Pumps

YpsoPump: The First Few Weeks (Part One)

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I’ve been staring at my chunky old Animas Vibe with its holes in the coating and an interface from the ‘90s, thinking about how I will possibly be able to while away another two years before its warranty is up. I’ve been dreaming up scenarios in my mind where new pump options would arrive on our shores and be rolled out to existing Animas customers sooner rather than later.

But I never, ever, really imagined that I would have one of these exciting new options in my hands so soon.

(This is the part where I tell you that Ypsomed Australia provided me with a YpsoPump and consumables to take home and trial. Followed by the part where I tell you that was no expectation that I would write, or even trial the pump itself. Followed by the part where I remind you that there’s a bias in place and that you should take my enthusiasm with a grain of salt).

I’ve been YpsoPumping for almost four weeks, and I am absolutely loving how sleek and light it is. When I started pumping insulin two years ago, I wanted it purely for the benefit on my blood sugars. I never thought that this sleekness was something that I could ever ask for, or want, in a pump.

It weighs eighty three grams, inclusive of a AAA alkaline battery and filled insulin cartridge. To put that into perspective, It’s about half the size of my wallet and a third of the size of my iPhone. Did I mention that it’s slimmer, too? I hardly notice it in my pocket when I’m lounging on the couch or in bed at night.

It’s also way quieter than my late Animas Vibe. I no longer hear the swish of insulin boluses being delivered. Or that little ‘tick’ every three minutes as the pump infuses basal insulin into my body.

The interface is made of up of predominantly symbols and numbers, rather than words, which definitely took some getting used to.

It also has a touch screen, which can only be switched on by pressing the button on the side of the pump. The main menu also has a three tap access code before you can go in and administer insulin.

Basal rates can be set in increments of 0.01 units per hour, which gives greater customisation than the 0.25 units on my late Animas. The biggest challenge for me is that they can only be set on the hour, rather than the half hour. So when I wake up at 6.30am, I can only set my elevated waking basal rate to run from either 5am or 6am, rather than my ideal time of 5.30am. I’ve been experimenting with some basal tweaks this week, and hopefully I’ll be able to work around this.

I’m also liking the vibrating reminders when my temporary basal rate is finished running. I tend to sleep over middle of the night alarms, but the pump has even woken me up during the night to let me know a temporary basal rate has finished running. It’s a really handy feature to have, reminding me to check my blood sugar and evaluate whether I need to run it for longer.

The biggest difference to my late Animas is that the YpsoPump does not contain a bolus calculator. That is contained in the companion mylife smartphone app. Or any other bolus calculating app, for that matter. So you would need to open your app, work out your bolus, and enter that number into your pump. The app then syncs with the pump via Bluetooth to obtain insulin data. At the launch event, we were told that the pump could eventually be controlled from the app.

I have no problem using a phone app to calculate insulin boluses. I’ve done it before when I’ve taken pump breaks. But I found it frustrating having to wait a good 15 seconds for the app to sync with my pump so that I could do a bolus calculation. I’m so used to being able to quickly glance at my insulin on board during the day before various activities. Not to mention that having my Bluetooth constantly switched on is a drain on both my pump and iPhone battery. As a result, I must say that I’ve been slacking off on bolus calculations.

I expressed to the rep last week that it would be helpful if the bolus calculator worked independently of having to sync with the pump. After suggesting that I could switch my insulin therapy settings to Multiple Daily Injections, I’ve been able to do just that. So long as I’m logging all of my bolus calculations and insulin doses in the app, I’ll be able to see my insulin on board without having to sync the pump via Bluetooth.

The pump can deliver insulin boluses in increments of 0.1 units, which is slightly less than the 0.05 my late Animas allowed. The bolus calculator automatically subtracts insulin on board from a bolus calculation, which might not always be necessary. It also lacks the flexibility to make adjustments to insulin to carb ratios or insulin sensitivity factors for things like physical activity. However, it is working a lot better for me in MDI mode.

