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Pump advice for 6 year old boy

Discussion in 'Parents of Children with Type 1' started by packmule, Jul 1, 2014.

  1. packmule

    packmule Approved members

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    Our six year old son is currently MDI with syringes, Dexcom, and CGM in the Cloud. We'd like to start pumping before 1st grade. We're considering primarily the Ping and OmniPod but open to the T:Slim. Minimizing site change pain and overall pump system reliability, durability and accuracy are the most important factors to us. Other pump-specific quirks can be dealt with.

    I like the Ping because it has a pump remote, seems reliable and durable even if not "cool", is compatible with our existing OneTouch strip Rx, and might offer an integrated Dexcom upgrade. We really like the cordless idea of the OmniPod, but I'm not sold due to many of the issues I've read about here and elsewhere. I'm interested in T:Slim because I love tech that pushes the status quo. Tandem seems to be doing that, though I'm not convinced the T:Slim is ideal for a rough and tumble six year old boy.

    I would appreciate any advice from people who have used these pumps on younger kids. How is the site insertion for each of these pumps? I'd really like to hear from people who have used more than one... why did you switch, and are you satisfied with the switch?

    Here's my +/- list for each pump.

    Ping
    Positive
    • Waterproof
    • Long battery life
    • Ping Remote/BG Meter (Compatible with existing OneTouch supplies)
    • IOB for food and correction
    • Potential future Dexcom integration / upgrade
    Negative
    • Corded
    • Loses IOB during battery change

    OmniPod
    Positive
    • Cordless
    • Waterproof
    • Long battery life
    • Automatic Insertion
    • Many claim insertion is relatively painless
    Negative
    • Reliability problems, i.e.: Pods falling off when wet, post-site change highs (old style pods only??)
    • Some complain about site insertion pain
    • IOB for correction only??
    • Freestyle meter / strip issues

    T:Slim
    Positive
    • Modern UI, easy to use
    • Tandem is at the forefront of pump tech (bionic pancreas, etc)
    Negative
    • Rechargeable battery
    • Not waterproof
    • Cartridge recalls / issues?
    • No negative correction?
     
  2. nanhsot

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    I am mostly going to address the negatives you have listed in the two pumps we have experience with. Honestly there is no right/wrong answer to this, it's really what works for your family. I'd first decide tubed vs not...then I'd decide remote vs not...and your decision is made I think. As far as positives/negatives:

    Ping: The loss of IOB with battery changes was never an issue, you have plenty of warning when the battery is low, it's not like it just dies. So you learn to change the battery first of the morning or whatever, when there is no IOB.

    Tslim: The battery charging is actually a positive in my book, plug it in at bath time, 10 minutes and you are fully charged. Or do like my son does and do it weekly for a little longer. The battery charge lasts a long time. Tslim IS waterproof, not sure where you got that information? We've had 1 cartridge issue, and ALL the companies for the most part have had recalls at one time or the other, that's just a scary part of pumping with all companies IMO. They had a big recall while using Ping too. We had one tslim cartridge pull apart at the connector, but not affected by a recall. Negative correction isn't a factor for us either, he just mentally deducts 10 carbs.

    And just as an FYI, both ominipod and Tslim are also planning Dexcom integration, I believe. I know tslim is anyway.
     
  3. Mimikins

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    Hi!

    I started pumping on the T:Slim yesterday morning. The pump is water resistant (I think the specifications are 2ft of water for 30 minutes) but not waterproof. The pump also only does a reverse correction if you are below 70; otherwise, a "your blood glucose is below target, make sure to test" reminder pops up. I am also a fan of the rechargeable battery and typically will charge it once every 3-ish days while uploading to their T:Connect app.

    Please remember that switching over to a pump is like diagnosis all over again while the doctors try to figure out the most appropriate settings. Even though very little has changed for my I:C and SF (and my basal rate seems to be keeping me stable, knock on wood), I am lucky if my two-hour BG checks are below 250 and will now need to discuss getting those possibly changed.
     
  4. StacyMM

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    No experience with the Ping.

