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The day old question that multiple parents encounter when deciding what type of insulin pump they should go for.
What insulin pump should I pick for my child, the Omnipod or the Tandem TSlim?
Omnipod vs Tandem? Which one is better?
What insulin pump is better for an active child that plays sports?
These are the questions that I see on multiple Type 1 Diabetes Facebook groups that I am part of. They come up all. the. time.
At the end of the day, the best advice that I can give you is to just pick the insulin pump therapy that best suits your child.
For us, the best insulin pump for our daughter is the Tandem TSlim x2. Read more to learn why.
What is the best insulin pump for your child?
Every person is very different, there is no perfect insulin pump. All pumps do work very similar in doing very well their insulin delivery, but what makes them different is the settings.
My suggestion is to meet with your child’s Endocrinologist, Diabetes Educator, and get all the information possible from them. Go home, have a nice sit down and study the pros and cons of each pump.
Each insulin pump company has a sales representative that are always willing to meet with patients and educate them on the pump settings and answer any questions you have. From my experience, most of these sales rep are Type 1 Diabetic themselves, and they actually wear the insulin pump they represent.
For us, the best insulin pump that suited our need was the Tandem T-Slim x2 insulin pump.
Before we started using Tandem, we were using the Animas Insulin Pump, but this amazing pump went out of the market (I was totally devastated!), so we had to pick another insulin pump. So our transition towards the Tandem T-Slim was very smooth.
I see the Tandem T-Slim insulin pump as a small/mini computer for diabetics. Its a very technological little pancreas, that basically makes our lives in managing our daughter’s diabetes much easier.
What insulin does the Omnipod and Tandem T-Slim insulin pump use?
They both use rapid acting insulin only, like Novolog, Humalog, and Apidra.
What is the cost of an insulin pump?
First of all, you will need to check with your health insurance about coverage. If you are unable to get your health insurance to cover this, some cover the costs 100%! The health insurance usually covered this under Durable Medical Equipment (DME).
If your health insurance does not cover 100%, at times it can be covered 80%, and you pay the rest of the 20% as a deductible. Or, if you are in a situation where you have to outlay the full cost of the pump and wait to get reimbursed, you should consider buying supplies at Diabetes Warehouse.
Need to pay out of pocket for diabetes supplies?
Diabetes warehouse is committed to providing affordable supplies to help you manage your child’s condition. They ship directly to your doorstep so that you never have to worry about running out of supplies again.
For the Omnipod, the cost is usually around $300 for 10 pods (1 month worth of supplies) and with the PDM about $700. The PDM by itself, is about $200.
For the Tandem T-Slim insulin pump its a bit more costly, ranging up to almost $6k-$8k.
So, my best tip for this, is to find out FIRST with your health insurance, and then decide and plan from there.
What are the advantages of using an insulin pump?
There are numerous advantages of using an insulin pump:
- You change your child’s site every 2-3 days, so no daily injections
- Your child will have more freedom as to what he/she eats during the day
- You can do extended boluses, where if your child eats a heavy carb meal, you can tell the insulin pump’s bolus calculator to send 50%-75% of insulin at that moment, and then the rest of the 25%-50% after 2 hours more or less. This will all depend on how insulin resistant or insulin sensitive your child is towards the food he/she is eating AND if they are going to be doing some type of physical activity afterwards.
- You can do a temp basal rate increase, for heavy carb meals
- You can just pull the pump out and dose your child, instead of measuring with a syringe to inject, especially in public spaces, or even in the car!
What are the disadvantages of using an insulin pump?
Like everything in life, there are some disadvantages of using an insulin pump:
- Your child can get skin infections due to pump site insertions
- The infusion site can kink, meaning your child will receive a small amount of insulin or not receive any insulin, because the bent cannula. So, there is a risk of your child going into diabetic ketoacidosis, if you don’t change the infusion site on time.
