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Permalink Reply by MyBustedPancreas on December 11, 2012 at 1:02pm

Yes, I totally agree about the pace of technology. I've seen it/lived it firsthand. As an adult, I don't have any issues with supporting new technology if I can. However, the slowness has more to do with the FDA approval process from what I know, not peoples' willingness to adopt the technology once it's out there. Granted, the FDA process is there to keep us safe, so there's that.

Regarding DKA, an occlusion in the line (and failure of the alarm to go off) is just one way it can happen. Pumps can also malfunction and tell you they are delivering insulin when they are actually not. Granted, these instances are rare, but they happen. My endo advised me not to get the Omnipod, for example, because I go into DKA very quickly and the pods are known to be quirky. That said, for someone who isn't prone to DKA and really, really needs a tubeless device, I think Omnipod is a great choice. It's all about individual factors.

My point was only that, IMO, these occurrences are less likely in "proven" devices. I would personally not have any qualms with an adult pioneering a new device, but if it was my kid, I would have second thoughts based on my own experience with T1D, and would probably opt to stick with a device that is more proven/tested in the pediatric population. Again, just my opinion, so take it for what it's worth.

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Permalink Reply by momofT1Dgirl on December 11, 2012 at 1:19pm

I both appreciate and love to hear what others think. I believe the best choices are made with an open mind, research, and discussions with others interested and/or experienced with the topic. Which is why I am here, soliciting conversation. T1D and pumping are both new.

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Permalink Reply by Laddie on December 11, 2012 at 3:41pm

Since you mention that your daughter is already using a CGM, I assume that she has a Dexcom. My understanding is that Tandem will eventually pair with Dexcom although I don't think that anyone has any idea when that will be. Animas will be the first one to come out with the combo Dex pump. Supposedly Omnipod was going to be next, but I read somewhere that they don't have a formal arrangement with Dexcom right now (but that may have changed. Think it's been back and forth between those two companies.)

I spoke with a Midwest Tandem rep about the Tandem/Dexcom relationship and he indicated that the companies have a good relationship and are "just down the road from each other." However, right now there is no upgrade program for Tandem. I assume that will change, but if you buy a T-slim now, you have to assume that your daughter will have this pump for four years.

I just went through a pump-buying decision due to an out of warranty pump. I had pumped with Medtronic for over 8 years and love their pumps, but hate their CGMS. I did have a few years of using a combined CGM/pump device and the integration is fabulous. I've been using a Revel pump with a separate Dex for quite a while. I won't give up Dexcom, but I hate having to carry separate devices.

I ended up going with Animas because of their next pump to be integrated with Dexcom (hopefully 2013). I was told that they planned to file with the FDA in January. The current upgrade program is $99 to upgrade to the combined Animas/Dex pump (the USA version of the Animas Vibe already being sold in Europe). The Animas Ping to me is an OK pump--a step backwards from the Revel IMO and of course very different from the t-slim.

When your daughter adds the pump to a CGM, you will quickly understand how important a combined device is. When I told the Tandem rep that the lack of an upgrade program was a deal breaker for me, he essentially dumped me and I never heard from him again.

Have you ever participated in the forums at Children with Diabetes? If not, I suggest that you post in the Parents of Children with Type 1 forum and ask your questions. I think you'll get some good answers from very experienced parents.

Good luck on your decisions. No decision will be perfect, but just be educated on what you're doing. Let us know what you decide. Also remember that unfortunately diabetes isn't going away and you have time to do your homework.

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Permalink Reply by momofT1Dgirl on December 11, 2012 at 4:07pm

Wow, lots of info to think about, love it! Nice to hear how you really like the integration of a pump and CGM. Never thought that I would mind them not being integrated, might have to rethink the value in that. I really like the Animas upgrade for $99. Too bad Tandem doesn't have an upgrade program, as I could see how that might be a deal breaker for some.

I think you hit the nail on the head that there is no perfect pump or decision. I really appreciate your input as you have given me a lot to consider.

I will check out Children with Diabetes, Thanks!

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Permalink Reply by MegaMinxX on December 11, 2012 at 4:35pm

I'm thinking the same.. that Animas Vibe + dexcom gen4 will likely be my next pump.
As a parent, a plus might be that the Dexcom receiver and the new Animas (Vibe) pump would both receive the signal from the dexcom Gen4 sensor. So the parent could have a receiver and be 20 feet away. So you get the best of both worlds, integrated and separate.

If you can, try to get a hands-on demo and try out the menu/button presses. Some diabetes care teams have pumps, or have Informational events with demonstrations.

Since the Vibe is currently only available in Europe, the only option for 'hands on' is to view the user manual, or info on the Animas UK website.

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Permalink Reply by momofT1Dgirl on December 11, 2012 at 5:44pm

I really like that idea, because right now we keep the Dexcom G4 receiver next to our bed at night. It has a great range. We love it.

Integrated and separate at the same time would be a real plus!

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Permalink Reply by acidrock23 on December 11, 2012 at 3:27pm

I agree that the smallest rate is the most useful, particularly if you are looking for precision. I am pretty obsessive about it but if I'm at 110 and boost my rate by .025/ hour, it'll get the 15-20 points I'm looking for to get me to 90-95. The sensitivity and, for me at least, importance of making these small adjustments, trimming the sails or whatever you want to call it, is something that I haven't seen a lot of in books but seems to me to be a big advantage of a pump and I would want whatever pump has the smallest adjustment parameters avaiable.

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Permalink Reply by momofT1Dgirl on December 12, 2012 at 1:02pm

Update- We have come to a decision that the Animas Ping would be a good choice for our daughter. I hope the insulin pump will help make living with diabetes a little easier for her. :)

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