I know just how hard a good bolus calculator is to find, and for me a diabetes app without one simply has no value. Ypsomed do appear to see the bigger picture of people who don’t use pumps and CGMs, and I’m confident that the company is working hard to make Multiple Daily Injections and glucose monitoring ‘smarter’ as well.

If you are looking for a bolus calculator, you can search for the ‘mylife app’ in your Google Play or App Store.

Come back tomorrow for part two of my review of the YpsoPump!

Updated: Find part 2 here!

The YpsoPump Launch Event

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My first week with the YpsoPump saw me in holiday eat-and-bolus-without-really-thinking-too-much-about-diabetes mode. Not to mention that it was my return to insulin pumping following a month long break. Week two saw me back at home with one of the worst Winter colds I’ve had in years and some of the craziest insulin resistance I’ve seen. It’s now week three and I’m just beginning to return to some sense of normality with the ‘betes.

Safe to say, I feel as though I’ve already been through a lot with this pump in the short time we’ve known each other. I really am enjoying the YpsoPump for its sleekness and light weight nature, and you can also check out my Instagram stories for more insight here. I’ll have some more to share here soon, I just don’t think I can fairly review a pump without using it for a good few weeks.

I had never even heard of the YpsoPump prior to searching the TGA website earlier this year in desperation for any signs of new insulin pump choices following the demise of Animas. I then noticed fellow blogger Ashley of Bittersweet Diagnosis had been trialling the YpsoPump, indicating that an Australian launch was on the horizon. A bit later on, I was fortunate enough to receive my own invitation to a launch event held in Sydney three weeks ago.

We were introduced to a Swiss company called Ypsomed (pronounced “Ipsomed”). As a manufacturer of tailor made insulin injection pens and autoinjectors, the company vision is to make self care simpler and easier. We were told that the company had a long, successful history of insulin pumps in the world, dating back to 1985. The YpsoPump had been designed to fill the gap in a market filled with complex, medical looking devices.

Ypsomed’s portfolio of diabetes products fall under the company’s Mylife Diabetescare brand. Encouragingly, their portfolio extended to people on Multiple Daily Injections and structured blood glucose monitoring. Products included clickfine needles, lancets, injection pens and a new Unio Neva blood glucose monitor using a custom brand of test strips. Not to mention that YpsoPump’s companion ‘Mylife’ smartphone app would also be useful to people not on a pump (it’s a free download from your App or Google Play store).

We were shown a roadmap of future upgrades to the YpsoPump system. This included the addition of the Unio Neva blood glucose meter that would send blood glucose readings to the Mylife smartphone app via Bluetooth. Ypsomed are also in discussions with manufacturers to add CGM integration into the pump. The YpsoPump will eventually be able to be controlled remotely via the smartphone app, but this looks to be at least 12-18 months away.

Ypsomed is also manufacturer of the wildly popular Omnipod tubeless insulin pump, which received TGA approval some time ago but has not yet managed to surface. The NDSS funds insulin pump consumables here in Australia, while private health insurers fund the actual device. Ypsomed have not been able to find a way to fit the funding model here in Australia due to the disposable nature of the Omnipod.

In response, we were told that a smaller ‘YpsoPod’ is currently in development with an expected 2021/22 completion. One half is disposable while one half is durable, meaning that this pump would fit the funding model in Australia.

Everything sounded really encouraging, with Ypsomed assuring us that they are here to stay and committed to the Australian market. This includes a dedicated Australian based customer service team. I’m also looking forward to catching up with a member of the Ypsomed team visiting Perth this week.

At the end of the day, more choice for people with diabetes is always a good thing. A massive thank you to Ypsomed Australia for having people with diabetes there.

Disclosures: Ypsomed Australia covered my travel and accommodation expenses to attend the launch event in Sydney. I was fed and watered across the duration of the event. I also received a YpsoPump and consumables to take home and trial. There was no expectation that I would blog about Ypsomed or the YpsoPump. My opinions and my time, including the annual leave I took from work to attend, are my own.

