Picking a pump in 2011

By | 28 January, 2011

The time has come. It’s hard to believe but its four years since I got my pump and its warranty is nearing an end so it needs to be replaced. On one hand, I can’t believe four years have passed since I stepped into a brave new world and felt a bit like I was having to learn everything I ever knew about diabetes all over again. On the other, I can’t imagine life without my pump and CGM any more.

Anyway, don’t tell the pump (because I need its loyalty for a few more months yet and it has a tendency to get stroppy), but the end is nigh and I’m on the hunt for a replacement. A quick survey of the pump marketplace shows that things don’t seem to have moved on a great deal since I last looked at the pump market in 2009, but there have been some developments so what are my choices?  

Omnipod now sell their tubeless pump in the UK which is real progress. Last time I thought the egg sized pod was too big to have attached to me for 3 days without being able to take it off and the lack of tubing left me in fear of leaving the remote behind as I dashed out the door. Having poked around at the Omipod at an exhibition I’m afraid that’s still my view. For me the pod needs to be much smaller and I need some way of convincing myself I won’t forget to pick up the remote before I’m up for that.

The Accu-Chek combo is still a tempting offer with its fully functioning remote control that also acts as a blood glucose meter. This means I can hide my pump in my bra and then use the remote to do a blood test, calculate how much insulin I need with the built in bolus wizard and then instruct the pump to deliver the insulin, all without having to delve into my bra in public. This is very tempting. Where the Omnipod fails me is that if I don’t have the remote I can’t bolus. With this, I can bolus with the pump (which is attached to me via tube so I’m going to have to try hard to leave it somewhere) or with the remote. The cynic in me does wonder though whether this is just a smart new remote to tart up a pretty old pump model.

Non-pumpers, if you’ve glazed over at the thought of all this tech, Accu-Chek seem to have done something clever by taking the intelligence behind pump bolus wizards and making it available to those on MDI.  Nice idea. The Accu-Chek Aviva Expert is on their website but info is pretty sparse. There is a pretty detailed review by Mike over at EveryDayUpsAndDowns if you want to know more.

The Animas 2020 seems to be big on looks and personalisation. It has a huge screen compared to the others so you can see a lot of data without flipping through menus. And their bolus wizard is customisable so you can input your favourite foods. It gets a big plus for having tiny 0.025U/hr basal increments meaning you can really tailor your basal rates to the nth degree.

Finally, we get to the incumbent. I’ve had a Medtronic pump for four years and I’m happy with it. Their latest, the Metronic Paradigm Veo is an updated version of my current pump. This is where the whole reviewing the market process falls apart. The big screens, sexy remotes and customisable bolus wizards are nice to have but they can’t compete with the one killer app offered by this pump – integrated CGM. I will sacrifice virtually anything for that. Speaking to an Animas rep 18 months ago they were very hopeful of offering a pump with Dexcom CGM integrated by 2010 but I’ve seen no sign of that. I’m not willing to wear a pump and carry a separate receiver for the CGM when an integrated version is available so it means my only choice is the Paradigm Veo.

This is no great hardship. Like the Aminas, it too has the tiny 0.025U/hr basal increments which will be an improvement on the 0.05 setting I currently have. The bolus wizard works well and I’m so used to it I find it really intuitive. I can’t fault the service I’ve had from Medtronic over the last four years. My problems have been minor, evenso they were fixed fast. The CGM functionality has been improved so I can now set it to alarm if I’m rising or falling quickly (great for anticipating highs and lows and taking early action) and it has the reassuring safety feature of if the CGM detects I am low and I don’t respond to the numerous alarms, it’ll suspend insulin delivery for up to 2 hours. Interesting.

So, just like four years ago, my choice is simple.  Integrated CGM is top of my list; therefore it has to be the Paradigm Veo. If pumps were like Mr PotatoHead and I could customise to my heart’s content, I would add in a fully functioning remote that displayed my blood sugar from the CGM and allowed me to dose remotely. Until the PotatoHead pump is available though, it looks like I’m sticking with Medtronic.

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About Alison

Diagnosed with Type One in 1983 at the age of four, Alison’s been at this for a while now. She uses Humalog in a combined insulin pump and continuous glucose monitoring system and any blood glucose meter as long as it takes five seconds or less.

