Happy Saturday, and welcome back to our weekly advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and educatoAsk-DMine_buttonr Wil Dubois.

This week, Wil tackles some basic questions about insulin pumps and what we might want to think about when choosing a new one, based on the options currently available. He's also got a few comments about carbs and food, that you might like to munch on. So go on, read on...

{Got your own questions? Email us at AskDMine@diabetesmine.com}


Jill, type 1 from California, writes: It's time for me to get a new pump. I currently have the Medtronic Paradigm. I like to use it on vibrate for the alerts but this pump vibrates so loud it may as well be an audible alarm. Also, the CGM on the Medtronic pump is often inaccurate. Do you know if the Animas would be better with either of these aspects?

Wil@Ask D'Mine answers: Seriously? You find the vibe on the MedT too loud? Huh. My big beef with the Medtronic family of pumps and CGMs is that, to me, they are too damn quiet! Well, your ears must work better than mine.

But to answer your first question, I honestly don't know if the Animas Ping is "better," "worse," or the same in regard to the racket the vibrations create or don't create. In my state of New Mexico, Animas wasn't selling enough pumps to justify the cost of the sales, training, and support people—so they pulled up their stakes, and headed out! This being the case, I don't see Animas pumps very often, and have no one to call to arrange to listen to one. That said, I very much doubt that Animas will abandon California anytime soon, so you should be able to locate a rep who can demo their current pump for you.

On a brighter note, I can be of more help on your second question. I'm 100% positive that the CGM on the MedT is more accurate than the CGM on the Animas, because here in the USA, Animas doesn't have a CGM-enabled pump at this moment. That potentially lovely combo device, called the Vibe, is only available across the pond in 13 European countries and in Israel, but for us in the States it's still being reviewed by the FDA after Animas submitted for approval in April of last year.

So if you want the CGM and pump together on your belt, you have to stay with MedT. At least for today. One thing you have to consider is that you will be married to your next pump for 4 years, and a lot of interesting things are likely to happen in that time. It's also unfair to judge MedT's current CGM by your current CGM, because their new 530G pump (the newest tech on the USA market, when it comes to pumps) uses an upgraded sensor called the Enlite that is definitely more accurate than the previous Sof-sensor, and may or may not be as good as the competing Dexcom G4 sensor. Unfortunately, I can't provide any personal perspective, because I've not had the opportunity to test-drive MedT's Enlite sensor yet. Not that I'm bitter about that.

Oh. Wait. Yes I am.

Hell, I literally wrote the book on CGM, so I'm a little peeved that after wearing every CGM sensor ever made, I've been unable to get my mitts on this one. Maybe my status is on the wane. Or maybe MedT is afraid of what I'll say about it.

Sorry, I got off track. Let me grab another shot of Hot Stuff Cinnamon whiskey to calm myself down, and I'll get back oInsulin Pump Choice Rouletten task. (((Slurp!))) Ahhhh... Well, it's not like any one is ever going to know I'm drinking whiskey at six in the morning while I'm writing this. Oops. Damn! Well, the cat's out of the bag now. You know, as people get older they sometimes speak (or write) without thinking first.

And speaking of older, something weird happens to MedT pumps as they age: sometimes the vibration alarms get louder. I don't know why, something inside must wear out, wear down, or come loose. My Novo rep was visiting me the other day and his "vintage" Paradigm pump's vibe alarm sounded remarkably like a garbage disposal. Of course, I loved it. He wasn't so enthusiastic.

But that makes me wonder if yours was too loud to your ears from day one? Or has it gradually gotten louder, and more annoying to you, over time?

Still, all of that said, there are some things—like shoes, cameras, and handguns—that you just need to try on for size and fit before you buy. I think the same is true for insulin pumps. I'd ask your doc to give you the numbers for the Animas, Asante, MedT, Omni-Pod, Roche, and Tandem reps. Ask them to take you out for a whiskey or a coffee and demo their wares to you.

You'll find the fit, and the volume, that you need.


Tim, type 1 from Washington, writes: Wil, I am a long-time reader, short-time type 1 diabetic (5 years). I have fairly good control (usually low 7s mid to high 6s A1c) and am not gaining weight (in fact I lost about 12 pounds from late December to March). I'm 6'3" and about 180-185. I just started on my first insulin pump, and I realize something has been going on for quite a while (long before the pump) that I haven't talked to anyone about. Between meals (60g carb per meal) I am often really, really hungry. There's no discernible pattern of low BGs or high BGs that happen with it. Is this unusual and/or does it point to a problem with my diet or insulin regimen? I don't deny myself, I have a snack, but am I missing something?

Wil@Ask D'Mine answers: If you're not fat and you're hungry, then you should eat. Next question?


Oh, Amy says I need to do a better job of answering your question before I can move on.

While what you are seeing isn't "usual" in my experience, I don't think you are missing anything, either. Your meal size is normal to maintain weight for a non-D male, maybe on the high side for a type 1, but so long as your blood sugars and weight are good, that's not an issue. And at 6'3", you are a big dude, so you probably need big meals.hungry stomach

It's true that hunger often comes from blood sugar spikes in an ironic case of mis-wired signals (when we're high is the last time we should be eating, right?), but you've ruled that out. It's also possible that you've got an imbalance in the GLP-1/DDP-4 dance like a type 2 would have. Taking something like Byetta or Victoza could square that away, but it seems like overkill in your case since your blood sugar and weight are fine.

One final issue might be the ratio of carbs-to-fat or carbs-to-protein in your meals. If your meals are very low-fat and/or low-protein, they might be burning off quickly, causing an energy spike and crash that sends "we need more food" signals to your brain. You could try adding some more meats, cheeses, or nuts to your meals and see what that does for your hunger pangs.

But still, with your weight good and your blood sugar good, I'd say just feed the hunger and don't worry about it. Unless you want to get checked for worms. (Just kidding!)

Thanks for being a long-time reader! See you all next week.


This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.