Pump for lean 6 yo

Hi all! We are about to get a pump for our 6 year old son who is very lean. We are between omnipod and the t slim with the control iq. We have researched both a good bit. Our endo gives both his approval.

We like the omnipod for being tubeless and also it seems like insertion maybe less traumatic than a tubed infusion set. We wish that the ability to pair with the Dexcom was already here (horizon)

We like the t slim for its control iq which works with the Dexcom. We are nervous about the tube and where we could put the infusion set on a lean child without bothering him.

I would love to hear what folks with experience with one or the other (or both!) think. Thanks in advance for the help!

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@JMCNEEL4 Hi Jason and welcome to the JDRF TypeOneNation Forum! I expect that you will get lots of good feedback here - you will need to sift through the responses [and other information to your question found using Search] - and find what will work best for your son. Never easy! I began using my fourth pump January 2019 after researching all options for nine months.

Putting in an infusion-set isn’t any more traumatic than giving oneself an insulin shot - and the real positive part is that one infusion-set takes the place of numerous [for me, 18+] over a three day period. With OmniPod, you DP NOT have a choice of cannula depth or angle - it is “one size fits all”. With Tandem t-Slim x2, you have choice of several cannula lengths and angle of insertion. I use Tandem, and previously Medtronic, and I select different cannula lengths and angles for the various locations on my body; I too am considered slim.

Best wishes for your son; hope that he will have a great youth and long, happy, productive, and peaceful life. I challenge him to join the many people he will meet her who are now living in their seventh [and longer] decade with diabetes; we will learn from what he offers others as we share our success and also where we messed up.

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That’s a great move for you’re son’s long term health. Unless you think the tubing is a deal breaker, I recommend the Tandem t:slim X2 with Control IQ, combined with the DEXCOM G6 CGMS. The reason is that the Tandem is the most advanced in terms of semi-automated insulin delivery. AND it is software upgradeable. If you don’t intend to start with a CGMS at the same time, or it isn’t covered, then I would choose Omnipod IF it is not considered DME under your insurance. When you choose a device that is DME, you are locked-in to that device for 4 years. If you use FaceBook, there are user groups for a Tandem, Omnipod, and Dexcom that might help with your decision. Good luck! Whichever you choose should provide your son with better blood glucose.

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Thanks for the information and the wishes!

Thanks! I’ll look for those user groups.

We chose the omnipod for our 8year old. She was at the time quite thin. She wears them on her arms, back and belly mostly, but when the weather is nice she wears it on her thighs as well. We LOVE being tubeless. We’ve never done the tubes, but can’t imagine it being better. I’m super skeptical about letting our Dexcom communicate with her pump as it isn’t always terribly accurate. We’ve had it be as far off as 100. :flushed: highs and lows aren’t always the best. We still rely fairly regularly on finger sticks for dosing for highs or lows. I know it’s different for each individual, but we love it. Hope this helps.


My daughter is 7 and has been wearing tandem t-slim since she was 5. She is small and I was worried that the omni pod would be to bulky. We are very happy with the T-slim. And now, with Control IQ, it is even better. The tubing is no problem for her. She wears her pump in a spandex running type belt under her shirt. She is very active, wrestles with her brothers, and has never pulled the tubing out.

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Thanks for the feedback!


We also have a 6 year old and have tried both pumps. We initially chose the Omnipod for the same reasons you express interest in it… being tubeless, waterproof, etc. We had very poor results with it and had to discontinue use after trying it for 2 months due to very high blood sugars and difficult of absorption with the insulin regardless of where we placed the pump. (Which we think now was a result of the teflon cannula most likely “kinking” due to his activity level as well as a new study that has surfaced regarding the fact that the degree of error in the actual amount of insulin delivered by Omnipod is very variable in children taking small doses of insulin and having small basal rates)

We went back to shots for a year and just recently started the Tandem T:Slim with EXCELLENT results. We initially used the teflon cannula, but it kept getting kinked as a 6 year old boy is constantly running, jumping, wrestling, etc. We switched to the steel cannula and have had great results. No kinking, the control IQ has led to many less lows at night. We were worried about it getting ripped out with the tubing as well… but he has been doing all the typical boy activities without any issues. We found some underwear that have a little pocket on the side and the pump fits snugly in it when he is playing sports or going to be very active. We have used his upper buttocks area for the cannula which has worked great in a lean child and use his arms for his Dexcom as their little belly’s are too lean.

Good luck!

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Thanks!!! That hits on several of our question/worries.