41 thoughts on “Picking a pump in 2011

  1. Stephen

    Dare I say it, I think I agree with almost everything you said there (and did so when I chose my pump!) – the lure of integrated CGM and the downfalls of all the others made it a really simple choice in the end. Gadgetry goodness 🙂

  2. Donald Thomson

    I’m on the waiting list and it looks like the Medtronic’s the one to go for – if I get a choice, that is. One question, though. Do I have to start wearing a bra or is there another way to carry it around . . . ? 😀

    1. Alison Post author

      Sorry Donald, a bra is essential. Ask Tim, he’s got a lovely selection that he wears 😉 I suppose you could carry it in your pocket or on a clip on your waistband but where’s the fun in that!?

  3. Tim

    You’ll be part of the Edinburgh group of hospitals Donald? If so, you’ll get the choice of the Medtronic Veo or the Medtronic Veo. Edinburgh does not do choice.

    Your’re correct in that pumps can only be worn in bras. So I’ve been wearing one since November. Once you get used to the chaffing it’s okay.

  4. Stephen

    @don172 – I bought a couple of bags / carriers but found them just to be a pain in the backside! As I’m primarily (well only …) a stomach infuser it sits in my pocket without any case almost unnoticably 🙂 That being said at bed time I use the provided case with a clip that just slips onto my shorts / boxers.

  5. Mike

    Good round up of the current front runners Alison. Always nice to have someone doing some gadgety research for me lest I ever get over what’s left of my pump-aversion.

    I’ve been speaking to the fine folks at Roche about the Expert, which I am liking more and more (a follow-up post is waiting in the wings). From what I can tell there are some differences between the Combo handset and the Expert (Bluetooth to communicate with the pump, snazzy pumpy delivery waves…) but without getting your hands on one for a few days it’s hard to know exactly what they are, and whether some of my niggles are still there or not.

  6. Melissa

    I think the Medtronic Veo is the only one on offer in West Lothian as well. They hate to give us a choice.

    I like the meter that comes with the Accu-Chek pump. I’ve got the Aviva Expert just now (which I’m guessing is just the same – but without being a remote) and it’s absolutely brilliant.
    Have there been any reviews done on here about it?

  7. Tim

    @melissa – I haven’t had a look at an Aviva Expert – I’ll see if I can get hold of one and review it. Oh, and congrats on your first Shoot Up post! 😀

    1. Tim

      @melisa – being amazing, I’m meeting up with the Roche rep on Saturday to have a demo of said Aviva Expert; so expect a review soon!

  8. Alison Post author

    On the choice issue, my hospital only offered the AccuChek until I pushed hard for the Medtronic because it had integrated CGM. They weren’t particularly keen to broaden their range but they submitted after some gentle questioning about the need for a patient to have a choice in the treatment they receive.

  9. Tim

    Update – I’ve contacted Accu-Chek and I’m getting an Aviva Expert for review, so I’ll post something up in due course. Don’t say I’m not good to you all!

  10. lizz

    Interesting. At some point I will need a new pump as mine is now discontinued. But there is a new pump (not mentioned here) which is having some of the fantastic gadgetry from the Deltec Cozmo incorporated, so i might go for that, since I don’t fancy CGM. Although I need it! Do you have two lines in?

    Did you know that pressure on the breast can reduce the lymphatic drainage in the breast? This is the reason I use a soft cotton cover from Accu-check which hangs from a hook in the centre of my bra. I can’t feel it there, hanging loose, at all, and it is completely invisible under virtually everything.

  11. lizz

    Just went and had a look at it. It has had a few improvements to my bugbears with it – improved and quicker site changeovers apparently, which is great, that drove me mad it was so slow in comparison to my Deltec. Also missed meal bolus alarms. Hooray! BUT – does it tell you when to change your sets over? Anyone know? Such a handy alarm to have! 3 days go by so quickly.

  12. lizz

    That alarm on mine is the BEST feature! As that’s what I’m most likely to forget.

    The pump which has been fitted with a lot of the Deltec features is called the DanaR made by Sooil.

  13. Stephen

    @alison or @tim can probably confirm/deny – I’ve not read the destructions yet 🙂 I’m quite lucky though as the 3ml resevioir lasts me about 3 days to the hour! As such the alarm that I’m running out of insulin prompts me to change mine.

