Am in need of pump wanna know about it?

Technology & Management
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Hellow guys!!! Doing okay?? Am 22 years old was diagnosed with TID 4 years ago am on MDI but i just wanna know about other technologies for managing this condition. May be insulin pump or CGM. how much does it cost?? Does it work perfectly than MDI???. am in Africa (TANZANIA) still in medical school really
confused how I will access this life saving technologies😓!!!

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I used injections (I’m assuming MDI is manually delivered insulin, meaning injection?) for nearly 30 years. It works well enough.

A CGM monitors your sugar levels for you. It can work alone or in conjunction with a pump. Dexcom is the most common, and (according to my doctor) the most accurate. You insert a small wire under your skin while the rest of the device sits taped to the outside of the skin. It detects the amount of glucose in the fluid between your cells. That’s a little less accurate than a finger stick test, and there’s a time lag between changes in your blood sugar and changes in the fluid the CGM is measuring. But you get a reading every 5 minutes, so it tells you a lot more than a few finger stick tests over the course of a day. It can warn you of highs and lows, show you how your sugars are doing overall, show you the arc as you digest meals and insulin takes effect and so on, etc. A sensor usually lasts 7-10 days before you’d need to remove it and put in a new one. It sends information via Bluetooth to your pump, phone, or dedicated receiver device.

A pump delivers fast-acting insulin on a continuous basis. A little more like your pancreas would do. You don’t use long-acting insulin in conjunction with that. Some pumps can work with a CGM in order to automatically increase or decrease the dosage to help prevent lows and treat highs. But even without that, you’re free from taking daily injections and the body tends to respond a little better to the continuous dose - most people need less total insulin that way, and are less likely to develop insulin resistance. The way it works is you insert a short tube (cannula) under the skin to deliver the insulin, and the pump can either attach to that via a longer tube or just attach directly to the skin, depending on which pump you choose.

Price is going to vary. Depends on what pump you choose, which ones are available, what prices are in your country, what insurance coverage you have, if any, etc. It can cost several thousand dollars out of pocket. Plus you need regular supplies to make it work. The cannula needs to be changed and replaced in a new site every 3 days to prevent infection. So you need those, insulin reservoirs, and other supplies. Likewise, a CGM needs new sensors and possibly other supplies, as well.

It’s liberating having a pump. You can easily dose insulin as you need it without having to prepare and take an injection every time. And it can help treat diabetes better, keeping you in better control. That’s especially true of the newer ones that can work directly with a CGM.

But your life is dependent on it working and on you having the supplies for it and keeping the battery charged (or, in some cases, having a supply of replacement batteries). If anything goes wrong (and you don’t have backup injections on hand), you’ll have no insulin at all and could get very sick in a matter of hours.

I don’t know how well that answers your question, but it’s the best I can do without knowing your circumstances and what’s available where you are.

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Hello @Ibrah I hope you are well.

We are primarily in the USA here. I suggest you contact a local authority on what medical devices are approved in your area. You should contact:

There are two diabetic associations in Tanzania. Their contact details are:

A tandem tslim or Medtronic pump is $6000USD without insurance. Plus consumables such as reservoirs and infusion sets which are (in USA ) pharmacy items. Insulet Omnipod are often pharmacy as the pump is disposable and therefore not a durable medical device. Pods are about $60USD each and last 3 days maximum.

Same for CGM but since they only last 5-10 days, CGM are pharmacy items. Dexcom is the most expensive at over $100USD each sensor and each lasts 10 days.

Freestyle and Dexcom as well as the Medtronic CGM are available in USA. There is also an implantable CGM here.

Wouldn’t your physician know what is available to you?

Cheers. Good luck :four_leaf_clover:

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Hi @Ibrah! I am on MDI also, but I have a CGM. I have the Freestyle 14 day. It is placed on the back of the upper arm and lasts 14 days. I really like it because I can scan the sensor and catch my blood sugar before a low or high happens -usually. Sometimes I get wrapped up with the kids and forget to scan. It also graphs your blood sugar numbers throughout the day. Here in the USA it is about $75 for 2 sensors. Blessings!

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Hellow @wearsHats I really appreciate your response you have provide lots of informations about how this devices works…think now its up to me to check what’s available in my country!

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Thanks @joe for the contact details and informations! Am gonna talk to my physian to know what’s available in our settings.

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Hi @homeschoolingmomof5 thanks for informations

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Welcome to the forum @Ibrah - and I wish you all the best in your studies in med school.
Many people do quite well on MDI and even prefer them (@WearsHats - MDI stands for “multiple daily injections” but since that does manually deliver insulin your terminology isn’t too far off). You should sit down with your doctor to find out what’s available, but the pumps here in the US are Tandem’s T-Slim (which I use), Medtronic’s series (they a number of pumps with different features, and Omnipod, which is the only one without tubing - it uses a PDM (personal diabetes manager) for remote control.
There is software that allows you to see your pump status on a smart phone, but forum users in some countries in Europe have said that capability is not available where they are so it’s not yet universal - you would need to check where you are. Having said that - it’s a nice convenience but you can always pull out your pump to see.
Talk with your doctor about your interests. Even if injections are working for you, a pump may be helpful in your medical studies and training. My Tandem pump has a closed loop system that works with a continuous glucose monitor (CGM) to help keep my numbers from going too low or too high, by adjusting the rate of insulin based on what those numbers are. You may not always be able to eat when you need to do that’s a great help. Medtronic has a similar system using its own CGM. Talk with your doctor to see about availability as well. Countries go through their own review of technology to make sure it’s safe, so check if it’s available for you.
Insurance is different here in the USA than it probably is where you are, and looking at our out of pocket costs without insurance may not give a good comparison, so work with your doctor to help figure out costs.

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Thanks for the MDI explanation.

To clarify, in return: I looked into it. Tandem’s t:connect app is not available outside the US. (Poking around, I found people in Canada and elsewhere also could not access it.) Tandem does not explain why that is, or if or when they’ll make it more widely available. They do have a website version to help you review and analyze your data, but you have to manually upload through a Windows or Mac computer. There are third party sites where you can download a copy of the t:connect apk (app installation file for Android), but I’m not sure how well that would work.

Otherwise, you make good points. A CGM can help. A closed loop pump can help. But nothing is perfect, and how well the various options will work for you depends on many factors.

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Thank you for your research! Other countries are ahead of us medically in some areas so I’m a bit surprised about the app - I remember the days when I had to log in, of in, and wait. It didn’t necessarily take long but using bluetooth and having everything transfer is so much more convenient. But at least you can do a good old fashioned download to get what you need.

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the most likely reason is “approvals” for regions. The USA is governed by the FDA and Tandem has those approvals… outside the USA requires adherence to each AHJ (authority having jurisdiction) and specific requirements and approvals. Europe, UK, South America, China, Japan (and many others) all have completely separate approving methods and authorities, and it can be very expensive to get multinational approvals. Not helpful, but that’s the likely reason why Tconnect is only available here.

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