Monday, November 12, 2012

New Pump Consideration Post 2012

My Cozmo is finally out of warranty.  If you've never realized how long my blog has been around, I definitely blogged about getting it four years ago.  Honestly, it's been four-and-a-half.  My little Cozmo has been well-loved, but it's time to move on to the next pump. 

This is where I am having a little bit of trouble.  I want a Tandem T-Slim.  I think it looks great, and I love that they still have potential to integrate with Dexcom in the future.  (Dexcom G4 = drool.  Not yet for me, but maybe early 2013?)  A lot of things I read about it and the handful of things I actually know about it just make sense to me.  Is it going to be as fabulously intuitive as an iPhone or a good Android phone?  I'm not sure, but hey, I've been dealing with regular clunky insulin pumps for so long, I just think you can't really get any worse, right?

On the other hand, a Medtronic would also be a practical option for me.  I've had a Medtronic in the past.  Two of them, in fact--my first and second insulin pumps were from Medtronic.  I know they are durable, but I also know they can be sensitive to static shocks.  I know I would have to use proprietary supplies.  I know I would be wasting their technology by using my Dexcom instead of their CGM system.  Yet, I can't shake the fact that I should be considering Medtronic.  They've been in the business a long time.

For practicality's sake, I am limited to a larger-sized reservoir, 300 mL plus, otherwise I'd be refilling my pump every day or every other day.  This makes my options very limited.  I can have a Tandem, a Minimed or an Accu-Chek combo.  I have not had my hands on a Accu-Chek.  I am not sure how I feel about the pump itself.  I personally think it still looks a bit clunky, although I do like the Bluetooth meter-remote concept and the 315 mL reservoir capacity.

Why am I saying all this?  Well, since it's National Diabetes Awareness Month, it seemed like a good time to talk about this and get your feedback.

Do you love your T-Slim, Medtronic or Accu-Chek?  Have you blogged about it somewhere?  I'd love to see some DOC feedback on these pumps so I can work toward a more educated choice for myself.  Post away in the comments, friends!  I want to know what you love and what you don't.

13 comments:

  1. Anonymous7:37 PM

    The T-Slim looks fantastic! I think that is a good choice, and since T-Slim and Dexcom are HQ'd in San Diego, it would seem that integration would be rather easy. I currently use an Animas Ping, and it's out of warranty but insurance will not even consider replacing it until it quits. I believe the Ping has a 300ml reservoir available FYI.

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    1. Hmm. When I last looked, I think the Animas pumps only hold around 200 units?

      I have realized I said '300 mL' when the correct measurement is usually 100 units = 1 mL. Will have to edit that, I think. :P

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    2. Yeah, Animas is still 200 units. Bummer. I am enjoying mine in comparison to MM. I switched when my warranty ended in anticipation of the Dexcom integration.

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  2. I have so many thoughts on this. I have the MM Revel. Had it for going on 2 years now and LOVE IT. When getting my pump, the big choice was between the MM and Animas Ping. The Ping definitely had some features that I liked (color screen, remote bolus, waterproof), but MM won out because of it's durability and reliability. I will say that I've done a lot with my MM (hiked mountains, backpacked through rough terrain, etc) and it has withstood all punishment. The screen is small and completely unexciting, but it is also incredibly resistant to scratching and breaking.

    As for the t:slim - it definitely caught my attention with its iPhone-esque appearance and touch screen. But there are a few things that leave me a little concerned and hesitant to jump off the MM bandwagon. First, they are an untested company with a new technology (the pump works differently than MMs). This is a concern because it has not been tested largely in the real-world market. I do a lot of backpacking and camping and need a pump that is RELIABLE. Also, MM has some great customer service. Will t:slim's be as good? It's a new company so I'm not clear that they have the experience to back their product.

    The pump itself also raises some issues. Will it be as durable as a MM or Ping? Is it at least splash resistant? You cannot keep a pump dry all the time. Just not possible. Also, the rechargeable battery thing is a big NO for me - as someone who spends a lot of time outdoors, it's just easier to carry a AAA battery in my backpack.

    For me, the t:slim issues come down to durability and reliability. I'm just not convinced that the pump will hold up in this respect, so committing to it would make me nervous. I'm connected to this thing 24/7 so I really want something reliable, a pump that I know has a proven track record.

    Also, you can use other infusion sets with the MM pump. You just need to order some special reservoirs from 50/50 that work with the MM and can be used with luer lock sets.

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  3. Here's where I exclaim that I'm still wearing my beloved Cozmo! Long live the Cozmo! w00t! :-)

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    1. Anonymous8:12 AM

      Me too, Scott. I'm on my second Cozmo (8 years total) and plan to wear it until it dies.
      George Davis

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  4. Hello! I have been on a MM for over 12 years now and up until the last two years I have never had an issue. But now I am 100% positive I am switching to a different pump. Here are some of the issues I have had with MM recently:

    Customer service is for lack of a worse term terrible! One CSR said "I've had 2 weeks of training on this so you must be doing it wrong" with my response being I've been on your pump for 12 years!

    I've been in the ER twice from DKA and I was suspicious my pump was not giving me my basal but they refused to change it out. Come to find out my no delivery alarm was not working both times.