  14. Stephen

    You can get either a 1.7 or 3 in the Medtronic line, but you’re told to change the reservoir at the same time as the needle. (There are ways around it, but it’s just not cricket 😉 )

  15. Annette A

    My cartridge lasts 8-9 days,but I can change cannula, cannula and tube or cannula, tube and cartridge. So I change the lot, then after 2-3 days change the cannula, then change cannula and tube, then cannula, then cannula and tube, then change the lot when the cartridge runs out. So I have to remember to change set, and remember if I’m changing full set or just cannula -accutrend are quite green by ‘allowing’ that. I have an alarm set on my mobile to remind me when/which, cos I look at that regularly, rather than using the pump alarms.

  16. lizz

    Cripes, your brain has clearly not been damaged by low blood glucose. I’d never remember where I was in the cylce! I don’t have a mobile. Well, actually, I do, but since I work from home it’s not much of a help as I never charge it! And tBH alarms aren’t so hot when it goes off, you turn it off, get up to change it and then forget what you got up for and get back down again. I usually change it once it gets sore.

  17. Annette A

    No, I still have a reasonable memory, even after 34 years of hypos 🙂 But I tend to turn off alarms and then not do them – which is why I use the mobile – it sits there saying ‘Cannula change’ on the front screen until I physically go into the screen to change it. And I dont do that until I’ve changed it, so I just have to remember to look at my phone to remind me to change. Dont like the idea of waiting for it to be sore…

  18. Alison Post author

    I don’t think my Pardigm has an infusion set change reminder alarm, but to be honest I’ve never wanted to use any alarms. I have to restart my CGM sensor every 3 days so that syncs nicely with the set change. Although even without that I’ve never had much trouble remembering to change my set.

    @lizz If I wear my pump in my bra I wear it in the middle too. Some people seem able to put it down the side but when I’ve tried that it feels like I have an insulin pump stuck in my armpit which isn’t something I really enjoy!

  19. lizz

    it may depend on where you wear it and how large your boobs are whether they get pressed on by the machine! Mine are definitely impinged upon if I have it in the middle in my bra, but mine isn’t there, the cotton cover has a hook, which hooks over the middle of the bra, and it suspends below my boobs in the middle. So catches on nothing.

  20. Annette A

    The trouble is if (like I do) you like to wear quite close fitting tops (not low cut, just close fitting, before certain garden ornaments start…) – then the hanging below the bra is not only obvious but also quite uncomfortable. I’ve found a style of bra (in M&S) that ‘lifts and seperates’ sufficiently that I can wear the pump in the middle without pressure on my boobs and (as long as it is indeed a medium to high cut top) without being visible. I guess though, if you are well endowed, that might be more of a problem (I’m not).

  21. lizz

    Lol! Do you mind telling me which one AA? If I decide at some point to go tight-fitting but not low cut!

    The things we women have to think about. Bet men don’t have to think about what they are buying clothes wise.

    I hate the pump on my belt as it gets in the way of bending over, an also, lots of things I wear have no belt. In a pocket works sometimes but there is always a bulge then…

  22. Annette A

    Just been to check if they have a name, but they dont. But, its pretty much the only non-underwired own brand version they do these days – sold in packs of 2 with a cross-your-heart type bit at the front (although its not a cross-your-heart bra) – which is the bit that seperates nicely 🙂
    I’ve also started wearing much fuller skirts (not a problem cos its winter) – I can then wear the pump in its hanging case on a longer cord, low down, so it sits just below my waistband under the skirt, but is hidden by the fullness of the material.
    Agreed, men don’t even have to think of this sort of problem.
    I regularly get asked at work ‘where’ve you hidden your box this time then?’

  23. lizz

    Some are born lecherous, some achieve lecherousness, and some allow lecherousness in the form of a plastic gnome hat to be thrust upon them. I think you must accept whatever comes your way Teloz.

  24. aileen

    Don’t forget the Animas pump is coming out with integrated CGM (Dexcom) in the very near future, and the CellNovo and OmniPod are meant to be integrating the Dexcom also. Some of the kids in Lothian use the DanaR. Everyone should have a choice and need to push for it!

  25. Alison Post author

    @aileen Do you have any info on how near “very near” is for the Animas/Dexcom pairing? Every time I’ve talked to them it’s been “very near” and that’s been a couple of years now.

    1. aileen

      Hi Alison, I think as long as there are no blips now, we are talking pretty soon…. maybe in a few months, but we all know nothing is definite until it actually happens! I think it will be released in the UK first like the Veo was. Exciting stuff!!!

  26. Alison Post author

    A quick update on the when are Animas releasing their combined pump & CGM question – they say it’ll be out in the UK in April/May. I’m crossing my fingers, but not holding my breath.

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