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For people who have experience with both an insulin pump and CGM: If you could only choose to use one of these devices, which one would you use? Share why in the comments!
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If I’d been approved and if i could have afforded it, I would also have tried a pod insulin delivery device. For now the CGM is very helpful, even though I’ve just had one printout (for a two-week period) in the past six months.
Having the accurate cgm information at hand to make necessary changes so much more useful than having to prick my finger every time I need to get a static reading without knowing the trend also
The advantage of the CGM is I learned I don’t require insulin 24 hours a day. The advantage of the pump is I can stop the insulin release.
I think for a newer diabetic the CGM is great, for someone with an active lifestyle and not afraid of adjustments (I make different pump adjustments) there’re definitely advantages of the pump.
For a newly diagnosed I’d think a CGM for the confidence of knowing the legend. After a year with both in a closed loop system, 3 with only the pump I’d opt for the pump alone.
It’s kind of up to the confidence of the person and definitely advantage to each.
But for mr, if only one the pump.
Tough question since having closed loop system – it is working so great, but I guess I have to go with the CGM as the pump would not work without that. I would manage but not be happy…
CGM. I use both in a closed loop system and would be very unhappy if I had to give up one or the other. However, I could manage manipulating insulin dosing with long and short/quick acting injections if needed as I have survived living with T1D for nearly 60 years and have managed doing so in the past. I rely & depend on the CGM to alert me of fluctuating trends in real time.
CGM allows me to live a safer, healthier life.
Can best manage defective pancreas with both. Have hypoglycemia issues. Without dexcom would be in er all the time.
I would miss either so much! But I decided I would keep my pump. I could go back to fingersticks multiple times a day. I did this for several years and my A1C can still be normal.
I had to think hard, but I would go with just the pump. Finger sticks to check my BS is preferable to trying to adjust two kinds of insulin to cover the daily and bolus requirements. Being able to adjust my insulin to different foods, activities, etc with a few buttons, not having to carry syringes or pens…. I pray I never have to make a decision like this!
I choose pump without the CGM. It is a tough choice because I really love knowing the data, but the alarms with the CGM are annoying enough, especially at night, that at times I feel I might be better off without it.
I very rarely get alarms at night. If you are getting alarms because of low blood sugar, you really should appreciate those alarms.
I would not want to live without a pump. I have been on a pump since the early 1990s and have been T1 for 64 years. Before the pump I would have convulsions at night after a lot of hiking. Those are not pleasant experiences! Not a one after getting a pump. I do love the freedom the CGM offers me but I managed for over 50 years without one. But I do NOT want to have to give up either!
Actually made this decision. Went off pump (many reasons) and kept CGM.
The insulin pump was the single most life changing device in my diabetes care. For 21 years before I got my first pump, I lived in a constant fog with multiple hypoglycemic episodes, every day. My life changed and improved instantly, as soon as I got onto an insulin pump, and off of the NPH, regular insulin syringe routine. My head cleared up immediately, my social interactions improved immediately, my ability to perform my work improved immediately.
I love my CGM system with Tandem/Dexcom G6 Control IQ, It has also improved the quality of my life. But, I could never go back to injections. I believe, at my age, injections would probably shorten my life, and definitely severely worsen the quality of my life.
A CGM is the only way to see what your blood sugar trends are, have alerts which for me are crucial.
I answered CGM only, but I think I’ve changed my mind. Prior to Dexcom I was a 15-20 fingersticks a day person, and I ‘spose I could go back. Most of my insulin doses are small fractions – can’t do that on MDI, and having different basal rates throughout the day, I would probably need to have at least 4 different Lantus injections of varying amounts. Ideally, I wouldn’t have to give up either one. Together my Tandem X2 with BIQ (not interested in CIQ) and my Dexcom G6 allow me to be aggressive in my D mgt
I am always interested in why people aren’t interested in CIQ. I know it helps me from climbing too high. Why aren’t you interested?
I started with only the pump years ago and would not give it up. You can always do finger sticks for glucose measurements. However, I would give neither up at this point!
Yes, same for me. But also very thankful for cgm. Both together are life savers for me. I had just the pump for 2 years before my insurance would OK cgm. Both are important to me. So grateful to not have to poke fingers 7x a day…..
Very ignorant question. Both, no one should go back to horse and buggy. Close to unsubscribing if the questions don’t stop insulting people’s intelligence.
