My husband was diagnosed this week with T1. I have been reading, and it looks like the pump is the best way to control diabetes. So when can he get the pump? He just started the insulin, just one shot a day right now, to start off with. His first apointment with the diabetes specialist isn't until Nov. 30th. I plan on asking if husband can get on the pump soon.

Also which pump is better to have?

Who pays for the pump? How much are the pumps? our insurance is blue cross blue shield from Mass.

Most specialists won't put people on the pump until they are doing well over 1 shot a day. If your husband only needs one shot a day, he's not a good candidate for a pump at the moment. That being said...if he is type 1...I can gurantee his control is subpar on this kind of regimen and that he actually needs more than one shot a day.

As I am sure you have read, a pump mimics natural insulin production by providing small doses of insulin every three minutes. Then when you eat you program a "bolus" dose to cover the carbs. You can do the same to lower a high bs.

What most doctors want you to do before going on a pump is mimic this with injections for awhile to get a feel for it and learn how blood sugar is controlled. This is done by taking one or two shots a day of long acting insulin (Lantus or Levemir) and injecting rapid acting insulin (Apidra, Humalog, or Novolog) everytime the bs is high or a meal or snack is eaten. It's a pain in the butt, but you have good control and learn a lot.

At my endo's office and most places, before a pump can be ordered you need to have a good grasp on carb counting and adjusting insulin for how many carbs are eaten. Some insurances won't pay until the patient is doing this. Some insurances won't pay till the person is on insulin for at least 6 months.

So basically how long till you get the pump depends on how fast your husband learns, how his endocrinologist feels, and your insurance policy.

I have a Cozmo. There are 4 main brands of pumps in the US- Animas, Cozmo, Minimed and Omnipod. They all have their advantages and disadvantages. Two pumps lesser used are the Accu-chek Spirit and the Nipro Amigo.

Animas
Smallest Pump on the Market
Remarkable Customer Service
Smallest basal rate adjustment
Holds 200 units of insulin
Waterproof
Bolus calculator calculates dose using bg target, ISF, and carb ratio and you can adjust this for time of day, however, time windows are preset.
Standard Luer Lock Connection
Comes with OneTouch Ultrasmart meter, but no communication w/ pump.

Cozmo
Waterproof
Lightest weight pump
Holds 300 units of insulin
Free software upgrades- when new features come out, you get them free
Standard Luer Lock connection
Bolus Calculator
Customize text on screen
Create menus of custom temp rates and boluses, and the pump will memorize these for the next time you do an activity
Meal Maker- pump will add up the grams of carbs in a meal for you
Cozmonitor- the pump can connect to a modified version of the Freestyle Flash meter and let you test your bs

Minimed
NOT waterproof
Holds either 186 or 300 units
Making pumps the longest
Proprietary connection
Bolus Calculator
For an extra $999 you can get a CGMS that communicates with the pump
Communicates with Paradigm Link meter (version of BD Logic), however, BD just announced that the BD Logic (and therefore the Paradigm Link) is being discontinued
For an extra cost you can get a remote control
Mixed reviews on customer service
Widest variety of clips availible

Omnipod
This pump is different in that a pod of insulin is stuck to you, than a PDA type thing (called the Personal Diabetes Manager or PDM) is used to wirelessly do all the programming. The PDM has a Freestyle Meter built in. The Pod part is waterproof and holds 200 units of insulin. It's unique in that you are not tethered, however, you can't do anything without the PDM. Also, the Pod is shut off after 3 days of use no matter how much insulin is left in it. There is no software you can upload to.

Nipro
I know very little about this, but here goes it:
Availible in a ton of cool colors
Uses a standard luer lock connection
I think it's waterproof
Bolus Calculator

Accu-chek Spirit
New to US market
No bolus calculator on the pump, but rather on a separate PDA
Comes with a PDA with software that calculates boluses, and does data analysis. The PDA does NOT work wirelessly with the pump.
Holds 315 units
Standard Luer Lock Connection
Comes with Accu-chek meter of choice, does NOT communicate w/ pump
Water Resistant
Programming of a bolus can be done in .1 unit increments, compared with .05 on most pumps


All of the pumps do the same thing basically. They all have temp rates you can program, you can suspend them all, and all but the Nipro and the Omnipod can upload to computer programs.

The pumps vary in what kind of set they use, how finely doses can be programed, how the bolus calculator works, waterproof status, meter they work with, and matching computer software.

Pumps cost roughly $6,000 and insurance should cover this. I have heard of people with no copay, and I have heard of people with a 50% copay. 20% seems to be a standard copay, which works out to roughly $1000. My pump copay was $10.

Oh, and I forgot to say some stuff I meant to say (can you tell I can talk about pumps all day?).

I started a pump 2.5 months after going on insulin- extremely quickly. Physically, it was excellent. Pumping early on encourages good control and prolongs the life of any remaining beta cells.

However, emotionally it was hard. I hadn't told my friends about my diabetes yet, and it was a real challenge then to have to explain the pump to them. I didn't think diabetes was a big deal, but then with a pump connected to me I felt like I was constantly reminded of it. I wasn't ready to be attached to a pump all the time.

However, my diabetes team was excellent and helped me through this, and I stuck it out, and I am glad I did.

My 18 year old son was diagnosed with Type 1 diabetes the middle of June 2006 this year - and he was on a Minimed pump within 4-6 weeks. The push was on because he was leaving in September for his first year on a very large college campus. We have BCBS, and our policy paid 100% for the minimed pump. This was all facilitated through our endocrinology office with the diabetes educator doing all the work on gettting the pump paperwork going. For us, it all happened very quickly thankfully. My son is doing very well with the insulin pump - there have been days that have not been so great - and it did take a good month to work through the kinks and frustrations but we have been very blessed. We never made a call to insurance - diabetes educator did all the work and we have an good rep for Minimed in Cincinnati, OH. Best wishes! :wave: