Andrew Stivelman
First published June 1, 2018 on insulinpumps.ca. Republished here for archival purposes.
Infusion sets. Cannulas. Reservoirs. Cartridges. Continuous Glucose Monitors. Basal. Bolus. Tubing. Insulin Pump."
If the terms above resonate with you (or frighten you), read on.
I am a person with diabetes (“PWD”), diagnosed as Type 2 (T2) in 2001. I’ve gone the normal route of oral meds and diet and exercise, but after they lost their efficacy for me, I have experienced how insulin pump therapy can be not only effective but life-changing for people in my situation and want to share that experience with others in my situation.
So, you are probably thinking to yourself, Type 2 on an insulin pump? Why?. What about my quality of life? What do I tell my significant other, or potential mate/s? Back in 2014, I wrote an article discussing this topic. We’re now in 2018, and much has changed.
I initially started with multiple daily injections (“MDI”). While I think it was a good introduction to using insulin, having to use two different pens and two different types of insulin (basal and rapid-acting) was not ideal for me. I also found the injections to be painful.
In 2012, Medtronic (Canada) was conducting a study to determine if T2 PWDs could benefit from insulin pump therapy. I jumped at the chance to participate and was fortunate to be able to use the pump for a year.
Despite my enthusiasm for the new technology and hoping to improve my overall blood glucose control (and lower my A1C), I still had questions about how using a pump affects one’s daily life, everything from where do you put it when you are sleeping, showering, or lying on the beach, to how would it affect a person’s sex life (after all, who wants to sleep next to someone with hardware connected to his or her body). Now, six years later, I can say with complete confidence that it was the best decision I could have made, and I have the scientific proof to prove it.
During the one-year trial with the Medtronic Veo, my A1c dropped significantly. Not only did the pump technology make this possible, but my understanding of my body, how it uses insulin (and how it needs a boost, or a bolus), how everything we eat affects our health, and a general better understanding of nutrition as a whole.
As for my daily life and activities, I found the pump to be completely unobtrusive once I got used to it. The ramp-up time to achieving that level of comfort was short. I was thrilled to eliminate the needles for basal and bolus MDI, and there is virtually no pain associated with the pump being attached to your body. Inserting, removing and changing the site on my body became second nature very quickly. I found many videos on YouTube demonstrating the process, in a very calm and methodical way. These tutorials were very informational and gave me a lot of confidence in what the future holds for this new chapter in T2 management.
I did not find the tubing or the pump itself to be any hindrance to my daily life and learning to sleep with the pump by my side (or in a pajama shirt pocket) was a non-issue. For those with active sex lives, no need to worry. The pump is connected to a small patch on your body and can easily be connected for those intimate moments; but it is always good to let a potential partner know what the situation is. (Note: If you have cats, beware. They are curious by nature, and on more than one occasion I woke in the morning to find the tubing had been a play toy for them).
While I had great success with the Medtronic, when the study was ending, I did not want to give up the pump experience, so it was time to look for a permanent one. The screen on the Veo at that time was difficult to read for me, not color and the backlighting did not help much. After investigating other options, I selected the Animas Ping due to the readability of the color screen. If you have any vision issues related to your diabetes, I recommend a color screen.
The Ping served me incredibly well, changing from the Medtronic setup and screens was simple (of course with the help of my CDE and endo). There is a choice of infusion sets (as with the Medtronic), and my bg control was excellent. My only real complaint with the Ping was the process of uploading your pump and meter data to Diasend Canada (web-based reporting software). The Ping requires a dongle (infrared transmitter) and the process of recognizing that my pump was connected was slow, and the data upload was also very slow.
Once Animas exited the diabetes (pump) business in 2017, it was time to decide the next course of action. In Canada, the only choices now are Omnipod® or Medtronic, although the t:Slim X2™ (Tandem) is on its way. I went with the Medtronic for many reasons: 1) previous experience with the Veo; 2) the beautiful color screen; 3) CGM option; 4) Medtronic’s in-house no-interest financing program.
I’ve been on the Medtronic MiniMed™ 630G since February 2018 with mostly excellent results. The biggest benefit (for me) is the beautiful bright easy-to-read color screen. The menu system is easy to navigate once you learn where each setting is located. You can use cartridges (called reservoirs in the Medtronic world) up to 300 U, whereas the Animas had a 200U limit. The 630G can be used simultaneously with the Enlite CGM sensor (more on that in a future article) for those who want to go that route; it’s not as common for T2 PWDs as it is for T1s, although that may change with time.
To date, I have had some issues with obtaining the same control as I had with the Ping, however I have found Medtronic’s technical support personnel to be superb. There are many variables when using pump therapy and should be made only in consultation with your endocrinologist or CDE, as you could have serious consequences if you adjust a setting even the tiniest bit.
The Carelink software used to upload and analyze your pump (and Bayer/Asencia) Contour Link 2.4 USB meter does not require a dongle; you plug the meter into your computer’s USB port and run the software on your computer in a browser. The reports are powerful, detailed and critical for managing your control.
In summary:Questions? Comments? Experiences? I’d love to hear from you.