Many people do very well without a pump so your horse and buggy statement is what is ignorant. Just because a pump works well for you doesn’t mean it’s the obvious choice for all.
They aren’t insinuating that you should only use one. They are just asking which one you find helps you better control your diabetes. That is how I interpret the question.
I totally agree about this being a very pointless and insulting question. Hopefully, you’re intent is to lower costs and increase insurance coverage so that all PWD can access these benefits.
My intelligence is never insulted, umm . . . since the bar is very low. However, Sophie’s choice is the choice none of us ever wants to face. Nor is the choice twixt CGM and pump. But forced into that choice, whether by cost, insurance, or a myriad of other fully legitimate and omnipresent reasons, the analysis and advice of Steven Gill and several others given here, are exceptionally sound.
Maybe a few of us are newer-ly diagnosed and highly appreciate the questions and user responses for how others live with this disease?
I selected “Use pump only, without a CGM” primarily because MDI (Multiple Daily Injections) left me with areas of lipohypertrophy … collections of fatty tissue that builds up from repeatedly injecting in the same area(s).
Even with testing my blood glucose levels up to about 20 times a day I needed to repeatedly inject correction boluses, which didn’t help matters. (I have gastroparesis, which is delayed emptying of stomach contents, which often led me to experience hypoglycaemic events {hypoglycemic, for my American cousins] which needed treating, and this led me to experience higher than ‘normal’ ranges of blood glucose levels.
Even with pump and CGM I still experience many episodes of hypoglycaemia [hypoglycemia] but knowing where my blood glucose levels actually are, and which direction they are travelling [traveling] I can decide how to treat my hypoglycaemia [hypoglycemia].
I wanted a CGM for the longest time and finally had the insurance to get it 3 years ago. My only problem without my pump is the basal, I get much better results with the constant micro-dose than using a long-term shot.
That may be the hardest ? “You” have ever asked. It’s almost like : spleen or xray vision superpower, but I said cgm since it’s so helpful to know w/o finger sticks….but no pump means back to NPH insulin, which sounds brutal. And means harder regulation and more injections.
“You” are mean, let’s pretend you never asked this.
Haha! I agree this was a hard one.
There are several long-acting insulins, besides NPH. They are quite good.
I am a pump user (Medtronic 640G), but I’m currently taking a “pump vacation” to let my abdomen skin heal. I am maintaining acceptable BG control via my CGM, the Freestyle Libre 2, and MDI using both slow-acting (Lantus) and fast-acting (Humalog) insulin administered via pen injectors. The CGM provides me with trends, which is essential to maintaining good BG control. The hour I spend every two weeks waiting for recognition of a new sensor allows me to appreciate the CGM’s importance. My time-in-range has barely changed since I switched from the pump (80-85%) to MDI (75-85%). The only pump feature I miss is the square-wave bolus. It’s also nice to be able to bolus without using a pen, but that also favors frivolous food consumption. Between the pump and the CGM, there’s no contest – the CGM romps.
I had to start out using insulin pump only. The CGM was added about 2 years later. Insurance was the hold up. If I had to choose between the two, I’d go with CGM.
This one was hard. I chose keeping my pump over CGM. I’m insulin sensitive, and had lots of severe hypoglycemic episodes on injections. Having a large amount of long acting insulin on board that I can’t take back gives me flashbacks of those unpredictable times. Switched to pump therapy 21 years ago. Adjustable basal rates, ability to deliver microdoses & suspend insulin delivery made all the difference for me. CGMs have been icing on the cake I shouldn’t be eating. 😉
I chose the CGM because I like knowing what my sugars are with out testing. I rely on the arrows to help me make proper decisions! I hope the day never comes where I would have to choose. I love my tandem Control IQ along with my Dex 6.
Using a pump BOUNDS you to 100yr old insulin technology. Injectable insulin will not get any faster. Inhaled insulin is simply revolutionary! It’s easier to use this and longer-acting basals than it is to manage a pump.
And regarding my CGM… “From my cold Dead hands!” Is the only way I would maybe get rid of it!
I put I would use the cgm only, however, I must admit that the pump definitely helps me especially during the night because I would have the dawn phenomena and wake up with those high blood sugars if I didn’t have the pump. Being able to increase my bolus as the night goes on takes care of that problem for me
I currently use atSlim Control IQ. While I love my G6, I can give it up easier than my pump. I started pumping in Feb. 1997 with Medtronic 507, it was a different quality of company then, it changed my life for the better. I refuse to give it up & will never do so willingly.