    I was also on auto shipments for my pump supplies. They sent me a 3 month supply every 2 weeks and refused to take any back. This went on for several weeks. At one point we didn't even pay the bill so they would stop sending it and they still did. Finally after an access of 24 boxes later they stopped.

    And to boot, come to find out I have scar tissue because I've been on the wrong infusion set for my body type (also hints several needs for no delivery alarms). So I am still using the wrong set to get rid of the ones I have. This results in scar tissue, several set changes, no delivery, and more.

    The latest issue was that my battery alarm went off. I used 6 different brand new batteries in my pump and it wouldn't even turn on. It didn't give me a bad battery alarm or anything. It finally came on after the 7th battery.

    I talked to my Endo about these issues and he was going to have my local Minimed rep call me. That was 2 months ago and I still haven't heard from him.

    There are other issues but these are the ones that stick out to me.

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  5. I LOVE my t:slim (and in other news, I hated my first pump, a Medtronic, for a variety of reasons). The t:slim IS intuitive and I think that's a huge plus. The full color screen is a big thing for me too, since I have retina damage and can't discern colors/shades of light too well. And so far, hands-down, Tandem's customer service is 1000% better than anything I ever experienced with Medtronic.

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  6. Chiming in -
    MM is a very durable pump. They are tried and true. But they are very proprietary in every aspect and you're sort of "locked in" with them.

    The t:slim is a sleek pump. It is water-resistant for 30-minutes up to 3 feet in water. The pump is VERY intuitive.

    The Combo, even though it's clunky, they actually did a great thing with the remote. You can hide away the pump ALL DAY and never have to touch it. You can control every aspect of the pump from the remote (unlike the Ping, where you can only bolus or see pump status screens from). There are also a lot of great features in the remote like reminding you to test again because your prior number was high, or if you're low, it calculates and tells you how many carbs you should need to return to normal. Their pump is also very durable as well, much like the MM.

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  7. Good luck with your decision! It's definitely a decision that needs to be made based on what's best for you and works for you. I chose the t:slim because I didn't want to be stuck with "old technology" for another 4 years. I liked my Minimed, it worked, but I'm a tech person and I wanted the latest and greatest. It's not for everyone though. I also enjoy helping a new company by being one of the first to use their equipment. If nobody did that and gave chances to new companies, we wouldn't have innovation with diabetes technology.
    I blogged about my initial thoughts and the cartridge changing. You can see them here: http://www.type1at18.com/blog/2012/10/29/tslim-initial-thoughts/ and here: http://www.type1at18.com/blog/2012/10/31/tslim-follow-up-cartridge-change-video/

    One thing I'm not sure I mentioned in either post that I have found I really like is the more precise insulin dosage. I can deliver in increments of .001 if I want (at volumes greater than .005 according to specs). I have found this is helpful, especially when correcting blood sugars and helps with accuracy.

    Feel free to ask any questions! I've been asked to write a post on the t:slim directly compared to my Medtronic and I'm hoping to have that up by the end of the week as well.

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  8. Anonymous10:56 AM

    My daughter had a Cozomo pump...LOVED IT...BEST PUMP EVER. We switch to PING. was a good pump. We liked the remote capability to do all the boluses. However alot of levels to go through to do things on the pump. Being water proof was great. Yes pumps do get wet! Just switched to the T:Slim. I was concerned my daughter would miss the communication from the Meter to pump, but she loves the T:slim. She said entering the information is so much faster that is is not an issue. Having a keyboard to enter is very quick on the T:Slim. The one down side of the T:slim is the loading of the insulin. A bit slower process, especially filling the tubing. But over all impression of the T:Slim is very good. Customer service has been good. Training was good. The pump is not water proof like the Ping, but can get wet. Similar to MM pumps. T:slim did but some of the patents from Cozomo and integrated them in their technology. However, there is no disconnect feature in this pump either. Not sure why any other company has not bought that technology from Smith Medical. It was great feature in the Cozomo pump. Still bummed that Metronomic cause so much legal trouble for Smith Medical that they decided to pull out of the pump business. It was a great product that has not been duplicated. But give T:slim a good look. I think you will learn to love it. New companies need to be supported to continue to bring more innovate products to market and give the big guys a run for their money.

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  9. One thing to be cautious of is how the different pumps calculate a bolus and how insulin on-board and corrections factor into those calculations. I believe Medtronic's is most similar to Cozmo's (for reasons that may or may not have led to Cozmo's demise). I bring this up only because I think when people go on trial after trial of various pumps, this can be overlooked and they may not get the bolus they expect.

    That said, there's a post on my blog (probably the most-read of all of them) on why I'm not getting a t:slim. I almost feel bad for writing it, as it may be construed as a kick in the pants of a new company who doesn't deserve to get beat-down, but it outlines some very real concerns that I have, and some that may get overlooked by those taken aback by the prettiness and shine of the new device. It may be worth checking out.

    When I got my first pump, I didn't do any evaluations - I just went with the proven, established leader in the business. I'd be lying if I'd never second-guessed my decision, but as of now, they're still my favorite.

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  10. Hi,The technology exists to treat diabetes in a way that it does not have to have a negative impact on any goal or dream you may have. Be diligent with your diabetes care and there are no limits to what you can achieve.

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