Insulin pumps for Dexcom G7?

[zannej]

So, the diabetes specialist said Mom absolutely qualifies for a CGM and Dexcom G7 seems to be the best option. She also strongly advised getting a paired insulin pump.

I saw this page: Insulin Pumps & Pens Compatible with Dexcom CGM | Dexcom

It looks like there are currently only 2 viable options as the middle one only works with the G6 at this time. IIRC, the 3rd one (Tandem T:Slim X2) only works with G7 sensors that have a line under the text on a certain part of the packaging. So, we'd have to make sure to get the right ones.

What we are looking for: Automatic pump that can read the sugar levels and dispense insulin as needed. User friendly & very easy to use without having to input a bunch of stuff and know what the carb intake, calorie count, etc stuff is. I was hoping for tubeless but not sure if that is an option. I want something that won't be too bulky, won't fall off too easily, and that she can't muck up by hitting the wrong thing. She's notorious for trying to look at stuff and ending up messing things up. Case in point: Every time I use my phone's GPS while she's in the truck with me, she will pick up my phone (even if I've asked her specifically not to touch it) and somehow mess it up so I have to pull over and reset it so I can still see where I'm going. Without fail! So, she can't keep herself from monkeying with stuff.

She also gets overwhelmed if things are too complicated and I want to make it so its easy for her to use and not too much of a pain. Was hoping for something small and inobtrusive that wouldn't get tangled on anything or get in her way.

Is there a compatible pump not listed that will automatically sense stuff?

She does NOT keep a regular schedule. We never have been able to stick to a set schedule for decades. She does not always eat at the same time, does not have a specific thing she eats for breakfast (if she even eats breakfast) every day. She doesn't like to eat the same thing over and over. If she ate something this week, often times she'll say she doesn't want it again for the rest of the week so she's super picky. Need to work on that too.

Anyone who uses Dexcom know anything about it? I'm using Youtube to look up the two options it showed but am hoping for more info and to figure out that if we have to use one of the two listed, which one would be the best for her.

 

[Amish Heart]

We had an employee use an insulin pump, but she was Type 1. Husband says you have to be on the arm reader and consistent with that with your diabetic doc first. What does the specialist say?

 

[zannej]

We had an employee use an insulin pump, but she was Type 1. Husband says you have to be on the arm reader and consistent with that with your diabetic doc first. What does the specialist say?

The specialist recommended putting her on an insulin pump but didn't give any indication what brand or type. She talked about a type where she could program it to constantly put out insulin in very small amounts all day, but that Mom needs to get her pancreas checked with lab tests first to see if she even produces insulin on her own anymore.

The specialist is trying to get the Dexcom G7 for her but needs to find a place that will get the best price with her insurance. Obviously the holidays have interfered with that process.

I've been watching videos with info about the G7 so I know some of the pros and cons and such. The specialist said Mom can wear it on her belly instead of her arm (she's a back sleeper so the sensor would get compressed on the back of her arm).

Right now its a waiting game.

 

[Tommyice]

The G7 doesn’t require a receiver--you can use an app on your phone. However, Medicare Part B will only pay for it with the receiver being filled and billed first. Then the pharmacy can fill and bill the sensors.
For the pumps, look at OmniPod.

 

[Spikedriver]

I second the Omnipod. If you want first hand info about pumps, I suggest going to Reddit. There are a couple Type 1 diabetes subreddits I am a part of. There, you can find many users of all kinds of Continuous Glucose Monitors and pumps.

The subreddits are:
r/diabetes_t1
r/Type1Diabetes

If you join and ask questions, clearly state that you're asking about pumps for your Type 2 mother and that your specialist has recommended that she be put on a pump. That would help clear up any confusion about what's going on. There are also subreddits for Type 2 diabetes where you might find pertinent information...

 

[Spikedriver]

I use the Dexcom G6. My insurance won't switch me to the G7 yet for some reason. It's no big deal to me. I don't have a pump and I use the receiver instead of my phone.