The couple of times I have had to be without, due to waiting for a replacement, I feel like a part of my body has been amputated.
I would choose cgm right now. However, it was a difficult decision as I value them both so closely and highly. If asked that question tomorrow the answer may be different.
I’ve lived with T1D for over 60 years. From injections and urine “dipsticks” to test glucose, to pumps and CGMs I remember years and years of being without either! You can live without these devices BUT I would not choose give up either device!
I was doing well with just the pump before adding in the assistance of a CGM, so I could easily give up the CGM again. I find the CGM makes testing/checking much more frequent than when just using the finger pricks for testing, but my A1C measures were just as constant with the CGM as without.
Whereas the pump changed everything for me with regards to much better BG control… So I would not want to ever have to give up the pump.
SAME!
CGMs are the game-changer. T1D Exchange published a study in 2019 showing that CGM use outperforms non-CGM use by an order of magnitude. The study is titled, “State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016–2018”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061293/
Among CGM users, those using a pump slightly underperformed MDI users for ages > 26. (See Fig 3 chart.)
According to the CDC, the MOST COMMON CAUSE of diabetic DKA is an insulin pump.
https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html
I don’t mention these things because I’m against insulin pumps. Not at all–they’re great for people who understand them and know how to master their nuances. Most important, people have to love them. It’s a lifestyle choice, not a medical necessity. Too many T1D’s falsely believe pumps can do more for them than they actually can. People should not be *encouraged* to use a pump–rather, to propose it as a potential alternative to pens (ideally, bluetooth connected) if their lifestyles accommodate it.
I absolutely agree. I’ve only been on a pump for a couple months, but so far it sure hasn’t made my life easier! I’ve been using dexcom for a few years and it definitely helps but also has issues. Sensors that quit often for sometimes a couple hours, or give wildly different numbers than my meter. We always have to be aware and ready to compensate, tech has a way to go to be truly lifechanging!
Hate my current pump. Medtronic 680 G. CGM prefer.
I use BOTH a CGM AND PUMP!!! AND I WOULDN’T have it any other way!!! Having the CGM, I can see the changes taking place (bg) and the direction it’s heading ON MY TANDEM CONTROL IQ PUMP!!!
I love having a closed-loop pump and CGM! I’ve come a long way, baby, since 1954 age 7!!! All my mother had was urine tests and monthly trips to the hospital for fasting bgs!!! 67years later I have an artificial pancreas, thank God.
I chose CGM. Ever since I was put on insulin therapy I dreamed of a day when I could tell what my BG was all the time. So…I wouldn’t give that up.
I use a DEX G6 and a t:slim 2x with CIQ. THIS SYSTEM WOULD NOT WORK WITHOUT THE CGM.
CIQ works wonderfully during the night I get almost a straight line during the night but that is not the case during the day when it shuts off the basal and then I run short later in the day and my sugar spikes. I often turn off the CIQ during parts of the day and I my control works well. So the pump still needs quite a bit of involvement on my part.
I still prefer the security of the instant results from a CGM. I’ve used 2 types of pumps. The Medtronic was terribly unreliable with it’s sensors.The Omnipod performed well but it has not been approved yet for a CGM
I chose CGM because that is the device that changed my life the most. I went from being very reactive to being proactive. Preventing highs and lows rather than reacting to them. I use both in a hybrid closed loop system and would hate to give that up, but could manage ok with basal/bolus and mdi which I did for 38 years before pumping.
Data over delivery.
Best summary. Few words say it all. Good job!
The pump itself completely changed my life. I pumped without CGM for 5 years and just adding this therapy and stopped long acting insulin completely stopped my sever , catatonic, and combative low bloodsugar episodes and stopped the need for paramedic calls since 2007! The addition of a CGM just helped improve over all A1c due to me addressing highs and lows quicker. But I was able to keep my A1c below 7.0 with just the pump alone. I wouldn’t trade the pump therapy for anything!
I had a pump for years without a CGM and had severe hypoglycemia several times. I am fortunate to be alive. I wouldn’t want to have to choose because the pump has allowed me to avoid other diabetes related complications. They are making so much progress with closed loop systems I am not sure how this is a relevant question. Anyone who has had a pump and a CGM wouldn’t want to give up either of them. If horrifies me to even contemplate living without one of these devices, because I probably wouldn’t live long without them.
