I’m guessing you’ve already read ShootUp’s overview of the market https://www.shootuporputup.co.uk/2011/01/picking-a-pump-in-2011/ and have come away none the wiser! My general view is that everything on the market at the moment does the job, like buying a car, its just down to whether electric windows or a fabulous stereo are more important to you. The only pump I’d exclude from that is the Omnipod, which plenty of people love, but I’ve read about too many pod failures and poor service to have confidence in them at the moment.
If you’re not anticipating wanting CGM at any point in the next few years, you have a vast choice.
If you’re particularly sensitive to insulin, you might want to consider something with small increments on the basal rates because it will allow you to fine tune them much more. Equally, if you’re using gallons of the stuff, have a look at what size reservoir the pump has – you don’t want to be having to change it everyday because it won’t hold enough insulin to get you through three days.
Do you need a remote? If you like wearing dresses at the weekend, a remote will be really handy for when you hide your pump in your bra. If that isn’t your chosen hobby, you’ll probably wear your pump on your waist, in which case, I’d question whether you’d really need a remote given the pump itself is so easily accessible.
Infusion sets – most pumps have a variety of infusion set types you can use with them, so I don’t think it’s a particularly important criteria for chosing one over another. They all have enough variety that you should be able to find one that works for you.
Insulin in the sun – I like sailing in sunny climes which means spending a lot of time in the very hot sun and I’ve never had a problem with insulin going off. That said, I don’t sunbathe because my skin fries quicker than my insulin boils so I don’t inflict direct sun on the pump for long periods of time. I know some people who live in hotter climes only half fill their reservoir when it’s really hot and then refill it every day and a half, rather than every 3 days when they change their set. So, that’s a long winded way of saying, I’ve never had a problem with it, some others seem to, but you can get around it by half filling the pump so the insulin is exposed to the heat for less time.
Finally, make an appointment with some of the reps and have a play with each pump to see which you prefer. Also take note of how responsive they are to questions – you need someone who’s going to jump fast if anything goes wrong, customer service is important!
@furrypaul – as a (lapsed) mechanical engineer, I too despise the throwaway nature of the omnipod; but I despise it less than I despise the need for an external infusion set and the associated “n” metres of tubing.
I am waiting for my local hospital to decide whether they are willing to fund an Omnipod (since they apparently have a deal with Roche!) but, frankly, if they can’t be persuaded, I will be sticking with MDI rather than use anything with a tube and a remote infusion set!
As far as stickiness goes, in my experience of using the trial omnipod (email them and they will send you one) it is the stickiest thing I have ever encountered. My biggest concern with the Omnipod is whether I can stand the pain and discomfort of having to rip the bl**dy thing off every three days! I know everyone is different but your skin would have to be monumentally different to mine for the Omnipod to fail to adhere like a limpet!
I haven’t yet experienced the automated needle insertion but it doesn’t particularly bother me; some people particularly like this aspect of it but I can’t say I’m bothered one way or the other.
One other thing to bear in mind about the Omnipod is that the new version is currently being assessed for its “CE” compliance which is expected to be granted by the end of June. How quickly Insulet/Ypsomed will be able to start to supply the new model remains to be seen, but the 40% smaller volume and lighter weight should make the inbuilt redundancy even easier to cope with; it is still a stupid design, just less stupid (in my humble opinion) than the competition.
I’m glad the wife is OK with it as that was a major consideration in my decision to proceed to pumping. Mine was even more anti-tubing than I was! What is your other half’s view of tubed pump vs Omnipod?
All the best with your deliberations.
Having actually got hold of an Omnipod (my DSN had one as they are considering using them instead of the Accuchek Combo if people want it) my first thought was ‘Not a hope’ They are huge in comparison to the cannula that I have on my skin, and I am told that if you sweat a lot, or even a bit, the stikines wers off pretty quickly. There is no way of hiding an Omnipod, whereas I can quite easily hide my cannula/tubing/pump if I want to (npot that I ever want to, its just that I can – but cannot see how that protusion could ever be hidden unless you wanted to spend life under a layer of very baggy clothing – not practical in summer, methinks).
And if you think the Combo pump is a bit old looking, have you checked out the Omnipod’s remote? It’s like stone age in comparison…AND important to remember if you go for an Omnipod – without the remote, it’s useless. So if you forget your remote/lose it/have it nicked/etc, you’re stuffed. Whereas with the Veo, you dont have a remote to lose, and with the animas and combo, if you lose the remote, you can just press the buttons on the pump.
When the doctor said starting on pump therapy could be a whole new phase in my life I didn’t think she was referring to me wearing a bra! (I will keep an open mind but I may try a few of the manufacturers solutions first)
Thanks @alison & @annette – You’ve given me a few things to think about, I’ll strike holidays & infusion sets off my list of things I need to panic/worry about. It never occurred to me that you could under-fill the pump in a hot environment, but then I guess the raised BG’s on holiday may not always be baked insulin (but I like my excuses). Ask me in 6 months whether I chose a stereo or electric windows and whether I chose the right one but its good to see that nothing negatives been said about the combo or animas.