Saying ‘Yes’ To An Insulin Pump

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I’m a terrible decision maker. My family often laugh at how long it takes for me to decide what I’m going to have for lunch or what movie we should watch in the evening.

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Switching from Multiple Daily Injections to an Insulin Pump is arguably one of the biggest decisions I have made in my life. Thinking about the time, thought and research I put into that decision, I realise that this is one of the few instances where my meticulous decision making was worth it.

Thinking about an insulin pump? Although I’ve written a lot about this decision over the past few months, I really wanted to stress in one post just how big of a decision it was.

I never really thought too much about insulin pumps before I started my blog and made connections in the Diabetes Online Community. I thought that they were only for young children, or for people struggling with their diabetes. Seeing others share so openly about their lives with pumps, particularly those within the wonderful OzDOC community, motivated me to find out more.

I attended an information evening back in October that was hosted by Diabetes WA, the diabetes organisation in my state. The evening covered the basic concept of insulin pumping. Representatives from the pump companies were present to show us the devices themselves, and I was able to grab information packs to take home.

The downside of this session was that I found it a little too light and fluffy. I recall the host making the statement “very few people give these back to me and say they don’t like it.” The session brushed over the seriousness of pumping. The representatives from the pump companies were a little too pushy. I didn’t feel comfortable going over and talking to them, because I was only seeking information at the time. I wrote about that night in more detail here. I do wonder how many people were convinced into signing up for one straight away.

Following this session, I decided to get back in touch with my diabetes educator, Gwen. This was a big step for me, considering that I had not had a formal appointment with her in a few years. My nerves were instantly relieved, and Gwen picked up as if our last appointment was only yesterday. She covered the topic of insulin pumping comprehensively and with the seriousness it deserved. She never displayed any bias, and respected that the decision was mine to make. You can read more about our session here.

Gwen gave me the option of making the decision on that day back in November. I could have said yes then and there. I knew full well that the wait for the pump would be even longer if I went home that day and made the decision at our next appointment. I could have said the words “yes,” but I knew that I wouldn’t really be convinced. I fought my feelings of urgency, because I knew deep down that I wasn’t ready to make such a big decision. I went back home and talked about it. I read about it. I thought about it.

By the time I came back to see Gwen in February, I had a much clearer head.

By taking the time to say yes, I felt much more confidence in the decision I had made.

Let the countdown to the big day in May begin…

Revisiting Gwen

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I know that the decision to switch to an insulin pump is not something that I should take lightly. I’ve been deliberating the matter for a while. I wrote about it earlier this week here. I also recently went to see my diabetes educator, Gwen, for some advice.

Gwen is a truly amazing person. You can read about just how amazing she is right here. Gwen’s stated goal was to arm me with the knowledge and skills to manage my diabetes, so that her position as my educator would eventually become redundant. And it sure did. The last time I had a session with Gwen was back in 2010, towards the end of my first year living with diabetes.

I knew that Gwen was always available to me outside of appointments if need be. I had her phone number, e-mail address, and I can even remember her squeezing me in once during her lunch break when I was anxious about too many hypos. I can remember giving Gwen a box of chocolates on the first Christmas after my diagnosis, because she had just been so wonderful during that first year of diabetes. I’ve seen her a few times in passing at the clinic when I go to see my endocrinologist. However, since transitioning from the ‘young adult’ to ‘adult’ diabetes clinic, I’ve seen her less frequently.

I was extremely nervous to go back and see Gwen a few weeks ago, after such a long time. In the car on the way there, I was reciting over and over in my head what I would say to her. Would she take what I needed to say seriously? Would she be supportive of insulin pump therapy? Would I talk to her about my blog, and my involvement in the Diabetes Online Community this year? Would she even remember me?

But walking into her office that day, my nerves were instantly settled. As she began reviewing our last session five years ago, she was so thorough. As she talked through the results of my last endo appointment and hba1c result, she was so familiar and so well prepared for me. As her patient, it felt as though that last session five years ago could have taken place just yesterday.

