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Accu-chek Insight V Medtronic 640g?

Discussion in 'Insulin Pump Forum' started by wildtoast, Jul 2, 2018.

  1. wildtoast

    wildtoast Type 1 · Well-Known Member

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    I've been offered a choice between these two pumps, I'm interested to hear people's opinions - particularly if anyone has experience of both and can compare and contrast! (I won't be getting the CGM along with the Medtronic, just the pump.)

    I'm doing a lot of reading (starting with the stuff the DSN gave me but also random threads on here and other places, blog reviews etc) and the Medtronic seems to be edging forward, I've seen a few reviews of the Insight where people said when asked if they'd have a different pump they'd like a Medtronic.

    Seems like the Medtronic doesn't have a proper remote, but boluses can be sent from the linked meter, whereas the Insight has a 'full' remote control so you don't have to get the device out from wherever you've got it stashed on your person.

    The Medtronic seems to have lots of options (clearly I haven't been properly educated on pump therapy yet haha) that the Insight possibly doesn't. I had a look at the demo pumps today and they both seemed to be of a similar size. Any input super welcome! :) Any considerations I should make that I maybe haven't thought of as a complete pump novice?

    PS where do people wear their pumps? This is going to be a whole new world!
     
  2. Chas C

    Chas C Type 1 · Well-Known Member

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    Hi @wildtoast - if I was you I'd make a list of the things you expect your pump to be able to cope with then go through the two pumps and see which one best meets your needs. You'd need a Medtronic user to give you advice on remote control, it was a few years ago that I did this exercise and at that time the 640G was not available.
     
  3. kitedoc

    kitedoc Type 1 · Well-Known Member

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    hi @wildtoast,
    I have an Animas pump so cannot give you any direct experience.
    However, ask both pump reps/educators if the pump can detect a reservoir or cartridge which is air-filled vs fluid filled.
    I have heard of a case where a person was woken by their pump alarm to indicate the reservoir/cartridge was empty and in their sleepy state accidentally filled the cartridge/reservoir with air rather than insulin. ( i shall not indicate the pump brand as the fault may well have been rectified from 6 years ago!) They woke up later with high BSLS and feeling very unwell !
    I do not use CGM often because it is too expensive here in Australia for me but I like that I have the option to use CGM in the future. And if night-hypos are a concern. then being able to link up CGM with a insulin rate reduction program when bsls are low is a neat option - but only if that is a priority in future ( probably more important for a child than an adult).
    How easy is it to use the pump screen? Unfortunately Animas pumps are being phased out but it was my choice prior to knowing this because its screen was easy to read, even in the middle of the night.
    With changing reservoir/cartridges regularly, how difficult or easy is each of the two pumps' procedures for this?
    Needle inserts : I found that the 90 degree insert devices for Animas could sometimes go in crooked. The 'kink' in the plastic needle left under the skin could slow the infusion of insulin, without setting off the obstruction alarm and result in me developing high BSLS. There is no easy way to know if a kink has occurred except by suspicion and being prepared to change the needle insert. I always stock more needle inserts than reservoirs/cartridges because of this possibility. You need to know whether you can be supplied with more inserts than reservoirs, although this is probably a NHS policy thing.
    I would think this situation of bent needle inserts is a possibility with all brands and is largely a matter of education and practice but others on site might have experiences to share.
    If you look up each pump company's website the Accessories tab should list the various options for carrying a pump, including belt clips, body bands, pouches etc. ( the soft toy lion is my favourite, just kidding !!).
    A belt clip works well for me, provided I am careful with tucking in and pulling out shirts. I often wear a shirt/coat/etc which covers the pump as added protection and slide the pump to nearer my back if I am concerned about bumping the pump whilst walking through a crowd or between lampposts etc.
    The tubing between pump and needle insert is bendy but stiff and relatively inflexible so that the insulin pushed through by the pump goes through into the needle and under your skin rather than just swelling up the tubing. The springiness of the tubing can make it a bear to keep in place under one's shirt !!
    Another point, just to remember with which ever pump you choose is the the need to allow for sufficient length of tubing for a belt mounted pump to be able to lower trousers, pants/slacks when sitting on the loo so that you do not put tension on the needle insert.
    I am carrying a rucksack with hip flaps, I move my pump from belt to a pouch slung across neck to opposite under armpit area on same side as my needle insert (but above and clear of said insert). My pouch happens to be an old travel wallet pouch. I wear a collared shirt to save the pouch strap rubbing on my neck and a pullover, shirt ect over to help hold the pouch in place a bit. The other solution maybe a body band.
    In the Insulin pump thread (Omnipod) you will find information about wearing pumps in hot weather.
    Best Wishes for your choice !!
     
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  4. Chowie

    Chowie Type 1 · Well-Known Member

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    I'm a noob to pumps. I have had the Medtronic 640g for about 6 months. I thought the remote was essential before I got the pump, I have never used it's limited functions more than once.
    My experience with pens and injecting is somewhat horrifying from reactions from very narrow minded intolerant people. The pump has not attracted any negative attention, so I would move the remote feature much lower on your list. I doubt you will find anyone that can give you a comparison. As far as I'm concerned the 640g is a game changer HbA1c before pump was normally 8.x% and occasionally low 9's%(79mmol/mol). after 4 months on the pump 6.8% (51mmol/mol).
    I would suggest ask users of both pumps what they like and don't like about each pump.
    I like the 640g, it's easy to use, reliable and does not get in the way of life. What I don't like, nothing really.
     