You can wear any CGM (Continuous Glucose Monitor) pretty much anywhere there is enough fat to keep the probe from hitting bone or muscle. I wear mine on my upper arm, but Dexcom only recommends using the belly. People wear them on the insides of their thighs, upper buttocks, upper chest, back of arms, you name it, it all works. There is a routine for putting one on - if you don't do it right it may not stick to you for the entire 10 day cycle. You have to wash and shave the area. Shave it even if there is no visible hair. The little tiny fuzz hairs that are barely visible can interfere with adhesion. Wash and Let it dry completely again. Then alcohol wipe the area and let dry completely. Then when you put it on, hold it on the skin without pressing it down. Do that for 20 seconds. Hit the button on the applicator and remove it. The CGM should be on the skin now. Take a finger and rub firmly around the adhesive patch for 1 minute, taking care to press down any part that may not be on the skin. Get a skin adhesive called Masticil. If the adhesive patch starts peeling up apply the Masticil under the edges of it.

One other thing is, the technology is good but not perfect. Keep the old fingerstick meter around. It's a good idea to test against the CGM now and then, especially right after starting a new sensor. The body will have an immune response to the probe under the skin for about 24 hours after insertion. That response can mess with the readings. The easiest way around that is to put the new sensor on 24 hours before the old one expires. Then, just switch the transmitter over. But if for some reason you can't do that, the CGM may be unreliable for the first 24 hours and will need to be checked with the fingerstick.

If you've got other questions, I'll try to answer as best as I can. Good luck with all this!

 

[Spikedriver]

@zannej Another thing I noticed was that you mentioned her schedule. I use Humalog pens for my bolus insulin, and Semglee for my basal insulin. I don't have to keep a set schedule with those, other than taking the Semglee at about the same time every evening. I can skip meals sometimes. What types of insulin does your mom use? And does she have any beta cell function left? I'm not sure I've ever asked if she is type 1 or type 2 either. It would be fairly unusual for a type 2 to be unable to produce any insulin, but I've heard of cases where extreme pancreatic fatigue just wears the beta cells completely out. There are some other types of diabetes that are subtypes of T1 like LADA. LADA comes on much more slowly than T1, often over a period of years, and is very often misdiagnosed as T2. Is it possible that is what is happening to your mom?

 

[zannej]

I have no idea what basal and bolus are. It's all Greek to me. LOL. Mom has never done the carb counting. She did calorie counting for awhile and used to really be on top of things but she burned out.

Omnipod does not yet work with the G7 (that was the one I liked from the list but when I looked at the dexcom page it said its not yet compatible but apparently they are working on it). Their FAQ doesn't have a set time when it will work, but they say they will update the app and announce when they are compatible.

The Diabetes Strong Youtube channel has a woman who tests out products and reviews them. She uses the G7. Said she tried the sensor on her thigh but her pants compressed it and gave false readings. She said its not accurate for first 24 hours so use finger sticks. She also said she never had problems with it on her belly (which is where Mom would wear it as it would get pressed on if its on the back of her arm). The lady from Diabetes Strong also said that the sensor has a 12 hour grace period after the 10 day period is up and that if you put a new sensor on an hour to 30min before the grace period ends, the new sensor will have time to warm up, but the results on the meter will be confused.

Mom uses Novelin 70/30. It does some rapid release and some slow release. The doctor said its 12hours but internet said 24hrs so I'm confused.

Thank you for the responses!

I'm currently trying to figure out the right dosage for her when her sugar is high. There was some formula but I am not as good at math as I wish I were and my brain won't focus.

 

[Spikedriver]

Bolus insulin is fast acting. We take it when we eat, or to correct BG when it gets too high. It only lasts 4 or 5 hours. Basal insulin is long lasting. It keeps BG level during the times between meals and overnight.

If your mom goes on a pump she won't be able to use 70/30. She'll have to go on Humalog or an equivalent. (Lispro is the generic equivalent. There are other similar brands.) It's good to get off 70/30. 70/30 is terrible insulin and it's not surprising that she's having trouble. I'm actually surprised any doctor would put her on it. It's a terrible way to live. Literally every other type of insulin is better. It's incredibly difficult to keep stable numbers with 70/30, especially if she's not carb counting. (Calorie counting has nothing to do with insulin and any medical professional that recommends it should have their license suspended for malpractice.)

If she goes on the pump she will have to learn carb counting and also how fat and proteins affect her numbers. She will still have to manually set the pump to give her insulin when she eats meals or snacks. Pumps can't account for that. There's no way around the carb counting. She won't be able to have any kind of control without doing it and it will be dangerous for both highs and lows. It's a lot of work and mental calculation and if a diabetic doesn't put in the work, the results are not going to be good.

The CGM also doesn't have to go on the back of the arm. It can go on the side of the arm too. She's also going to have a pump on her 24/7. She's going to have to deal with that inconvenience. Pumps with tubes are always catching on things.

