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Starting My Pump, CGM research

Discussion in 'Parents of Children with Type 1' started by Junosmom, Oct 28, 2013.

  1. Junosmom

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    We are very new (9/18/13) and so I've put off even thinking about pumping. So much to learn! And, I was originally told that most insurance companies require 6 months before authorizing a pump, so I figured I had some time.

    I called today, and we've met our deductible - and there is no waiting period for a pump if the dr. prescribes it. (Though still, I must pay the hospital bill and then 20% of the pump bill, not including meds :eek:) I'm a little nervous, because I'm just getting the hang of the shots, and the pump will be a whole new ballgame, I guess.

    Still, it would save me quite a bit if we can get the pump okayed at the Dec meeting with the endocrinologist. We have United Healthcare, and they gave me a list of five pump companies that are "approved" for my plan. I am reading each website, one a day.

    I would be interested, however, in any recommendations of pumps or CGM. (The CGM has to come from our prescription plan from CVS.) I am particularly interested in CGMs that work with the pump well. I am told that pumps can be obtained from Animas, Edge Park, Liberty Medical, Medtronic (minimed), or Roche Insulin. So far, I've read the Animas website which has a Ping, and seems to have a lot of advantages. Trying to find costs.

    I'd also welcome advice if you think I should not go for the pump this soon, though, as I said, it would save me the deductible cost, which will take me a little while to hit again next year.

    Thank you!! :)
     
  2. Melissata

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    I would recommend getting one of the pumping books to start with. Pumping Insulin is a good one. You can order it online. If you feel ready to go ahead, then do it before the end of the year. There are only two different CGM's to choose from. If you choose the Minimed pump, it has a CGM that uses the pump as the receiver. There are many issues though, and many people have decided that Dexcom G4 is far superior and it is a stand alone system, which can be used either with or without a pump. Many people would give up their pumps before they would give up the CGM, so if you decide that you are not ready for a pump yet, you might want to go with the CGM only for now. It makes a pump start much easier. Hopefully others will chime in here.
     
  3. Sarah Maddie's Mom

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    Ok, there are two main types of pumps. Tubed and tubeless. The each have advantages and downsides.

    Tubed pumps:

    Medtronic 530G is integrated with their CGM, meaning that it displays on the pump and supposedly will stop delivery if bg values read too low ( this is new in the US and people are only now starting to report back on it.) I do not know if Medtronic is still going to be marketing their 522 and 723 pumps.

    Animas Ping - tubed pump, 200u cartridge no CGM integration at present

    Tandem t:slim - newish, touch screen, very "cool" not at present integrated with CGM

    Tubeless:

    Omni-pod - not integrated with CGM, operated by separate Personal Diabetes Manager (PDM)

    Call your endo's office - find out which they have dummies of or actual models of that you can look at and hold. Pumping is very tactile business and you can't really make a good choice without actually interacting with them.
    In the meanwhile, I'd check out all the websites and tutorials.

    That's a start.
    Good luck
     
    Last edited: Oct 29, 2013
  4. Mish

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    to add onto what Sarah said above, you've got things a bit confused in some ways.



    Animas, Medtronic, and Roche are all companies that actually make pumps( Ping, 503g, Accu-chek Sprint, respectively) and will supply them to you as well. EdgePark and Liberty Medical are just distributors (think of them like big CVS pharmacies....) Those three pump companies often also act as distributors. This doesn't mean that you are limited to only those pumps, it sounds like your insurance authorizes those companies.

    Tandem T-slim is also a great newer pump to the market.

    Now, for CGM - there really are only 2 on the market in the US - the minimed system (which is newer in it's current Enlite version, so none of us here have much feedback on that) and the Dexcom G4 which seems to be the hands down winner. Just do a quick scan of threads for Dexcom or g4 and you''ll be able to read a ton of info.

    Integration into a pump isn't as amazing as you'd think, really. In both cases, you still need to wear two separate insertion sites; one for your pump, one for your sensor.

    Also, as far as cost goes; you shouldn't have a hospital bill, you'll pay for your pump at whatever copay you have, and your supplies will be the biggest expense as those items are not reusable. They'll come from one of the approved durable medical providers. Your "meds" will be the same insulin you currently use - minus your long acting.
     
  5. Junosmom

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    thank you and clarification

    Thank you! Still reading and will get book.

    "Also, as far as cost goes; you shouldn't have a hospital bill, you'll pay for your pump at whatever copay you have, and your supplies will be the biggest expense as those items are not reusable. "

    Clarification: The hospital bill which I refer to is the bill from our initial hospitalization for two days upon diagnosis. I still have to pay that and then part of the pump - so a lot of cost all at one time, though because of the deductible, it will save a significant cost if pump purchased right now. I wasn't expecting hospitalization to get the pump. Sorry for the confusion.

    So far, have read the Animas website. More reading tonight. Thanks also for the CGM info. I have lots to learn.
     
  6. nanhsot

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    You've gotten lots of good advice, I don't have much to add, however if your child is older/approaching puberty cartridge size is an important factor in making the decision. Pumps generally have 200 or 300 unit cartridges. In the early days of honeymoon 200 units seem like a LOT, but remember you will keep this pump for 4 years. In 4 years if your child is a teen and in puberty 100 units a day isn't unusual. I know that seems scary and crazy now but it happens over time, promise! Pumps with only 200 unit capacity mean changing everything out every 2 days, it's kind of a pain in the tush.
     
  7. missmakaliasmomma

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    Don't feel bad if it takes you longer than you anticipate to start pumping. Since it is very overwhelming, let yourself breathe a little. It took 3 years for us to start pumping, and neither of us liked it so it only lasted 5 months.

    I do know that once puberty starts, we'll basically have to start pumping again since it's so up and down. I'm ok with that though, she'll be able to do a lot more herself. I already explained to her that she will most likely have to pump again at some.

    I personally wish I had known about CGMs right off the bat when she was dxd but NOT ONE ENDO ever brought it up. The first I heard about it was when we had the reps from the pump companies come and I learned that MM had the integrated one. When I joined this site, I felt so ignorant. There are so many things out there I didn't even know.

    You definitely do have to consider costs when pumping and cgms. I'd imagine it costs a lot more to keep up with a pump and cgm than shots.
     
  8. Mish

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    Gotcha. ;)
     
  9. Dave

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    The pump versus cgm is a good question. When I think about it, the cgm is the winner. For example when we change infusion sites....no big deal...we can just use mdi...but when we change the G4 out and I have to wait two hours for it to 'calibrate' its like the worst longest two hours of my life. I think I'd sell the house and all the belongings and move the family into a one-bedroom apartment to keep the G4.
     
  10. nanhsot

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    I think this definitely varies by age and by kid, I think we actually asked this question before, those with younger children for the most part voted CGM while those with teens/preteens voted pump.

    My son would give up his CGM before his pump, though he now does use both all the time (for the past few years cgm use was sporadic, usually related to MD visits!)
     

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