    In regard to your OmniPod negatives. My daughter has used it and my son still does. She switched because we were having so many problems. She is very happy off the pods and he is very happy on them. If cordless is a very important feature, then this is really your only option. That's why my son is on it.
    ~The insertion is very simple - fill, stick and press a few buttons.
    ~We've had a few boxes with stickiness issues but most stick on fairly well - we do add Skin Tac and Hypafix tape, which helps. Many people go without tape and are perfectly fine - it's something you will have to see for yourself.
    ~Our only issue with IOB is that it's linear...and my kids do not have linear absorption.
    ~And our only issue with insertion is that there are no other options - you get the angled cannula and that's it. If you want to try steel, straight sets or a different cannula length, you can't - the pod only has one option. If you don't need those, however, it's no issue.
    ~The Freestyle issue was a mess. In my experience, Insulet could do a better job at communication - new pod roll out, known issues and fixes, strip problem - they just don't seem as on the ball or as upfront as other companies I've dealt with.

    And your T:Slim negatives. For the record, the T:Slim is my all-time favorite pump. For me, this pump feels so far ahead of the other pumps. The touchscreen, the ability to go to thousandths on settings, the ability to choose any time length and time (we use a 15 minute temp basal a lot and I have basal patterns set with changes at 7:15 am and 9:20 pm...matches her schedule and needs so much more perfectly), and it's general ease of use are huge positives for me. Plus, seeing it as the pump of choice for Ed Damiano's work is a huge plus in my mind.
    ~Rechargeable. In the beginning, this was my biggest complaint. We already charge two Dexcoms and it was a hassle. We got into a system, though, and the warning on low battery makes it easy to charge in plenty of time. We are CGM in the Clouders, too, and charge two Dexcoms, one pump and two uploader phones. And we make it work :) Hard ot get used to but so easy once you have a habit. You can charge in the car, while playing on the computer, while your son is in the bath, etc.
    ~It actually is waterproof. Not like the Ping, from my understanding, but on the Tandem group I'm in, many users swim with it on. I have an Aquapac because I'm just not that trusting yet...and because my daughter is much more into play than many adult users and it just makes me feel better. Probably stupid but I like the backup.
    ~We've been using it for 9 or 10 months, I think. One bad cartridge and one box of bad sites (Cleos, which aren't made by Tandem) in all that time. So, for me, that's pretty good.
    ~There is a negative correction. It just doesn't reverse to target. If you are below 70, it reverse corrects to 70. If you are between 70 and target, it's neutral. If you are above target, it adds a correction back to target. It has never been an issue for us. If she is below 70 and is getting ready to eat, we can either give a glucose tab and not count it (it raises her about 20 points and her target is 90) or we just let it go. I'd love to think that diabetes was so precise that every calculation was dead on. But it's not. So my expectation that a correction to 70 in 4 hours would happen exactly like that, is small. In those 4 hours, she coudl be eating a snack, climbing a tree, going swimming, taking a nap, playing basketball, get excited about a movie, ride in a car, etc. It's always a constant rebalance so that 4-hours-from-now-perfect-condition correction isn't something I've ever given a second thought to.

    There is no one right pump for everyone. I suggest you get in touch with reps, get your hands on the pumps, walk through the features and see which one seems to be the best match for your son and your family. I think most people take a liking to one pump fairly quickly and most are pretty happy with their pumps afterward. And, for those that aren't, changing pumps isn't easy but it can be done sometimes. (But don't count on that - really spend the time getting to know the pumps so you can make a good decision and remember that many, many people keep the same pump for years with no regrets!)

    Good luck!
     
  5. hawkeyegirl

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    I think other people have already covered what I would say, but I wanted to add that we have first-hand experience that the t:slim is indeed waterproof, even if the USB port is open. Jack has jumped in the pool while wearing it twice now, and once swam for about 10 minutes before anyone noticed it. Because this is all so new to him. Sigh.

    I also wanted to add that I would not be concerned about the durability of the t:slim. My son is 10 and has worn it for football and basketball, as well as general 10 year old boy horsing around, and it looks as good as the day it came out of the box. I know it looks more fragile than the Ping, but I don't have any reason to believe that it is.

    We've used the Medtronic, the Omnipod and the t:slim, and the t:slim is my favorite of the three.
     
  6. ksartain

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    The IOB on Omnipod includes food boluses. Also, you don't have to use the on board meter. You can use whatever you want and just add the number to Omnipod. We use a different meter.