 

[zannej]

Thanks for the explanation, Spikedriver. The Novelin 70/30 is what Mom has been on for decades and she didn't want to take any other sort. She balked at the idea of switching to something else for some reason. She got used to it and was doing OK up until the last several months when she got burned out and stopped really taking the insulin regularly and didn't take meals at regular times.

The Bionic Pancreas insulin pump advertises that you do not have to carb count and that it picks up what your blood sugar is from the sensor but you can tell it when you are eating meals so it can compensate. Apparently you don't have to tell it when you are eating, but it helps. I don't think Mom has ever carb-counted. Our current gp is not the one who told her to calorie count. The doctor who told her that bs is retired (possibly dead now) and he sucked. Mom said she'd prefer to have both the pump and the sensor on her belly rather than on her arms. Still waiting to hear back on when/if she can get the CGM but it won't be anytime this year- given that its the last day of the year. I'm hoping it will be early next month.

 

[Spikedriver]

@zannej don't get too attached to the idea of that Bionic Pancreas pump. There's really no good way, as of now and in the near future, for machinery to replicate the pancreas. For one, whether the insulin delivery is by pump, pen, or syringe, it is meant to be injected into fat cells where it absorbs at a known rate. Natural insulin from the beta cells goes directly into the blood stream and has less than half the duration of the fastest insulin we currently have available. No pump can react as quickly and accurately as the human body can. When that Bionic Pancreas says "You don't have to carb count" it is pure crap. I'm going to repeat that - absolutely, positively BS!

I'd kind of like for you to PM me. Burnout sucks, but a person has to get around it or through it, or that person is going to suffer consequences. Insulin Dependent diabetes is a lot of work - period. For me, I am just now discovering and coming to terms with some of the ways it has affected me, my life, and my relationships with people. I've been dealing with it for almost 36 years and Ive been quite successful at it. A person has to put the work in, both mentally and physically. There aren't any shortcuts. There is literally no other way. Whether she wants to carb count or not is irrelevant. She's got to learn it and do it.

Maybe I missed this answer in a different post. Is your mother a Type 1 diabetic, or an insulin dependent Type 2?

 

[havasu]

Am I the only one who reads this thread and think of transmission fluid?

 

[zannej]

@zannej don't get too attached to the idea of that Bionic Pancreas pump. There's really no good way, as of now and in the near future, for machinery to replicate the pancreas. For one, whether the insulin delivery is by pump, pen, or syringe, it is meant to be injected into fat cells where it absorbs at a known rate. Natural insulin from the beta cells goes directly into the blood stream and has less than half the duration of the fastest insulin we currently have available. No pump can react as quickly and accurately as the human body can. When that Bionic Pancreas says "You don't have to carb count" it is pure crap. I'm going to repeat that - absolutely, positively BS!

I'd kind of like for you to PM me. Burnout sucks, but a person has to get around it or through it, or that person is going to suffer consequences. Insulin Dependent diabetes is a lot of work - period. For me, I am just now discovering and coming to terms with some of the ways it has affected me, my life, and my relationships with people. I've been dealing with it for almost 36 years and Ive been quite successful at it. A person has to put the work in, both mentally and physically. There aren't any shortcuts. There is literally no other way. Whether she wants to carb count or not is irrelevant. She's got to learn it and do it.

Maybe I missed this answer in a different post. Is your mother a Type 1 diabetic, or an insulin dependent Type 2?

I think she's type2. She became diabetic while pregnant. Miscarried but the diabetes never went away. I'll have to ask her if she knows how to carb count. She had some sort of plaque build up on her brain and has a bit of trouble remember things and focusing now. Some of it could be from recovering from being ill, but I'm hoping it is not permanent. Some times she can think very clearly and other times she has brain fog. I get the brain fog a lot. The bionic pancreas is just a catch phrase type thing. I know it can never fully replace a pancreas. It does let people input some info about what they are eating and if it is low carb or high carb but it isn't as advanced in the carb-counting stuff as other pumps. I hope the omnipod thing will be made compatible with G7 soon. I'm also hoping that my mother can get back on track to pay attention to the carbs and that I won't have to do it for her bc my memory absolutely sucks.

I do remember that she used to be really good at keeping on top of stuff and taking the insulin and such.

Am I the only one who reads this thread and think of transmission fluid?

LOL. Gotta drain that fluid and refill with the new stuff!