- You still need a backup of syringes and two types of insulins (rapid-acting and long-acting) in case of a pump failure
- You need to either buy batteries for your child’s insulin pump or charge your child’s pump every few days
- It can be more expensive, especially if your insurance coverage is very low and has a high deductible
- Some insulin pumps are not waterproof
- If damaged, your child might need to get back to multiple daily injections, while the health insurance sends you a replacement.
What insulin pump is compatible with Dexcom G6?
The Tandem T-Slim x2 insulin pump is fully integrated with the Dexcom G6. Meaning that it literally reads your child’s Dexcom G6 graph and trends, and depending on the glucose levels it delivers insulin for you, without your input.
Omnipod does not have this yet. There is a newer Omnipod called the Omnipod Dash, where you can see your child’s insulin on board on your iOS (iPhone), but the Dexcom is not integrated like it is on the Tandem T-Slim.
Omnipod Insulin Pump
Omnipod is a tubeless, wireless and waterproof insulin pump.
How does an Omnipod Insulin Pump work?
The Omnipod is basically managed with a Personal Diabetes Manager (PDM), that connects with the Pod.
From this PDM, you can see how much insulin on board (IOB) your child has, you are able to do insulin doses from it, and manage your child’s basal rate. The PDM basically looks like a cellphone, but its sole purpose is for the management of the Pod that is in session.
How many units of insulin can the Omnipod hold?
The Omnipod holds about 200 units of insulin and needs about 85-100 units in order for you to be able to use it. You will need to calculate the approximate amount of insulin your child needs for three days (taking bolus and basal into consideration), and go from there.
Does Omnipod work with Dexcom?
Not at this time. Omnipod is not integrated with Dexcom. You are going to have the PDM for the Omnipod and the Dexcom’s receiver or cellphone, in order to manage your child’s diabetes, and dose from the PDM.
What are the pros of Omnipod?
- It can be discrete since your child can place it in different parts of the body, and hide it under the clothes
- No injections
- 24/7 insulin being delivered to your child
- The PDM is a blood glucose meter
What are the cons of Omnipod?
- If you lose or damage the PDM, you are unable to dose with the Pod. You will need to call customer service for a replacement and go back to multiple daily injections until the PDM is in your hands. Talk with your health insurance in case of the PDM being lost or damage about coverage. When we tried the Omnipod, the PDM fell in the pool, and we had to pay $200 to get a new one.
- The cannula is thicker than that of an infusion site. For our daughter, it hurt her more than a regular infusion site
- Your child can get skin infections
- Can be bulky, especially for thin children
- Cannula insertion is automatic. You will not know when the insertion will be done, and your child might not like this suprise insertion.
Tandem T-Slim Insulin Pump
The Tandem TSlim x2 insulin pump is an insulin pump that is like a mini-computer, as I like to say, to manage Type 1 Diabetes.
How does a Tandem T-Slim work?
The Tandem works just like a regular insulin pump, where your child will be receiving fast-acting insulin 24/7, for their diabetes care management.
How many units of insulin can the Tandem T-Slim hold?
The pump holds up to 300 units of fast-acting insulin, and it should be changed every 2-3 days to prevent skin infections.
How does the Tandem T-Slim Insulin Pump work with Dexcom G6?
The Tandem insulin pump is fully integrated with the Dexcom, meaning that it also reads the Dexcom G6 graphs and delivers insulin depending on the settings you imported.
At the moment the Tandem T-Slim insulin pump has two types of technology: Basal IQ and Control IQ.
Basal IQ, predicts when your child’s insulin levels will go low. The insulin pump will automatically shut off basal insulin, in order to prevent extreme low glucose levels.
At times, the basal shut off is not enough, therefore, a low carb snack to raise sugar levels might be needed.
Control IQ is the newest technology, and for us, the best lifesaver ever!
Its an advanced hybrid closed-loop system that works with high and low glucose levels. If there is a prediction that your child’s glucose levels will be high, the pump will automatically send about 60% more insulin (based on basal, and amount of insulin your child needs), in order to correct high sugar levels.
Control IQ also has two activity settings: sleep mode and exercise mood. In the beginning I was very scared of using these two activities, but let me tell you, my fear was unfounded.