    As far as site insertion pain, we have only experienced pain after insertion a couple of times.

    With pods falling off, as long as you are willing to tape it down, you should be fine. We use Opsite when we know Chris is going to be in the water or if he'll be exceptionally active to ensure his pod stays put. We do the same thing with Dexcom.
     
  7. hawkeyegirl

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    Yes, all three pumps have IOB for food and correction. They all calculate it differently, but all three track both.
     
  8. Snowflake

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    We are happy with the Omnipod now; we weren't a year ago. When you read feedback on the Omnipod, make sure it's feedback written in the last 9-12 months, since the introduction of the smaller pods.

    We've had very few failures or alarms in recent months. I'm not sure if the improvement is because the new pods fit DD's little body better, or if Insulet has changed its manufacturing practices.

    Omnipod prep and insertion is pretty hassle-free, and I think the remote insertion is a good feature for little kids. We haven't had issues with pods just plain falling off, but we also don't have much humidity here, and we always add additional adhesive.

    As for the strip issues, I have been extremely frustrated by the strip maker (Abbott) customer service over the last few months. I think those issues have now been resolved, and our local Walgreens is finally reliably supplying the correct strips to us. That said, I think it's a legitimate concern whether you want to sign up to be married to Abbott after that fiasco!
     
  9. funnygrl

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    I cut the cord and have been using the Omnipod for about 3 weeks. I'm loving it! No failed pods yet. It seems like that issue has been largely improved on? I'm love swimming without worrying about missed basal. Even just lounging by the pool without worrying about disconnecting and reconnecting , especially if my site is under a bathing suit or someone breaks out the water melon or chips and salsa and I need to bolus. I'm loving sundresses without worrying about the pump. I love more discretion and work. I am using my sites than I ever did with Medtronic because I don't need to worry about reaching. The sites really don't hurt much at all. I have knocked off there pods, which is annoying. I think because I forgot they were there and haven't been careful? I've started using skin tac and it's helping with they issue. I was able to draw some insulin out of the ones I've knocked off. No issue with the bolus calculations. I do think the PDM has a lot of unmet potential, which I wrote a whole post about.

    When I trialed the Animas 2020 in the past, which is very similar to the Ping, I loved the bright screen and fun mentalic colors. I couldn't stand all of the button pushing for a bolus.
     
  10. mmgirls

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    The t:slim is not approved with Apidra insulin, and many have reported issues with occlusions. I think it still is an issue? So if you use Apidra and not willing to try another you might have issues.
     
  11. packmule

    packmule Approved members

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    Thanks for the great feedback everyone! We have a meeting setup with the Animas and Tandem reps next week... and we're still waiting to hear back from Insulet. Interestingly, the Tandem rep was an Animas rep for several years and has worn the Ping, OmniPod, and t:slim. She will be bringing all three for us to look at at the same time.

    How important is local support when pumping? Apparently Animas no longer has a local representative covering Oregon. Oregon is covered by a rep out of Seattle.
     
  12. packmule

    packmule Approved members

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    Good point... we're on Novolog and Lantus currently and plan to stay with Novolog.
     
  13. dshull

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    My son is 9. We have used both the Ping and the Omnipod. If you can afford it, I would not recommend having the Omnipod as your primary pump. Get a tubed pump through insurance, and then later if you want it, get the Omnipod for $199 through their cut the cord program. I am not a fan of omnipod, we tried it for a month, had problem after problem and his average BG went up 15 points in just one month. If this was my only pump, I would be furious. I could go into more detail about why *I* am thoroughly frustrated with the Omnipod but suffice it to say, if you have the option to get it later through cut the cord, I would recommend that.

    As for Ping vs Tslim - just pay attention to what kind of basal rates your son would need to have on the pump. Our son was honeymooning when he went on the Ping (and still is almost 2 years after DX), and the rates he would need on the pump were too small for the Tslim. So while I thought it was a great pump in many ways, it just didn't have the small basal rates we knew he would need, at least initially.
     
  14. packmule

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    You're not the first to caution against the OmniPod as a primary pump. I like the idea of starting with a tubed pump, then getting an OmniPod as a second pump if we choose to.

    I will look at the basal rates offered by the t:slim to make sure it will work for us. Currently we're on 6u of Lantus once per day... not sure how that would translate to a Novolog basal in the t:slim.
     
