Pumping mamas?

[quinek]

Hi!

I'm Kylee, and I'm new here, just got diagnosed with T1 last June (I'm 23). I'm currently on 1:10 of Regular and 22u of Levemir at night. My last A1C was 5.8 (they initially diagnosed me as T2, when my A1C was 7.1... when I got my diagnosis of T1 4 months later it was 11.4... ugh!). So far my A1C's have been 5.8, 6.3 in December, 5.8 in January, and I'm due for another in a week.

I'm 16w3d pregnant, due at the end of August in the blistering heat of Phoenix. :T

My question for those of you who are/were pregnant and pumping is, if you started pumping during pregnancy, how many weeks were you?

I've finally come around to the idea of pumping and have been researching but can't seem to find if there is a "cutoff" week for starting pump therapy. My endo is kinda ol' school and hasn't breathed a word about pumping to me, so he has a big talk in store for him next week, but I have a little nagging fear that he's going to say, "No, you're past x weeks so you can't start." I am so dead set on starting pumping it's not even funny so I want to have my ducks in a row and be able to convince him.

This is a big thing for me because, apart from baby's health, I am a labor and delivery nurse and a student certified nurse-midwife and I am a big natural birth advocate, so if I can keep myself and the bub healthy enough to avoid induction and other interventions/issues I would be a happy girl. :D

The other reason I was wondering about some sort of cutoff is because I called MiniMed to ask them about the whole process were I to go with the Paradigm, and the lady kinda hesitated when I told her how many weeks I was and said she might have to talk to her clinician because it might be past recommend time. Which is sort of goofy... because I'm pretty sure my endo's decision outweighs the pump company's decision.

Well that's about it from me; thanks for any info you may have. I will now return to waffling over which pump to choose! I was thinking about the Paradigm because of the continuous glucose monitor but now I think it doesn't sound all that great since it's interstitial and fingersticks are still required... so now I kinda want a pump that has the meter attached so I have less to carry around!

[fgummett]

Welcome!
The pump is simply a tool... a darn good one in my opinion and if you have educated yourself enough to feel that it will benefit you in your pregnancy and beyond, I don't see a single reason why there should be any "cut-off date"... is there a "cut-off date" for changing your insulin regime during pregnancy... so why is this any different? Now I can see the Minimed folks being anxious about liability but I'm sure your agenda is to do the best by yourself and your child. It will require extra work and more frequent testing but with your background I'm sure you already knew that. Best of luck :) Frank

[fgummett]

Pumping Mamas..! I like it :top:

My Endo. is actually past retirement age but although a classic old school doctor he is pretty good at keeping up to date. When I wanted to start the pump, the Minimed rep. said that he wouldn't even talk to them... felt that pumps were just another money-making scheme. Anyhow I marched in with an armful of paperwork and laid it out for him what I wanted to do and why. No problem! In fact, at each six month checkup he proudly tells me how many more pumpers he has now ;)

[w5wjp]

The Endo I see is an old very very formal Hispanic...he even calls his nurses Nurse Smith instead of first name. He is one of the top Endo's in this area and one of MiniMed's biggest supporters. His theory on pumps is that anything that will keep the A1C down is good.

[Keezheekoni]

I pumped once with a pregnancy. It was a long time ago though...I can't remember when I got it. Probably sometime in the second trimester, around when they do the OGTT.

[panda1076]

Hi

I am 9 weeks pregnant right now, and I am pumping. Though I have been pumping for over a year now, independent of the choice to become pregnant.

I use the OmniPod, which I love. If you want a pump with an integrated meter, so you have less to carry, the OmniPod is a great option. If you are not familiar with the OmniPod, it's the only tubeless pump available. You wear a "pod" that hold insulin and inserts a cannula. Then, you carry separately the PDM (personal diabetes manager) which controls the pod and stores all your settings and ratios. The PDM has a built-in freestyle meter. And because there is no tubing, you don't have to physically carry it with you at all times. You only need it near you whenyou are bolusing for a meal, testing your BG, or changing pump settings. You can get more info at Home - OmniPod Insulin Management System (http://MyOmniPod.com).

I can't comment on how many weeks you can be before starting on an OmniPod, but I know plenty of pregnant people wear it. Pumping during pregnancy was highly recommended to me because you can micro-manage your BGs so much easier with a pump. My BGs have been great during pregnancy so I am happy with my setup. I have been keeping my fasting BGs in 70s-80s and keeping post-meal BGs below 130.

The OmniPod does not have CGM built in yet, but I was wearing a DexCom separately for a while. Originally I was eager to wear it during pregnancy, but I came to realize that it's really not accurate enough to trust, and that I during pregnancy I find myself testing my BG every hour or 2. So i felt like why do I need to carry around another device and waer another sensor when I don't trust it anyway. Also, these CGMs will beep at you when low. With the DexCom it has a built-in alarm at 55. So because it was inaccurate, it would always wake me up middle of the night saying I was low even though I was really 100 or 120. So I got sick of it. And now, especially, since I am keeping my BGs in the 70's and 80's, I am sure it would wake me up every night multiple times! So think it through before choosing a poump just because of the CGM. I know a few people on the MiniMed CGM pump and they hate getting woken up at night (as do their husbands!).

Good luck choosing a pump and with the pregnancy!

[panda1076]

I was just thinking more about CGM. To be fair, here is some more information in case you really do want CGM.

With the DexCom SEVEN that I used, you had to calibrate 2x per day. However, the more you calibrate, the more accurate it is. I calibrated 4x per day and still didn't trust it.

DexCom came out with a new model, which I have not tried yet. With the new DexCom, you can calibrate with readings from any meter. I supposed if I uploaded all of my finger prick readings from my OmniPod into it (13x per day), maybe it really would be accurate enough for me to trust. (The model I was using only allowed calibration with a OneTouch Ultra that you had to connect via a cable to the CGM Receiver.)

Also, Abbott finally got FDA approval for the Navigator CGM. From what I have heard, Navigator is supposed to be the most accurate. But the sensor is bigger than the DexCom.

So, I might actually consider trying Navigator or the new DexCom. I suppose if I really am keeping my BGs lower than usual, I would want to know if I am going low. I definitely am less aware of hypos. These days, I get to 50 and am just starting to feel symptoms. Whereas before, I'd feel symptoms at 70.