So my 5 year old is really wanting to try an insulin pump. She was diagnosed in June 2019, should I make sure her levels are more at range, we have been experiencing a lot of lows and constantly changing her ratios around. I’m just not sure how the pump works at all. I’ve done some research.
An insulin pump will certainly make things easier. When combined with a CGM, they’re life changing. My Tandem with basal-iq is fantastic at preventing low glucose levels while eliminating the rebound highs. Do as much research as possible before you decide on a pump. The next 6-12 months is going to be exciting for new pumps and technology.
Tandem:
Currently has basal-iq with low glucose suspend
Will be releasing the control-iq loop system in 2 weeks
End of 2020 the tubeless t:Sport will be launched with an app that will be able to control the pump on iOS devices.
OmniPod:
Tubeless pump requiring a separate PDM
Second half of 2020 they will introduce their loop system without having a need for the PDM with an app on Android phones, no iOS planned at this time
Tidepool will also be launching their loop algorithm in mid 2020. They’re algorithm will be in the app controlling the pod on iPhones only.
Medtronic:
Have a planned launch of their 780 Hybrid loop pump sometime around March or April 2020.
Hi @Dee314 you can go to each manufacturer web sites and they will tell you about how their system is set up.
Generally, a pump uses only fast acting insulin. The “basal rate” takes the place of the long acting insulin. Basal is accomplished by very small amounts of insulin delivered over time. Basal requirements change with age and weight.
A meal “bolus” is accomplished by sending the whole amount at once. You use bolus to either correct a high blood sugar or for meals/carbs.
All of this insulin is delivered by an “infusion ser” which is worn like a band-aid and is either a small plastic tube or small metal needle. They stay in place with tape but must be changed about every 3rd day.
Some pumps interface directly with CGM. Newer pumps alter insulin on high and low blood sugar. You can get a copy of “Pumping Insulin “ for a generic idea of how to use and modify pump settings.
There is no mandatory waiting time to get a pump. There is no requirement for good or bad control. Your endocrinologist may have their own ideas but some children start pumping at diagnosis.
Good luck.
Others have made great comments on why a pump can help, so I won’t repeat. One thing to keep in mind is that when you get an insulin pump, you are locked in to that pump for 4-5 years, depending on insurance. Because of that, the only pump I would recommend is the Tandem t:slim X2. They are integrated with the Dexcom G6 CGMS, and are about to roll out new Control IQ software that makes it the most advanced pump actually available. The new software is available only to those 14 and up, but clinical trials for younger children are currently running. Tandem pumps are software upgradeable, which is a big deal.
BTW, Omnipod is generally not considered a pump for technical reasons, so it can be possible to start on Omnipod and switch to another pump without the 4-5 year wait. Check insurance.
Good luck! Your daughter has been diagnosed during a time of rapidly improving technologies and should have a long and happy life with T1D.
I have the Basal iQ system with my new Tandem pump and it has vastly decreased the low blood sugar alerts I receive. Instead of one every couple days, I am getting maybe one every 3 weeks. And I get them for BG’s in the 70’s instead of in the 40’s. So the lows have been well taken care of. All this has caused my average blood sugars to rise, though, so I am going to download the new Control iQ software as soon as it becomes available.
I don’t entirely agree with all the comments made. I have 2 kids with T1D, been dealing with it for 3.5 years.
#1 - so long as you understand counting carbs and ratios, there is no reason to delay a pump. The doctors really just want to be sure you understand what to do in case it malfunctions, that’s why they make you wait.
#2 - for an “active” child, I STRONGLY recommend the Omnipod. It is the only tubeless pump, and will give your child the freedom to run around and do physical activity without being “tethered”.
#3 - someone above mentioned Omnipod Loop. But really, the Omnipod Horizon is what you want to watch for. It is the closed-loop pump/CGM set the be released in late 2020, working with the Dexcom G6, which doesn’t require any regular finger pricks for calibration.
Bottom line, to agree with an earlier comment, do some research. But get on a pump ASAP. Your child will appreciate being able to snack more easily by using the pump for small doses, you won’t have to carry around a bag of syringes everywhere you go, etc.
Oh, and while we haven’t tried the Tandem, we DID try a 6 week free trial with Medtronic (also something to look into) and were generally disappointed with how cheaply the product was made, worrying about disconnecting it to do things, and the scary, daunting infusion set. Applying an Omnipod is much less scary.