  15. andiej

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    I only have experience of the Omnipod so will address just that. 3 months in and not 1 single failed pod. Autoinsertion for us is a major plus and whilst my son is 10 I think the fact that you never see the needle makes it less scary. IOB yes it's for meal boluses too and reverse correction works well for us. My son describes the pain as similar to a finger prick. Yes there were the freestyle issues however it seems resolved and i think the fact the freestyle strips are used is a major plus for us as the freestyle and freestyle lite uses significantly less blood than other strips. I'm not aware of another strip that only uses 0.3 most are around 0.6. I think the verio strips whatever they use are 0.4. For us this means less occasions to repoke as enough blood is gathered first time. As for adhesive issues it varies person to person but there are things available to overcome this if its a problem. we have no adhesive issues and my son has bodyboarded for hours on end without an issue as well as swam and been to the waterpark.
     
  16. Snowflake

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    I was worried about this when we moved from Texas to Colorado. In Texas, our Insulet rep was local; here, our Insulet rep is in another state (Utah, I think). Honestly, it hasn't turned out to be a big deal.

    Last year, before we transitioned to the new pod, when we were having major problems with frequent pod failures and were considering switching pumps, we were able to get an in-person meeting with our rep within a week, and she spent an hour and a half troubleshooting with us. I would estimate that the distance only added a couple of days to getting a meeting compared to if the rep was local. We also had incredibly good phone support from a woman in the home office during that period -- she gave us her direct line, and we were talking every couple of days.

    I can't speak for how the other companies handle this, but hopefully it would be similar!
     
  17. hawkeyegirl

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    If your son uses 6 units of basal per day, the t:slim would be just fine for him. The minimum basal rate is 0.1, but can be adjusted in 0.001 increments from there, which are the smallest increments available. Some people use less basal on the pump, and some more, but with your son using 6 units of basal a day, it will not be an issue.

    I would absolutely have insurance pay for a tubed pump and do Cut the Cord for the Omnipod. That way you have a back-up pump from day one. It is what we did, and it has worked very well.
     
  18. rgcainmd

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    I just wanted to second what andiej has said about the OmniPod. No failed Pods here, either, and my daughter can swim all day without interrupting delivery of her basal insulin. We've used only second generation Pods (and PDM) so no problems with Pod failures or test strip issues. Pods stay on with a little preparation (no more hassle than keeping Dexcom adhered). Priming is a breeze and takes so little time. No problems with air bubbles in a tube (because there is no tube). My daughter finds insertion completely painless most of the time and no more painful than a fingerstick other times. Auto-insertion with no needle visible is great. It's nice having the meter built into the PDM; one less thing to shlep around. No need to wear anything but the Pod instead of having to be connected to a larger tubed pump all the time. I didn't think needing less blood with the FreeStyle strips was going to be such a big deal (a fingerstick is a fingerstick, right?). But I was wrong; you need so very little blood for these test strips, so no need to squeeze and squeeze after poking into a more callused area and no need to poke again in another spot. Great BG control here; we had pretty good control using MDI, but with the OmniPod it's been even better (after the not unexpected yucky BGs everyone experiences at pump start). We've only used the OmniPod, so no personal experience to compare it with another pump; all we know is that we love the OmniPod.
     
  19. jenm999

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    My son is also 6 and we are pump shopping. We are narrowed down to Ping and Tslim (though DH wants to eliminate Tslim because it's new to the market; he thinks the next generation will have all the bugs worked out).

    He only takes .5 units of Lantus. Do any of these pumps have a minimal basal rate? .5/24 would be .02, though I bet we'll have some hours with no insulin at all - his BG goes down steadily all night, such that we are now instructed to give him an uncovered 20g snack at 8 or 9 pm, so that he soars to 250ish and wakes around 80. I don't like that, would rather suspend basal at night than do an intentional high.
     
  20. mmgirls

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    Let me direct you to a very recent this thread of mine, it ended up being a great run down of most of the pump.

    My youngest just DX in March is on a hand me down Ping from my oldest and currently we are only giving basal and covering breakfast with a bolus and bolusing if bg above 150 at dinner or needs a bit extra. she does run the minimum basal of .025 at night but you can set a zero basal on the PING. Less than 3units a day TDD
     

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