by Alison
Musings on UK pump developments
8:17 am in Kit & equipment, Living with diabetes, News by Alison
- Omnipod pod and PDM
I have a couple of friends who are in various stages of getting themselves insulin pumps (do I really go on about it that much??). Having had similar conversations with each of them about what’s currently on the market in the UK, I thought a quick overview of some interesting recent developments in the UK pump market might be useful.
Bear in mind I’ve only used a Medtronic Paradigm pump, my thoughts below are based on reading reviews and publicity material, playing with samples at conferences and talking to people. This isn’t a scientific, double blind randomised control trial, it’s just my musings.
The Omnipod is a step nearer to the UK
Our friends over the pond have had the tubeless Omnipod for a couple of years now. The overall impression from people who use it seems to be very positive (save for a few reliability problems early on that seem to have now died down).
Personally I like the idea but have reservations on two fronts – firstly the pod is pretty large to have attached to you at all times. On a standard pump when you disconnect to shower or whatever you’re left with an infusion set roughly the size of a 10p. As you don’t remove the Omnipod pod for the entire 3 days until you replace it with the next pod you’re permanently attached to something roughly the size of half a small apple. My other concern is the tubelessness. My pump is attached by a piece of string which does have the unexpected benefit of my not being able to forget it or lose it easily. I don’t have to remember to pick it up before I run out the door as it’s attached to me. As the Omnipod is tubeless, that means you have to remember to carry the remote to do any dosing. Not an insurmountable problem I’m sure, just something that concerns me.
Insulet Corp recently gained a CE mark for the Omnipod, meaning that they can now sell it throughout the European Union. News reports say “the product will be available to a limited extent in selected markets in 2009 with broader availability in 2010“. Always good to see more choice on the market. One interesting issue for Omnipod entering the UK market may be their website – their .co.uk address is currently owned by a company that “specializes in mid-20th century designer furniture and distinctive accessories”!
Paradigm Veo
The Paradigm Veo is already here!
Having had to wait impatiently for the Omnipod to hit the UK shores (and it’s still not here yet), it was a nice surprise to see that we actually got the Medtronic Paradigm Veo in the UK before our American cousins.
The Veo is an upgrade to the existing Medtronic Paradigm Real Time – it has some tweaks to the CGMS but it’s big new feature is that if you fail to respond to the CGMS hypo alarms it will suspend insulin delivery for 2 hours to help reduce the risk of severe hypoglycaemia. Thankfully severe overnight hypos haven’t been an issue for me since I was a teenager struggling with ye olde insulins of Ultratard and Actrapid, but if this had been available back then it would have been life changing for me. For more detailed info try the INPUT blog.
Accu-Chek combo systemNew combined approach from Accu-Chek
Pumps are very personal things, what suits you depends on what kind of life you lead, what you like, what you don’t like etc. What’s really exciting at the moment is the diversity in the types of pumps and features that are available, we’re really starting to see a market where each supplier has a defining feature whether that’s the lack of a tube, integrated CGMS, great remote functionality or the ability to give really small doses of insulin like the Animas 2020 . The next step has to be to get all the good stuff into one pump. For what it’s worth my wish list includes:
- CGMS. This is my “must have” pump feature. I’m not interested in having it as a separate device, that’s just too much stuff to carry. It has to be integrated.
- A remote with full functionality would be handy – so I can hide my pump in my bra when I’m wearing a nice dress and not have to fish it out at the table to change my basal rates.
- If I’m carrying a remote, it’d be nice for it to have built in glucose meter so that’s one less thing to carry.
- I’m surprisingly ambivalent about tubing. If I could get over the fear that I’m going to find myself on a train to London having left the only way of controlling my pump on my bedside table – and they could make the pod smaller – I’d certainly think about going tubeless. It’s not a big deal for me though; the tubing on my pump isn’t something that really bothers me.
Here endeth my thoughts for the day. Comments?
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Good article Alison! Is it just me or does an “Omnipod” sound like one of those baths of goo they put people in in The Matrix – they sound a bit sinister to me…
Considering that in the near future, ALL insulin pumps will be tubeless and have a integrated CGMS, you might as well swallow that blue pill.
I love my OmniPod! It’s been great especially since I can wear it on my arms. Although I haven’t been able to slow down time like Neo…
@Mark It’s strange, I never make any effort to hide my diabetes and I have no issue wearing my CGMS transmittor, but the pod at the moment is just too large for my liking. I can’t wait for the day when they all have integrated CGMS, just a shame it’s not here yet so currently there’s no choice in the market in that area.
@Mark I’m disappointed Mark; I thought all our readers had super-human bullet-time powers….
@Tim @Alison The OmniPod really isn’t that big… Imagine slicing a large egg in half and attaching it to your skin. Just think what we’ll have in 5 years from now… (begin dream sequence)
@Mark If they can get it down to the size of half a small blackbird’s egg, then I might consider it. Chickens eggs are too big to go on my arm at the moment! Even better would be a flat-ish patch.
Glad to hear that insulin pumps are progressing across the pond as well as here in the US. Alison, I’m with you on size being an issue for the omnipod. I find myself a bit irritated even with the size of the CGM transmitter for my minimed system, so I know an omnipod is not for me at this point. I call my CGM transmitter “the tick”, and if you’ve ever seen a big white cow tick, you’ll know why. But…it’s a very useful “tick”, so I also agree with you that CGM integrated with the pump is my #1 must have feature. Looking forward to everything shrinking a bit more in the future.
Is the “egg” the international measurement for diabetes equipment or something? For example, “I like this new meter, it’s smaller than a ostrich egg” or “My new diabetes equipment case is larger than four partridge eggs laid end to end”?
@Tim Actually, I’m now hungry for an omelette.
Hmm well I have to say I have used the old Paradigm and am now using an Accucheck, and there are differences between the two, but I love my Accucheck. My funding for the new one with remote, is in progress and I am quite excited! The have developed massively and who knows what the future will hold xxx
Hi Alison
I think your list is spot on. However, I would also mention the bolus wizard. Do you use this? I think this is an often overlooked feature. By calculating the IOB curves for every bolus, this gives you a correction bolus which is as accurate as it can be without stacking. If you think about it it’s probably a more significant step towards a closed loop systems than the LGS in the Veo. If you are prepared to spend your day looking at the recommended correction amount based on the CGM score and giving that bolus then you have a semi-automatic control. It works even better if you increase / decrease based on CGM up/down trend.
Good point Roger, I do use the bolus wizard. I didn’t think to mention it because I think all pumps have a version of it so I take it for granted. But you’re right, if you get that set up correctly, it does make a huge difference. Interestingly it was the one pump feature I didn’t think I’d use because I’d been calculating doses in my head for so long, why would I need it? Having got it, I use it every day!
@Roger Cor! I love it when we get geeky – IOB curves, closed loop systems, etc. – it combines two of my hobbies namely diabetes and geekery