Hi Clair,

Can I ask, which infusion set does your daughter use? Can you post a link to the type of spandex belt your daughter uses?

Auto soft 30 infusion set.
I sewed the spandex belt myself. The following link shows a belt that is similar to the one I made.
Fusion Belt | Jet Black I Running Belt I Anti-Fanny Pack – Fusion Belts

My 8 year old is about to start the T: slim next week. We ordered the Tru Steel infusion set. Do you have any experience with that one? I was between the the Auto soft 30 and the Tru Steel. I should have asked for both to try.

We started with Omnipod (b/c tubeless & waterproof). My daughter loved it, but really needed the closed-loop technology, especially overnight, to handle the random hormone surges and growth spurts.

After a ridiculously long fight with our insurance company, we switched to the tslim with Autosoft XC, then TruSteel, and now Autosoft 30s. Control IQ is great, but only if the insulin is making it into her body. She is also very lean and very active, and had tons of bad sites with the XCs. The TruSteel didn’t adhere well — I don’t know why, but I’ve read others had the same issue. She could have used SkinTac, which she uses with her Dexcom, but she hadn’t needed it for the Omnipod or XCs, so she decided to try the 30s. I think these are the ones for her. The insertion device is a little awkward, but she doesn’t want to try the VariSoft. I think she’s just understandably fed up at this point.

Frankly, I’m irritated because if you read Tandem’s own literature, it recommends the 30s for people who are lean and active. And I said that to our endo, nurse educator, and Tandem rep. But they all insisted we try the XC first, and then they all insisted we try the TruSteel. And I let them talk us into it both times, because I figured they had more experience than we did. Grrr.

Anyway, whenever Horizon comes out, I suspect we’ll switch back. My daughter really liked the Omnipod, and didn’t have nearly this many issues with them. But until then, we’re dealing, because she really needs the responsiveness of the closed loop, and I’m not up for the DIY Loop.

Which is a very long way of saying she seems to be doing better with the 30s, and is also lean and active. :slightly_smiling_face:

And I should have said: just ask your Tandem rep or the Customer Service 800# for both kinds to try. They have been very accommodating with us, and I’m sure would be with you, too: they want this to work just like you do.

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Hi Emma @Emma5602, as @srozelle pointed out, the various pump companies will send samples of infusion sets for you to try, especially for first-time pump users.

I’m NOT a slim child, but rather a very slim [BMI under 20] old guy, and I found that the AutoSoft 30 infusion set works best for me. Be aware that the cannula comes in a choice of lengths - 13 mm and 17 mm; I have used the 13 mm for a few years and have had very few malfunctions.

Best wishes and happy pumping for your daughter. And YES, the Control IQ feature is absolutely awesome.

I’ve never used the Tru Steel. I just watched a You Tube about how to insert it. It looks like a “thumb tack” where the needle stays in the body. We chose the Auto soft 30 because my daughter is so little, not a lot of fat, and the auto soft 30 goes in at an angle so it isn’t so deep. The auto soft only has one place that tapes to skin unlike the Tru Steel. The auto soft is inserted with a needle, then it comes out and only the plastic cannula stays under the skin.
I hope that was helpful information. I don’t know how much of a supply you got at once, but you could try something different the next time you order.
It is a little overwhelming when you are first learning how to use the pump. It will get easier. My daughter has been Type 1 for 5 years.
You are doing a good job! You are not alone.


Hello! Just adding that in our experience we have a very lean 6-year-old daughter and she’s been on the T:Slim with basal IQ for a couple months now and it’s working very well. We rotate the tubing site in about six different fairly-close-to-eachother places on her lower back/upper buttocks, where she has the most “padding”, albeit not very much. We’ve only had an issue with insertion one time when I aimed a little too high on her lower back and it bent the cannula.

We haven’t gotten the control IQ yet (she was about ten pounds under the weight limit) but we use the basal IQ and it’s awesome. I requested the shortest tubing option and also got her a couple of these stretchy bands on Etsy that are made to hold pumps around your waist (sort of a stretchy workout/swimsuit type of material) and it works extremely well. She and her siblings are incredibly active and rolling all over the place and we’ve only once had the site accidentally pulled out.

I hope that helps!

Edit: Just adding that we have the Dexcom G6 that we have paired with this, which has been extremely helpful. It’s helping me (finally) sleep at night knowing that if she goes low at night the pump will both alert the Dexcom next to me and stop her background basal temporarily. We also have the insertion set that’s the regular 90 degree angle and like I said it’s only ever been a problem one time out of lots of site changes (every three days).