Pumps and CGM

[Thisonemaybe]

Hi. My son has type 1 diabetes, he's 15. He has no sense of hypo symptoms and is injecting so much he's ending up with hard lumps regularly despite cycling the injection site. We are looking into CGM and pumps, but don't know where to start. He enjoys sport.. running, cycling, skiing and swimming. I would appreciate any recommendations, pros, cons, tips and advice. Thanks

Have you spoken to your team? They normally have a list of available pumps and whether you can be approved for funding for the CGM. My son is 9 and is on the omnipod pump, which is great as it doesn’t have any tubes. We have been approved for funding for the dexcom g6 so hopefully that will begin in January. Self funding the dexcom is around £160 per month. My son also has no hypo awareness so really looking forward to getting started.

My son has Medtronic 670g which works with a guardian sensor. The pump can suspend insulin if he is low or dropping quickly and can add insulin if he's rising if high. He's had tubed pumps since he was 13 months old, is now nearly 12, and swims, surfs, hikes all with the pump. He only takes it off for a bath or shower.
He also has no hypo awareness at all so the low suspend function is a literal life saver, especially overnight when he doesn't wake for anything.

We self fund the dexcom g6 for my 6 Yr old DS. He has excellent hypo awareness, at home he would grab his kit bag at 3.8, but at school he would sit there low and wait until it was the set time to test. The dexcom alarms and that's his que to get his glucotabs. Teachers are aware of what his doing and he doesn't need to ask to get up. We've found it brilliant for timing bolus and you can see exactly how different food hit. His Hba1c improved massively after getting it. Amazingly helpful for sports and days out too. Some sensors don't last the full 10 days but dexcom will replace with a new sensor for free. Different hospitals have different criteria for funding of dexcom and libre.

We have the omnipod, it was a massive ball ache to get as my hospital do not like it for paediatrics due to the basal increments being 0.05 compared to the tubed pumps dosing as small as 0.02u per hr. His basal needs are big enough to cope with the jump so for him it's perfect. But it took a year of arguments and me being a pain. We absolutely love it.

Both stay on for sports, showers, baths and swimming. You don't need to disconnect the omnipod at all. Neither require anything to be carried on him, his Dexcom will work with his phone in his bag across the classroom, and he only needs the pdm (omnipod handset) to put in carbs and adjust insulin.

@FireUnderpants do you mind me asking what phone you have? Trying to prep for January and thinking phone for Christmas, two birds with one stone

Thanks for all your messages, I will have a look into those. We tried a Libra patch, as they are funded in our area and it kept peeling off within a week and gave wildly different readings to a finger prick. I am hoping a CGM will be more reliable! There is possibly funding for a CGM and pump, but they said it is more difficult to get.

The most important thing right now is does your son want it?

I had a pump for.10 years and gave it up drove me mad. Same with the cgm.

You need to speak with your team to see the options

My son has the 670g and this works well for him. There is the new t slim/dexcom combination which is working well for others.
If you’re on Facebook, try joining some groups - such as “UK CWD Advocacy”. There are other pump specific groups.

We funded the dexcom before we had it in an integrated pump. I configured something called “Nightscout” so I could view his levels remotely - brilliant! We don’t do this now he’s older as he self-manages, but it was great for supporting remotely.

My son has an iPhone 6, I have the follow app on my android. Dexcom have a full list of compatible devices on their site.

I would avoid medtronic, they are large and heavy the integrated CGM is (imo) the only good point and their CGM is not as good as dexcom. Omnipod is a good option, you can get some fake pods to trial to see if it works size and position wise. Its tubeless and controlled by a handset. Accuchek solo is a new addition to the tubeless pump market. If you are looking for integrated CGM then something like the T slim could be good, it is a tubed pump that will adjust insulin rates dependent on blood glucose and will help prevent big swings in levels (hybrid closed loop).

Personally I use an Insight, great pump controlled by a horrible handset, I use it with dexcom alongside artificial pancreas programme called android aps to close loop, it's not officially sanctioned but its great, freely available technology. I wouldn't recommend the Insight for regular pumping as the handset would drive you to despair!

Pumping takes time and commitment to get right but can work really well if he's motivated

Thanks everyone, sorry for the slow reply.. busy week. With the dexcom 6, what pump would you then use?

@Thisonemaybe

Thanks everyone, sorry for the slow reply.. busy week. With the dexcom 6, what pump would you then use?

If you want integration then it's only the T Slim at the moment

Thanks, I'll look into the that one.

@Thisonemaybe

Thanks everyone, sorry for the slow reply.. busy week. With the dexcom 6, what pump would you then use?

If you want to loop with G6 you can also use a Dana pump.

My DC has the Omnipod. Has been amazing, they use it together with the libre and miomio
We've been told the libre2 had been approved for use and will get it in the new year