Choice of pump (and CGM)

Spiker

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My pump DSN advised me doing a pump Suspend during a hypo is worse than a waste of time and I agree. There is no chance of it helping with the hypo and it creates an unexpected high later which can only worsen the normal hypo rebound effect.

I mean, maybe it would be useful for a very gradual overnight hypo - but far better just to wake the user up with a bloody loud and persistent alarm.
 

Jemzor

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71
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@Spiker the rep confirmed Animas is going down the route of reduced basal rather than suspend - largely because it is more representative of what a normal pancreas would actually do and it would therefore create less complications when managing sugar levels.

I see the benefit of smartguard in that it can prevent the hypo in the first place, but it's the after effect which still leaves questions to be answered.
 
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Pudgem

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Hi Jenzor.

I thought I would tell you about my recent choice, if it helps. I like you felt my decision was being steered by the cgm rather than the pump. Which is why initially I was all over the vibe. Then I heard about the 640g and insight and swung back and forth more times than I can remember.

I have now decided to go with the insight, and my reasons are:

For me, the remote is going to be a huge help. I have a busy job, in and out of the office, travelling, meetings and all sorts. The idea of getting the pump out at meeting etc to give bolus's was worrying me slightly.

I really did prefer an integrated system, but the 640g will cost more which I would prefer to avoid as will be self funding, and also I am not convinced at how reliable the smartguard will be given the spikes etc.

I have been reading a lot about the dexcom G5. This is obviously not yet out and is likely not to be until the end of this year at the earliest. The fact that this will communicate with my iPhone means I will not need a separate receiver, and given that the sensors last longer is a much more cost effective option.

I of course could be wrong about the dexcom and its features but from the presentations dexcom have done, it's certainly heading that way. Even if I am wrong, I cannot wait for the insight. It's a lovely looking pump, has the convenience of the pre filled cartridges, and the remote from what I have seen so far is amazing - a bg meter on steroids! I am sure it won't happen, but I secretly hope that accu-chek will eventually release a app to similar to the Dario app which could replace the remote. - I can keep dreaming!
 
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Spiker

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The combination of the Insight pump, Dexcom G5 sensor and iPhone sounds pretty cool. If I was at the point of deciding on a pump and CGM today, I could well go for that. I would particularly like to have a decent remote for my pump. Or, well, any remote at all to be honest.
 

Heathero

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Messages
362
Type of diabetes
Type 1
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Pump
I've been T1D for 30 years on MDI's throughout. I recently had 'the chat' with my consultant, have had some structured training and been referred to the pre-assessment clinic for a pump. The clinic is offering a choice of the following:

1. Animas Vibe
2. Insight
3. Medtronic 640G
4. Dana R

The omnipod is not being offered due to high cost - regretably

I am interested in a solution that incorporates CGM as I would look to self-fund this.

It is quite a dynamic time for pump choosers with the more recent introduction of the Insight and 640G. With this said, I have changed my mind more times than I care to count! The Vibe was the choice for a while as it is waterproof and has the integrated CGM receiver, but the safety limitation on bolusing multiple times in short timeframes is making me think twice . I also can't help but feel we are entering a new generation of potentially very useful pump tech (basal suspense & BG predictions) which given the age of the Vibe, is not included - or maybe it just feels new as I've yet to use a pump.

The 640G seems to be ticking all the boxes and being that I am familiar with the Bayer USB Next, the choice of meter is also fitting. My only reservation is with the integrated CGM and its high associated cost. According to some users, the Dexcom sensors appears to be lasting 14 days. The Medtronic seems to last 6 days? Can it be used for longer?

The reason why I have mentioned the choice of pumps in this war of CGM is becausing I feel the choice of CGM is driving this (rather than vice-versa). So whilst the 640G looks great on Youtube and paper, if the CGM is not the most appropriate then I would lkely change my choice of pump back to the Vibe. The clinic has not received the 640G yet, so I will still ned to play with it before deciding.

Going for 2 separate systems (eg. Insight + Dexcom) would be my least favourable option.

I am interested to hear your views on the CGM and particularly if you use the latest Medtronic CGM equipment (or pump!).
.
 

tim2000s

Expert
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Now I don't know a huge amount about Smartguard, but from what I've read, the way it works is that it suspends at a pre-defined level set by the user and resumes at a different one. In theory then, you could set a suspend with a downward trend and a level of, say, 4.0, and resume at a level of 3.9 with an upward trend. If it's that clever of course...
 
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Diamattic

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Messages
678
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Type 1
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@tim2000s - Thats pretty much it. The old Veo system had 'threshold Suspend' which would alarm like crazy and still make you confirm both the alarm, and the suspend. Which i see is no different then if an Animas pump alarmed at a low, and you just reduced the basal yourself for like an hour.

However, smart guard is different in that it doesn't alarm. It sees the trend going down, and suspends for you (unless you turn the feature off) and then tracks you BG and either alarms when you get to your low alarm, or turns your basal back on when you level out above the set level. The key thing is it does this all without you having to tell it. So if its at night you can stay asleep lol Unless of course it doesn't work and your low alarm goes off.

But i thin its a cool option, mostly because you can sleep though things, or continue to be active and not have to manually fiddle with alarms and junk when you wanna be playing hockey, or cycling, or driving.
 
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