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There are several pumps available in the US right now - Omnipod, Animas Ping, Minimed Revel, t:slim, and Accuchek combo.
Some things to consider about each:
Minimed Revel - This is the only pump that currently has an integrated CGM. It's an extremely reliable pump, and Minimed has been doing insulin pumps for a long time. It has Carelink, which is a great online software system for managing data. It also comes in two sizes - one that holds 180 units and one that holds 300 units. I am about as rough on my pump as a 14 year-old boy and I have the Revel. It has definitely withstood every bit of abuse I have thrown its way! The pump is water resistant, BUT NOT waterproof. Basal and bolus increments go as long as 0.025, which is important if your son is very insulin sensitive.
Animas Ping - The Ping holds 200 units of insulin. It is the ONLY pump on the market that is completely waterproof. The Animas Vibe is the next model that is supposedly coming out next year and will be integrated with Dexcom. It also has low basal and bolus rates of 0.025. The meter it comes with can also function as a remote, which I know a lot of folks love. This video does a great job of comparing the Ping to the Revel (http://www.youtube.com/watch?v=2M0KeIqdYro). Anecdotally, it does seem to me that the Ping is a little less durable than the Revel (based on the number of people I've seen on this site who have needed their Ping replaced). But it seems to be a pretty solid pump. If your son spends a lot of time around water, this is the pump to go with.
Omnipod - I know a lot of people love the tubeless aspect of the Omnipod, and if tubeless is your son's top priority, this is the one to go with. HOWEVER, the pods can and do fail. Right now, the pods are fairly large (although I think they are coming out with smaller pods very soon, if they haven't already). Each pod holds 200 units of insulin. I know some people have complained about the way the system works (because the pod expires after so many days, and it's easy to waste insulin if a pod fails). My endo would not recommend the Omnipod for me because I have a tendency to go into DKA very fast and the pods just have a lot of issues. That said, if tubeless is THE most important thing, this might be the right pump for him. I will say that I am very active and the tubing on my pump has never bothered me. The pods are waterproof, but the PDM that communicates with the pods is not.
t:slim - This pump is very new. It just came out last year and has only been in widespread use for several months. The cool factor is definitely there, but it is tubed and doesn't really offer features that are mind-blowingly better the Revel or Ping (IMO). The touch screen is nice, but would make me nervous. Also, I'm wary of any new company. Pumping can require a lot of support and this company hasn't been around long enough to prove that they can do this. Also, the pump looks cool, but I would question its durability, especially around a 14 year-old. The pump uses rechargeable batteries, so your son would have to remember to charge it (other pumps use batteries you can just throw away, which is less environmentally friendly, but easier). Also, I don't think the t:slim is waterproof. But if coolness is a factor for your son, and you think it would encourage compliance, you might want to consider this one.
Accucheck Combo - I don't know much about this pump, but I do know the meter works as a remote (similar to the Ping) and it has the largest capacity (I believe 315 units).
Some things you want to consider when selecting a pump:
I would recommend narrowing it down to 2 or 3 pumps and then getting information from each company. Make sure you look at all the features and consider whether they match your son's lifestyle. There is no one perfect pump. It's about finding the pump that is right for the individual user.
Wow! Thank you so much for all the info!
I've only used the Omnipod so I have no point of reference or advice to give on any other pumps.
That being said, I find the Omnipod to be fantastic. I'm going on 3 years of use now and I would not consider another pump at this point. I do not know what it's like to have a tubed pump, but the Omnipod goes as well as I could expect with my lifestyle and activity level. For the three day stretch that they are active, I simply do not have to worry abput ever having to disconnect for showers, workouts, meetings, airports, swimming, or even full live training in Jiujitsu.
The smaller pods are already in use in Europe and are expected here in the U.S. around the end of February.
Admittedly, it wasn't set, forget, and go for the first 6 months or so. A lot has been made about the rate of failure and I did see scary failure rates for the first 6 months or so. Personally, I think a lot of that for me was user error and finding out that pod placement and site choice are absolutely key. A pod that works perfectly at one site will not work at all if it is shifted over a couple of inches for the next pod. Now that I've worked out my rotation through 6 or so areas that still have probably five useable sites per area, my error rate has dropped to practically 0. I haven't had a failure in over 6 months now. Before that, I had one or two failures per 90 day supply.
Still, on the Omnipod site, there are some that have just plain given up on the pod, so YMMV.
When the pod fails, what exactly happens? Blood sugars go up? How long does it take before you realize it fails? Could it cause serious problems if we don't get it right in the beginning? I really think the Omnipod will be best for him, but I want it to be safe and not make anything worse for him. Thank you for answering!