Wouldn’t want to give up either pump or CGM. Hope I never have to choose.
That is great question. If I had to choose it would be a cgm .
As much as I love my cgm, I would choose my pump because instead of injecting myself 3-4 times a day, I only have to inject the pod every 3 days. The PDM (pump’s remote control) will take blood testing strips and give me a reading that PDM calculates how much insulin I need for my meal, or for correction.
I feel insulin dosage is more important than saving my fingers.
I find questions like this offensive.
The better question, IMO, is how can we get affordable access to any of the tools that are available?
I love this question.
I’ve never minded giving injections. What I did mind was my pump coming “unglued,” falling out, and having to get back on the phone to request an insulin refill, which I got sometimes, but not always.
My Dexcom CGM is the lifesaver and makes living with diabetes easier while using my pump has lowered my A1c and raised my TIR.
Visibility is everything. These days, insulin delivery comes secondary especially with the newer insulin varieties on the market.
The pump because I can adjust basal rates and reduce, stop, or take more insulin quickly. I am very active most of my waking hours. It would be more challenging to make insulin adjustments while biking, walking, working.
I used to always say cgm is the one I couldn’t live without and I still lean that way, however I had to be without my pump two separate occasions for 2 days and really missed it. I think I’ll say they are both equally important to my life.
If forced to choose, it would be the CGM. I can’t do anything with a pump or injections without knowledge and the knowledge it gives is invaluable.
That being said, I just switched to the t:Slim a couple months ago. Changed my life for the better for sure. I definitely wouldn’t want to be without it. 😉
CGM paired with a pump is a game changer. Once you’ve experienced the benefits of looping there’s no going back.
I would hate to have to choose but if forced I think I would take a CGM over the pump. I am hypo unaware so being able to see when my BG is dropping is really crucial.
I have never felt my pump settings are correct. So, I would definitely go with the CGM over the pump. I have tried checking my basal rates, etc on my own and every time I think I’ve got it right something goes wrong. I have not been able to find an endo in my area who can help with this. It’s very frustrating!
Why chose either or?? The technology is there to have both. The CGM makes the insulin pump that much smarter and more benefit to the user. I am a brittle diabetic and CGM is crucial for knowing where my blood sugar is going. The insulin pump is crucial for the very fine tuning of insulin delivery to try to keep me somewhat in good numbers.
Hypoglycemia unawareness makes my Dexcom a priority above my pump.
This was a good question…difficult to answer. For 15 years I used a pump with no CGM. My control was good, not great. I then used the Medtronic CGM for a while, and saw minimal improvement to my control, but I also grew very frustrated by the daily regimen required by that CGM. Now I’m using the Dexcom G6 CGM (its been about 2 years) and I love it. My control has been better than ever, and the Dexcom has improved my daily regimen considerably! With all of that said, I can’t imagine NOT using a pump. However, it’s a question I’d like to ask my endocrinologist: “Could I maintain good control with injections and the Dexcom CGM?” If I could, I’d definitely choose a CGM over a pump. But, my guess is that my control is due to both my pump and my CGM working together. I’m very grateful for the technology advancements I’ve seen in my lifetime.
The pump changed my life 32 years ago and the CGM changed my life two years ago one without the other it’s a hard choice but I would pick the CGM just to know where I am at all times
I have to choose pump even though I would hate to give up CGM.
I could not live with one basal rate/day or deliver it according to my needs.
I guess it would be (for me) the pump. While the pump is not as useful without a CGM, I used a pump for many years without a linked CGM. While I am sure there are people out there that use a CGM with MDI’s, I don’t think that it is a popular combination.
In my opinion, the advance in CGM technology is the most important game changer in terms of managing T1D. I was on MDI for over 19 years and started using a pump in 2017. I go back from time to time to MDI to take a break from the pump. I can certainly live without a pump if I were forced to only choose one of the two.
I have had very scary experiences with very low blood sugars, so a CGM has save me and my husband a Lot of Grief!
A CGM can keep you safe from hypoglycemia in the night. If you know your Sensor Glucose, you can easily use a smart pen instead of a pump. Preventing lows is more important than convenience. No pump does take away the ability to auto adjust basal and calculate bolus amounts though. Tough choice.