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  5. wildtoast

    wildtoast Type 1 · Well-Known Member

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    That's a good idea, thanks. It feels kind of weird to get given a choice between 2! Usually it's a case of 'this is what you get' in the NHS. I know as a HCP myself it's important to give patients a choice but now faced with it I almost wish someone else would decide what's best for me!

    About the remote, I'm not sure how much I even need one to be honest. I'm fairly shameless, I'm not bothered about injecting in front of people so I doubt I'll be bothered about getting my pump out. I did read a few reviews of the Accu-chek that said the handset was very slow and frustrating to use, the DSN did mention that it's not very responsive too ("It's not for entertainment it's a medical device!") and I reckon I might find that more of an annoyance than not having a remote at all.

    In Medtronic seems to offer a lot more in the way of varying basal rates which might suit me as my job and therefore activity level is pretty variable, both day to day and through the year.
    Both do extended boluses which is the main reason I'm wanting one. Just getting my own thoughts in order really!
     
  6. wildtoast

    wildtoast Type 1 · Well-Known Member

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    Thanks for replying! You're doing amazing with your HbA1c, the pump thing is clearly working for you!

    That really sucks the reaction you've had from people with your pens. I haven't had any experiences like that touch wood (though if I did the Very Patient Pharmacist Dealing With Angry People Voice would come out and they'd probably get a loud lesson about diabetes) but I hope you are happier now you have the pump.
     
  7. wildtoast

    wildtoast Type 1 · Well-Known Member

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    Wow thanks for all your input! I would never have thought about the fluid v air issue or about the needle inserts, I will have to do some more reading!
     
  8. Chowie

    Chowie Type 1 · Well-Known Member

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    I can't comment about the omnipod, but I was taught (and from youtube lots of others) for the Medtronic, you follow the pump instructions where you 'prime' the line, so even hypo or drunk you can't stuff it up (I have tested both).
     
  9. wildtoast

    wildtoast Type 1 · Well-Known Member

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    :nailbiting: It really is a whole new world! I guess if I can get used to injections I'll get used to this too. Apparently doing an air shot with pen needles is too much hassle for some people... the amount of needles I've had that are broken inside and therefore didn't deliver insulin is scary, so I will be following pump instructions to the letter!
     
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  10. Chowie

    Chowie Type 1 · Well-Known Member

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    Having become an expert with injections, after the first few pump tubing and cannula changes, the cannula changes are a walk in the park. I was going to be a good little boy and follow the rules exactly and I did for about 2 weeks. I follow the principles, but I have been known to do a change as I go to a bed (a big no no) alcohol swabs not no more. For the first few changes and days it's a bit daunting, but after that it just becomes part of you.
     
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  11. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Chowie, I find that I need to use alcohol to remove the sticky gunk left on the skin from the white sticky patch holding the needle in. I am worried about the possibility of building up an allergy to the adhesive (and my doctor tut-tuts if he sees residual sticky gunk on my skin there!!)
     
  12. Angusc

    Angusc Type 1 · Well-Known Member

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    I've used Medtronic pumps for years I like the Medtronic 640g due to the insulin suspend feature but that requires the sensor as I get a lot of low suspends any thing from 3- 16 per week a lot at night or when asleep and as I have very bad warning symptoms so currently just won a appeal on the sensor funding thank god
     
    • Winner Winner x 1
  13. Kalobe

    Kalobe Type 1 · Well-Known Member

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    I use Medtronics 640g. I’ve been using Medtronics for 6 years. I think this pump is the bees knees. It can be remotely accessed via the Contour Next Link 24 (blood testing kit). I was given one of these test kits with the pump. I can inject or bolus at 0.05 of a unit. (Not many syringes can do that). The basal can be set to different rates per half hour if you need that much adjustment! The pump links to CGM and can be set to turn off the basal insulin if your blood glucose drops too low. You set what is low or high. This pump can be used without cgm too. The cgm is flat and discreet (unlike Dexcom).
     
    • Informative Informative x 1
  14. wildtoast

    wildtoast Type 1 · Well-Known Member

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    Anyone know how much the CGM costs to self fund in the UK?
     
  15. Angusc

    Angusc Type 1 · Well-Known Member

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    enlite 2 sensor is 50ukp per item and lasts 6-12 days but is only supposed to be used for 6 days
     
  16. Kalobe

    Kalobe Type 1 · Well-Known Member

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    I quite often can get my sensors to last 10 - 12 days (self funding, every little extra helps!) the signal will eventually start to drop out for a few minutes near the end of it’s life, but for me has stayed fairly accurate.
    The cost is a bit cheaper with one of the Medtronic offers. I use the lite package as I can’t stretch to being full time. £236.23 for a box of 5 on the lite. Transmitters are £350 for the starter box which includes an insertion device, charger and a test thingy but no sensors. The transmitter will last a year.
     
    #16 Kalobe, Jul 11, 2018 at 11:39 AM
    Last edited: Jul 11, 2018
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