So, Gwen’s verdict on pumping, in a nutshell?

A pump is a big commitment.

Pumping is not any “easier” than Multiple Daily Injections.

However, a pump can give me more “flexibility.” A pump delivers insulin constantly in order to regulate glucose levels, as opposed to injections which are given at set times of the day. The rate at which a pump delivers insulin can be adjusted throughout the day to factor in activities such as work, physical activity and sleep. The units of insulin delivery on pumps are so precise that you can bolus for something as small as the milk in your coffee!

There are also a few requirements for pumping in Australia.

First up, I must have an appropriate level of Private Health Insurance for a period of at least 12 months, in order for the cost of a pump to be covered. Big tick there.

Second up, I need to show that I qualify for a pump. Translation: I have type 1 diabetes and I’m a good student who will show up to my education sessions. Big tick there.

Third up, a pre education session with Gwen (big tick there), where paperwork is completed and passed onto my endo for sign off (not quite there, yet).

Finally, pump fitting day followed by 3-4 daily sessions with Gwen in order to fine tune the pump. Sadly, there’s a 3 month waiting list at my diabetes clinic for this.

I’m really glad that I did go and get another perspective from Gwen that day. Gwen was plain thorough. She discussed the matter with the seriousness that it deserved, without trying to sway my decision either way.

So, as the session came to an end, I sensibly decided that I would go home and think about it, and come back in the New Year for another check in. Class dismissed!

No Responsibility From Insulin Pump Companies

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Last night, I attended an information session on insulin pumps at Diabetes WA. And this morning, I’ve got about a million things that I want to write about.

I’ve been on Multiple Daily Injections since I was diagnosed five years ago. I’ve never seriously considered an insulin pump, and I can’t say that I know too much about them. I’ve thought about going to one of these information sessions over the years, but it was just one of those things that I never got around to. Okay, truth be told I procratinated on RSVPing to those events until it was too late. Over and over.

I guess what motivated me this year was the fact that I am now a part of the Diabetes Online Community. I think, talk and write about diabetes every day. I feel more motivated towards my diabetes managment, just from interacting with you. I see so many of you blogging, tweeting, screenshotting and instagramming pump stuff each day. I want to understand it. And I want to seriously consider it as an option going forward.

Representatives from a few of the insulin pump companies were there to chat to before and after the session. And to be honest, they were absolute vultures. I’ve never seen such eager salespeople out there in full force, desperately wanting our business. When our fantastic host Margie asked for some sample tubing to show us, it literally seemed like a race to see which rep could get to Margie first. As I asked one of the reps if a meal bolus was as simple as inputting the number of carbs into the device, she began hurriedly cramming in as much information as she could before the talk resumed. I’ve never seen anything like it.

The topic of Continuous Glucose Monitors came up briefly. As I have written in recent days, Continuous Glucose Monitors aren’t subsidised by the government here in Australia. The cost of purchasing a CGM device and its operating consumables is excessive. While having a CGM may not matter to myself, I know that it could make a world of difference to young children and parents out there.

I thought it was rather interesting to hear the representatives in the room quickly removing themselves of any responsibility for those excessive costs. They urged us to write to our Members of Parliament. They urged us to lobby the government for subsidies towards CGMs and diabetes devices. As though it’s out of their hands.

These companies are responsible for the excessive costs of these devices. These companies are making a profit off of our disease. There are so many companies and product lines out there for that very reason. That vulture like behaviour occurs for that very reason. And I hardly got the feeling that these people genuinely wanted to help me make my diabetes management easier. I so badly wanted to know if they even had diabetes themselves!

I hope I haven’t taken anything away from the Diabetes WA session. It was fantastic and I have so much more to write about. Stay tuned – I’ll have more in the days to come.

At 10.41pm, I was cutting it close with yesterday’s #DOCtober photo. An exclusive look behind the scenes of the jacket I wore last night.

https://instagram.com/p/80lsx1A_bu/?taken-by=franksita