I was really scared to make the leap to the pump last year for my 11year old, but I’m SO glad we did!! Many benefits! So much easier and let’s him be more independent and me less freaked out. I’m glad to know I can do it old school in a pinch, like if the pump ever malfunctions, but the pump makes it so much easier. We have the Tandem tslim/dexcom G6 combo - love it!!
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Hi Tracie @TeeLu, I found your enthusiastic endorsement of pump use for your child of 11 years to be very uplifting.
- Have you activated the “Basal IQ System”?
- If so, has the Basal IQ System eliminated or significantly reduced BGL below the “In Range” 70 mg/dl?
Pumps are great. I recommend sign up for one of the JDRF summits (looks now though as they fill up quickly). They are a great way to talk to other parents of children living with T1D and an opportunity for children with T1D to meet others their age with it too. You would probably find out a lot about the different pumps. That may help you in selecting the best one for your daughter.
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I agree - give it two weeks and get the Dexcom G6 and Tandem combo! We have kids that start pumps shortly after diagnosis all the time - even at age two.
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How about the Omnipod or Omnipod Horizon?
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Hi Dee @Dee314! Congrats on getting through your first 6 months after diagnosis–it’ll only get easier from here.
I’ve had T1D since I was 7 (I’m 16 now), and for most of that time, I didn’t have a pump or CGM. It’s great that your daughter knows what she wants and isn’t scared to try it! Switching to a CGM was a really difficult choice for me, but it ended up being a total life-changer; I don’t regret it at all. If you and your daughter feel that a pump would be beneficial for her, I think you should give it a try. There’s no right or wrong time to switch as long as you consider your options carefully and talk to her endo. If she decides she doesn’t like it, she can definitely switch back!
Good luck and feel free to message me if you have questions–I’m not on a pump but I’m here to talk about anything else. 
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Hi,
Yes Basal IQ is great - has spared us (or at least softened) many lows. He was diagnosed in March 2018, used novolog and lantus pens until August 2018, and started the pump the same week school started, which seems crazy to me in retrospect! (chaotic week to introduce a major change, but whatever! It was fine.) Because they had shipped us his Tslim earlier in the summer, we had one without Basal IQ pre-installed so had to wait a few months to upgrade the software and run it. I’d say he’s been using Basal IQ for a little over a year. It is SO helpful. Scenario: 2am, Dexcom low alarm goes off, he’s 75 gentle down, very often this requires no intervention b/c Basal IQ will take care of it. Obviously it can only do so much if he has a big bolus on board, but even still, it’s amazing how the basal kicking off for 5, 10, 15 minutes makes a huge difference! One minor scary thing: all of his settings are on the aggressive control side and assume the availability of Basal IQ - not great when there’s no data!!
What about you? I think I remember from the site that you’ve had Type 1 for a long time, but I don’t remember what you use.
Tracie
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Tracie,
I’ve had diabetes [official diagnosis] July 4, 1957 - my 16th birthday present. I didn’t begin using the Dexcom G5 until July 2018 and have grown to really like it; only recently upgraded to the G6 and began using Basal IQ with my Tandem t-Slim x2 which I began using almost exactly one year ago. I began using MiniMed/Medtronic pumps 16 years ago this month and I tried another CGM in 2005 that didn’t work well for me - dropped using it after a couple of months.
I’ve been under aggressive management since the late 1970’s when I helped [under direction of Joslin Clinic] develop what is now called MDI or Multiple Daily Injection - a really break-through way to look a t diabetes management. I’ve found the Basal IQ to be really effective for me, like this afternoon during and following a gym workout, my insulin suspended six different times. I’ve tried the “hands off” way of monitoring and let the pump and CGM do its own thing - only taking carbs when I get arrows indicating I’m dropping and I’m already below 90 mg/dl. I’ve really liked the way the pump suspends during the night. I have my low and high settings at 72 and 195 mg/dl; when I first began Basal IQ my low was set at 85 - just while I was seeing what the software would do.
I’m really looking forward to moving to Control IQ in a few weeks - I’ve read the entire manual and feel comfortable with what it will do for me.
Probably a lot more information than you wanted - but that is me,
Dennis
Oh wow, you have quite a range of experience! I can’t even imagine treatment pre-fingersticks. It must have been scary. I know how this has turned out world upside down in a way, but am so thankful for all this tech that brings some peace of mind (for me) and independence (for him)!
Yes we’re eager for control IQ too - will have to wait longer as he’s only 12 & it’s approved 14 and older for now. Best of luck with it and let me know how it goes if you feel so inclined! Or I’ll keep an eye out in the forum.
Regards,
Tracie