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Diabetes Lessons

As doctors, sometimes the biggest lessons that we learn about disease pathology are those that we learn from the people that have that disease. Diabetes is one such disease.

I recently gave a show-and-tell lecture about insulin pumps to the new interns and residents as well as the 3rd-year medical students on their pediatric clerkship with the inpatient endocrine service. We discussed different types of pumps (point A on the picture) and they got to push the buttons and send a bolus or change a basal rate. They also looked at real time CGM (Continuous Glucose Monitors, points C and D on the picture) sensors used to check glucoses levels every five minutes. Read more »

An Artificial Pancreas For Type 1 Diabetes

Researchers at Massachusetts General Hospital and Boston University have reported that an “artificial pancreas” has worked in 11 patients enrolled in a study sponsored by the Juvenile Diabetes Research Foundation (JDRF). The device consists of insulin pumps, glucose sensors, and a laptop with regulatory software. Read more »

*This blog post was originally published at Medgadget*

Patient Perspective: The Pros And Cons Of Insulin Pumps

I wrote a quick status update on Facebook, after receiving the Solo demo in the mail and then meeting with the local Animas rep for lunch to discuss pump options. My brain was buzzing with questions.

Just a quick Facebook musing that opened up the damn flood gates for me.

And the flood gates were opened.  Lots of comments, lots of perspectives, and lots of people who had great information to share.  Turns out I’m not the only one who has been thinking about this.  🙂

I’ve been a Minimed pumper for almost six years now, and have never had an issue with Minimed customer service or the pump itself.  When my pump broke two years ago, their customer service department took my call at a few minutes before midnight and a new pump was overnighted to me.  I have no problems with the color, the size, or the functionality of my Minimed 522.

But two things happened that made me think about switching.  One was the CGM upgrade, which I tried for ten weeks and still didn’t have any semblance of success and/or comfort with.  (Thankfully, the Minimed CGM works fine for some diabetics, so it’s not just me.  Appears to be personal preference.) And the second was that I haven’t seen many changes at all in the six years I’ve been pumping with Minimed (starting with a 512 and now a 522).  The CGM component was a big one, but for people who aren’t using that feature, there isn’t much going on as far as upgrades that mattered to me.

So even though Minimed has been good to me, I’m on the prowl.

With Cozmo off the market, my options are limited.  I’ve given a lot of thought to Omnipod, and while I love the idea of no tubing, I don’t like the idea of a larger device stuck to me for the duration.  I also don’t like the idea that if I lose the PDM, I’m screwed as far as dosing my insulin.  It’s important to note that I’ve never worn an Omnipod, so I’m purely speculating.  And Omnipod works great for lots of diabetics that I know, and even some cute kiddo ones.  But it’s not about the product – more about my personal preferences.

The Solo pump demo arrived in the mail yesterday and that thing appears to have both the tubeless delivery that I’d prefer and also the ability to disconnect the bulk of the pump, but it’s not a working model and with pregnancy goals on the horizon, I’d like to make a change sooner rather than later, if possible.  Still, Solo has a lot of promise and coulda been a contenda.   Could still be one, depending on their timeframe.

I’ve looked at Animas, too.  The Ping seems to be my top contender for several reasons, but the main one is the meter doubling as a remote control for the pump.  I’ve written countless times about my desires to have the pump reasonably concealed, and when my 522 is stashed in my bra at a dressy event, reaching for it to access the buttons turns me into a female, diabetic version of Mr. Bean.  I like that the Calorie King info is stored in there.  (The Dexcom/Animas integration, whenever that happens, is also a nice future-state.)  I also like the option to take a hundredth of a unit.  Precision is a nice option.  I’m not sure how I feel about the infusion sets they use (sampling some this week) or what it might be like to use their user interface, but I want to see for myself.  Thankfully, pump reps are all about hooking us up with samples so we can see if we want to make a full transition.

But then there’s the whole money thing.  And the insurance thing.  And the “closet full of supplies” thing that will be rendered sort of useless if I switch.   And the “do I want to wrangle with a new device” thing.  There’s also the “you can always go back” thing.  And the “pumping isn’t permanent” thing.  And the “if you continue to put weird phrases in quotes, people will get annoyed” thing.

There’s a lot to consider.  And I’m excited to see what options are available to me.  But there’s only so much information I can get from “official company representatives” and websites.  If you’re a pumper, what are you using and why?  If you’re thinking about going on a pump, what factors are playing into your decision?  And if you’re like me – currently pumping but thinking about changing pump providers – what would you do?

Your feedback is, without fail, among the top resources I’ll be using to make my decision.  So thanks in advance, and power to the pumpers!!

*This blog post was originally published at Six Until Me.*

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