Every time my child goes to sleep, I have the pump to automatically activate the sleep mode (you set a time for this), and it keeps her in range, between 110-120mg/dL glucose levels during the night. If there is a prediction that she will be low, the pump automatically shuts down basal insulin in order to correct.
Similar with with the sleep activity, the exercise activity, has been perfect for very physical activities.
If your child is like mine, that every time she is very active, her glucose levels dip (meaning two down arrows on the Dexcom), then this setting is a MUST for your child.
The exercise activity, lets your child’s glucose levels run a bit higher, between the 140 md/dL range, and works the same way with prediction, in that if going low, it shuts down basal insulin, and if running high, will give a bit more insulin to prevent extreme highs.
What are the pros of Tandem T-Slim?
- Integrates beautifully with the Dexcom G6, so when correction is needed, you will not need to input glucose levels. I barely need to give correction doses thanks to Control IQ.
- Control IQ and Basal IQ have been life-changing for us when managing our daughter’s glucose levels, and in turn she has a better A1c.
- Updates can be done on the computer, on their secured system (you will have an account and your Endocrinologist can also see it from their end). When we updated the pump to Control IQ, you actually had to go through training for this setting.
- You can dose off the pump itself, no additional transmitter or glucose meter to carry with you. You can dose based off Dexcom G6, which has been very accurate for us.
- Because of Control IQ and Basal IQ, her glucose levels are in range for longer periods of time.
- You are able to get different type of infusion sets. Tandem has 5 types of sets, even a stainless steel needle one, that seems to work best for kids, does not kink and seems to be better in preventing scar tissue.
What are the cons of Tandem T-Slim?
- Has tubes, so, your child can get caught with a door knob or something else, and the infusion site can be ripped off the skin
- Skin infections if the infusion sites are not changed between 2-3 days
- You will need a clip or a waist slip belt in order to place your pump, and it can be more noticeable
- Its not waterproof, so for showers and going to the pool and/or beach, you will need to take the pump off
- Do not expose it on direct sun (ask me how I know), it can overheat, and will not send any insulin until its cooled down
Why we decided on the Tandem T-Slim
We did try the Omnipod, when Animas Insulin Pump went out of the market. We even took a training with the Omnipod Sales Representative and we were willing to give it a try.
However, for my daughter the unknown of when the cannula was going to be inserted, the fact that we did lose our PDM in the pool (major setback here), and we were unable to dose her with the Pod for 2 days, were some factors that did not sit with us very well.
Also, every time the Omnipod cannula was inserted, my daughter had the worst scream of pain ever that I do not wish to any parent to hear. One of the last changes that we did for the Pod, she had a black and blue injury from the cannula insertion. She never got this when she used the regular infusion sets with the Animas.
The Tandem was very similar to the previous pump she had, so the transition to this pump was smooth. She likes that the infusion site changes does not hurt her as much. She does not mind the tubing, and on all the years that we have had Tandem we have only had like 2 rips (one an accident, the other my son did it).
What are the features you should look for in an insulin pump?
Here are some considerations you need to take before choosing an insulin pump for your child:
- Decide if you want tubes or no tubes
- Is it integrated with Dexcom G6 (Continuous Glucose Monitor)?
- Does it have the ability to shut basal off to prevent low blood sugars? This is based on the CGM’s readings
- Is it touch screen? Easy to input numbers for corrections and bolus?
- What type of infusion sets does it use?
- What is the size and weight? How will it look for my child? Consider your child’s body habitus
- Is there an ability to upgrade to new features or products, as technology progresses
- Is it waterproof?
- What is the warranty and durability of the pump?
- How is the customer service? Does they have 24/7 services? What happens if there is a pump failure?
- Does my health insurance cover the pump? If not, what are the costs for the pump and supplies?
- Where can I get the diabetic supplies? From the company itself or a third-party supplier?
So whatever pump you decide for your child, make sure you think of all the pros and cons of the ones listed here.
We have never regretted getting our daughter into a Tandem T-Slim pump and this can also be a great option for your child and your family.