@nigho Well I hope you manage to get funding through your hospital for the Omni people at my hospital seem to really like them, I’ve got a trial pod on the way now, its kinda silly but I hadn’t considered asking them for one. I’ve seen two different sized Omnipod units at the hospital so I may have seen a sample of the smaller case, in which case its definitely better but even so it looks like it’d be limited on where it can be easily placed on me. My wifes has the same doubts as me on the omni but is pretty supportive of the pump & tubing but has already got her apologies in advance for leaning on the cannula, catching the pump, strangling me with the tubing during an argument etc,etc.
@annette – while I admit that my 3 day “test-drive” of the trial pod does not constitute a randomised control trial, but I deliberately got a bit sweaty and had several showers during the period I wore it and it took me a good five minutes and a fair bit of discomfort to remove the pod it was so securely stuck! As for “hiding” it, I wore it for three days, to work, to client meetings and to social events and when I mentioned to people that I was wearing it they all said words to the effect of “Where is it then?”. My wife kept asking “are you still wearing it” and even my daughter didn’t spot it until I told her on day 3.
I find it fascinating that you think the pod is “huge in comparison to the cannula that I have on my skin”; from my point of view, while that is clearly true, it is not a relevant comparison. I consider it to be “tiny in comparison to a tubed pump”, while the new model if/when it gets approved, will be even smaller.
Your comments on the Omnipod remote are worth a thought too. You say “So if you forget your remote/lose it/have it nicked/etc, you’re stuffed” but that is a) not true, since it will continue to deliver the programmed basal dose, and b) no different than an MDI-er forgetting/losing/being robbed of her short acting insulin. Your point about not being able to deliver a dose directly from the pod is valid and appears to be one of the most common wish-list items on various Omnipod forums. But then we come back to the throwaway design and I suspect the cost of adding another complex mechanism to the pod itself would wreck the economics of the product completely.
Anyway, its great to see other views on the world; wouldn’t it be a dull place if we all agreed?! At least we have a choice – talking of which I must find out how my funding request is getting on…
@nigho – I understand (maybe incorrectly, after all, I’ve never tried one) that the stickiness does depend on the acidity of your sweat. Some people are naturally more acidic (I know I’m one, I ‘eat’ through nickel plating on jewellery like no-one’s business!) and they dont react so well to the stickiness, which therefore isnt.
The Omnipod is, I agree, smaller than my tubed pump. But the bit I stick to my skin is much smaller. And that’s the bit people can see protuding out of my body as a lump (or rather, not see, as it doesn’t, whereas the Omnipod would; rather than seeing my pump as anything other than a phone/pager type gadget in my pocket/on my belt). I do however accept that this is only relevant if, like me, you tend to wear close fitting clothes – men’s shirts would probably hide it quite well, providing they weren’t tight. And I’d be worried about wearing it on my arm if wearing a tshirt as it would be much more likely to be knocked if ‘out in the open’ – which surely would have an effect on the life of the stickiness?
If you lose your Omniremote, I still think youre stuffed – because you cant eat anything unless you have spare insulin and syringes with you in a bag that hasnt been lost/nicked/etc. It is exactly the same as losing your MDi stuff, I agree, but one of the supposed benefits of the pump over MDI is being able to do without soem of the junk you have to carry ie pens/needles/etc. And having on several occasions left the house without pens etc whilst on MDI, and still occasionally leaving the house without my remote, I’d be stuffed with an Omnipod. Its all very well saying that you still have your basal – but that isnt going to help when you’re out for the evening and cant eat/drink anything except lettuce and water!
But like you say, everyone has their own opinion, needs and requirements (but memory transplants dont yet come as standard…). (And I agree regarding the throwaway nature of the omnipod). Wouldnt it be nice if we could all try all the options to see what fits our lifestyles before plumping for one, rather than only having the option of trying one or two?
@annette – I have no idea idea about the effects of the acidity of sweat on the Omnipod adhesive, but it seems like a plausible idea. If true, the difficulty I had in removing the trial pod suggests that my sweat must be verging on alkali!! 😳
I actually wore the trial pod on my arm and because I kept forgetting I was wearing it I did keep knocking it (including a couple of huge collisions with door frames!). These events obviously had no effect on the stickiness though I will have wait until I try a real one to find out what effect they have on the functioning of the pod itself or on the cannula!
You make an interesting point about “one of the supposed benefits of the pump over MDI is being able to do without soem of the junk you have to carry” since if you were to do everything by the book (and we all do, don’t we? Yeah, right! 😳 ) then you would be carrying spare infusion sets, insulin, injection kit in case of occlusions and pump malfunctions, wouldn’t you? Hmm, maybe not.
Nice idea about trying out all the options before making a choice .