What exactly happens could be an unsolveable mystery, but the pump usually alarms. For me, most of the failures are occlusions where the canula kinks and cuts off the flow of insulin. I've had failures where the alarm does not go off because, although there's an occlusion, the insulin still flows, but it ends up leaking from somewhere upstream. In those cases, there will be the unmistakeable odor of leaking insulin and other tell-tale signs.
The only other failures I've had are priming failure where the pump fails to load the insulin properly before being attached. In thos case, there will be a definite alarm and priming failure alert.
Then, there are any number of occasions and mishaps where the pod becomes physically dislodged.
As with any case where insulin supply fails, BGs can go up, with all the associated problems and dangers. How long it takes to notice rising BGs, I imagine, is mostly dependent on the indivudual.
I think of wearing the pod as an art-form rather than a science. Half the fixes I use for whatever issues have arisen are probably not even applicable to the next user, but there are probably any number of precautions and fixes that they could use that wouldn't work for me.
Due diligence is absolutely required though, but with some planning and a bit of trouble-shooting skill, I've had very few problems, relative to MDI anyway.
If you find one or two pumps that you are more interested in, I would call the companies or your endo's office to see if you can set up a trial period with your local rep. This is a sure way to find out if you like the pump by getting to actually use it. I've used the MM and Animas in the past and am currently on the OmniPod. They are all good pumps, it really comes down to personal preference. I absolutely love the tubeless factor of the OmniPod but some people find it too bulky. However the new smaller pods were recently approved just not available to users just yet. MyBustedPancreas listed a great list of features for each. If you have any specific questions, feel free to ask me :)
Hi there, my son is also 14 and started on the omnipod abut 2 years ago, it was the only one he would consider, he tries to be incognito as possible with his D, generally to his detriment but that is another story! We had a few ups and downs with the omnipod at first be overall we are very happy. Unfortunately there is a new layer of concern with any pump vrs MDI, pump failure! However the pros far outweight any cons esp with busy teens looking for more independence. so much better to wip out their PDM and do a quick bolus. The biggest issue we had was highs after pod changes, alot of people experience this but it is resolved with a small bolus after changing the pod without food. It is great for swimming, may need to add some extra reinforment we like tegaderm for more "vigorous" swimming or activity, but once they have a sense of this new thing on their body it gets bumped alot less and that pretty much becomes a nonissue. If he is currently pretty stable the transition should be pretty smooth, some endos recommend a saline week to get used to it, we did this. and they start with a slightly lower basal at first so their are some adjustments. dont expect perfection, expect some frustration and extra testing at first to figure out setting but also through a throw out the lantus party!! as this is my only experience it is all i can share, please ask away if you have more questions. along with the 14 year old ...we probably have more to share at another time! best wishes! amy
Thanks! I appreciate all the comments, will definitely help with our decision. Jared is an ice hockey goalie, and is very active so the Omnipod does sound like the best choice for him. We ordered a sample to check it out.
I can definitely say that an Omnipod would work well in your son's situation. Once it's on, you no longer have to fiddle with the pod itself. You can tape over it, wrap it up, then cover it in pads and 4 layers of clothing, and it can remain fully functional and running through it's basal program, unaffected.
For me, that's one of the biggest advantages of having it and going through my day's activity. As long as I make sure it's adequately protected, and that may take some effort dopending upon the day's activity, I'll never have to disconnect it or worry about not having my insulin supply or my basal program working.
My jiujitsu instructor tells me that another T1 in his classe disconnects his tubed pump for lessons and training. Since my lesson and training may run for two hours straight, that would simply not work for me. I've had occasion where I've done all day activities which would have required intermittently connecting and disconnecting as needed. With the pod and remote PDM, I jucould adjust my basal rate according to activity, and still bolus as needed, without worrying about it.
My daughter has been using the Cozmo pump for just over four years. We loved it but as you probably know, it is on longer being manufactured or supported by Smiths Medical. Today, we switched to the Tandem t-slim. It looks like it is going to be a great pump. Very intuitive and easy to use.
The t-slim is another one we were interested in, let me know how it goes. Thanks!
We're on Day 6 with the t:slim and so far we're very happy. Last Friday one of my daughter's non type 1 friends saw her new pump and said "that is so cool...I want one."
The touch screen is very easy to use. It’s nice to be able to enter a BG number instead of holding the up button for a (hopefully short) period of time.
Making changes to basal rates, carb ratios and correction factors is very simple. Much easier than using the Cozmanager Software and much more intuitive than trying make changes to the Cozmo pump.
The Cozmo had approx. 6 customized presets for increased or decreased basal rates. The t:slim allows you to make any change you want for any period of time. Though I believe the maximum time for an increase or decrease is 72 hours.
The extended bolus is a great feature as well. It will default to 50% now and 50% over the next two hours. Changing the percentages and times couldn’t be easier.
There are a few things I’ll miss about the Cozmo. The Cozmo could fill 23 inches of tubing in a few seconds. The t:slim is very slow.
Hope this helps!