Actually, I do carry “infusion sets, insulin, injection kit in case of occlusions and pump malfunctions”, all except the insulin (cos I figure I can just use the insulin in the pump reservoir), in my handbag . Because I’m a bit obsessive like that. Problem comes when I dont have my handbag with me. (Like on a night out.) But those occasions are few and far between these days – I’m lost without my bag!
Infusion sets can sometimes just go wrong. There’s an upcoming video blog in which I have a BG of 17 because my set just hadn’t worked properly and was only trickling in tiny amounts of insulin. Oops! If in doubt, you just do a set change.
Yes, as @tim says, sometimes they just stop working without warning, or start to stop working (so some gets in but not enough to stop a high creeping up on you – those can sometimes be dealt with temporarily by bolusing every couple of hours – to get through the evening for example, then change cannula when you get in). And sometimes, I get occlusions that are solved by unplugging the tubing from the cannula, pushing a minute amount of insulin through the tube (to check its not blocked) then reattaching and turning back on. Conclusion – its the inner bit that has got a bit blocked that just waggling it a bit (by removing and reattaching the tube) clears it out. Doesnt happen very often to me – about every couple of months, I’d guess, but it varies.
In terms of spares and that sort of guff; I carry around two black pencil cases – one sits in the bottom of whichever man bag I’m using and currently has in it:
Spare infusion set & reservoir
Spare meter and a few test strips
Spare pump battery
Blue firing-thing for inserting set
(I’m also going to carry a few hypodermics so I can draw up from my pump reservoir if needed, but I haven’t got round to that yet…)
This means I’ve always got a handy set whenever I need it. I had trouble with a set on the stag night I went to a few week’s ago and so I just changed my set in the pub and all was well.
The second pencil case (if you’re interested) just has my main meter, strips and Fruit Pastilles and is the one that sits by the side of my bed at night, gets shoved into man bag at last minute, etc. etc. etc., and generalyl carried around the place, while the first one sits there unopened for weeks on end.
Interestingly enough, the trouble I had with the set on said stag night was that it was in my back and was actually absorbing *too* well, resulting in lots of hypos. I need to set up a new basal profile for when I use my back, but not having time to do that, I just bunged in a new set in my normal crappy-absorption stomach!
@tim I’ve heard quite a few people talk about infusion sets being more/less efficient on various parts of their body, I’m grateful that’s one quirk I don’t seem to have!
@furrypaul When I first started pumping I had a few blocked sets – I discovered using Quicksets in my stomach just didn’t work for me, they just kinked and stopped the insulin getting in. I swapped to using Silhouettes in my stomach and Quicksets in my thighs and bum and over the last 4 years I’ve had about one blocked set a year.
And this is where pumps and me sort of don’t quite seem compatible.
At the moment when I need to leave the house quickly I grap my pen and fruit pastilles and get to the car before going back because I put the pen and sweets down before getting the keys and left them on the side. On a good day I also don’t forget the kids. To be ultra prepared I also take my testing kit. That’s it. Am I Bad Diabetic?
Whilst I appreciate you adore your girlie accessories @tim () the idea of having to grab so much stuff seems a big problem to me and turns my faulty pancreas from a manageable ‘condition’ to something that must be forefront of everything all the time.
However, maybe that’s why I’m now having to sort everything out just because I haven’t given it the dedication it needs. But, I still believe a highly obsessive MDIer can exist with far less kit than a pumper. So, for now, I’ll stick with my sleek Novopens.
Although I now have more ‘bits’ to my kit (batteries, sets, syringes etc) it takes up less room than the old kit and pens and spares did – I just have to pick up my meter (acts as remote) and my emergency kit (in small bag which resides in whichever handbag I’m using at the time). But I fear it may be a gender thing (@tim not included as he’s gone metro and uses a manbag, @alison neither as she has a horror of carrying junk so doesnt often, I think) – most women carry a handbag, which already has in it sweets/tissues/money etc, so the addition of an emergency kit isnt a big deal. Most men dont.
I’d stick with obsessiveness rather than gender reassignment though…
@seasiderdave – ah, the old “carry junk” or “not carry junk” argument . I’m a fan of the former, so that issues with pumps, hypos and what not can be swiftly sorted out while on the move and so they can’t escalate into a bigger problem. However, this does mean carrying girlie accessories
I don’t think either way is wrong or bad, just merely personal preference.
I’ve not found infusion sets more/less efficient, but I have found that on my back they are more likely to occlude and need replacing after only 2 days (I usually wear them for 3), and on my legs they have never yet ‘taken’ – despite several attempts, I’ve not got one to work, so I’ve given up there. Plenty of other sites to use atm
@furrypaul – I’ll drop him an email to see if he’ll do an interview. But, tragically, most of the celebs won’t do them for shitty little sites like Shoot Up . Or some promise to do an interview and then don’t reply to my further emails *cough* Sir Steve Redgrave *cough*
@furrypaul – I think mine took about 2-3 weeks to arrive; but as m’collegue says I would give the horse-pital a ring to see what the plan is as you’ll obviously need a bit of training before starting proper.