Process of Picking A Potential Pancreas

The first time I met an endocrinologist was during my DKA hospitalization when I was accurately diagnosed with Type 1 diabetes. I barely had any idea what diabetes was, and I certainly didn’t understand the job of an endocrinologist. I don’t remember a lot about our conversation (can I blame DKA fuzziness?) but I do remember one thing he said very clearly. He asked me if I was good at math and when I told him I was he asked when I would like to start on an insulin pump.

About 11 months later, I understood a little bit more about diabetes and diabetes management. I was struggling with high blood sugars and using NPH (not the actor) successfully, and was ready to try the insulin pump because the doctor told me it would make my management easier.

Once I made the decision to start pumping, the process went very quickly. I was on my dad’s insurance (still in college), and was approved very quickly. Side note: His coverage was better than anything I have had since, and I was only responsible for about $600 of the cost of the pump.

The thing is – I never actually picked which brand of pump I wanted. When I decided to pump, the Medtronic pump was on my doorstep a few days later.

As much as you can enjoy wearing your pancreas on the outside of your body, I have enjoyed wearing the Medtronic MiniMed insulin pump.

Some aspects that I have appreciated over the years:

  • Their customer service has always been exceptionally quick and helpful. Any time, day or night, I have always received the help I have needed. Even away from home, they were quick to overnight me samples to replace forgotten supplies.
  • Also related to customer service, I found the infusion set (Sure-T) that works best for me at the recommendation of one of their representatives. It is the cheapest infusion set that they offer, and it is refreshing to not be up-sold and instead matched with the best product.
  • I think that the MiniMed pump looks the most non-pump like. I’ve enjoyed the fact that it has been mistaken for a microphone pack and a garage door opener.
  • Wearing a pump has allowed me to successfully navigate my unscheduled life. Sleeping in, delaying or skipping meals, and eating fast food all became easier on a pump.
  • I have always been able to use a meter that transmitted blood glucose values to the pump. I don’t underestimate the value of this – especially when the number is in the high 200s. When it changed from the BD meter to a OneTouch meter, I was able to enjoy this linked testing with a $0 copay for my test strips.
  • I used my first (gray) pump for four years. When my warranty ended, I briefly thought about switching to another brand of pump, but there was nothing that motivated me make a change. Except color – I switched from gray to clear. In addition to the color options available for the actual pump, using the Skin-it products I’ve made my pump as plain or as fancy as my mood desired.

old and new (2)

Diabetes Device

Then DexCom entered the picture. The DexCom system is the continuous glucose monitoring system that works best for me. Others systems work well for other people. The DexCom is my choice.

As the ending date for my warranty approached, it was time to revisit my pump choice. The MiniMed pump is integrated with it’s own CGM. The Animas and Omnipod pumps are working on integration with the DexCom system. For me, it came down to a single decision – which is more important to me, my insulin pump or my CGM?

Some people don’t like it, but I have grown quite attached (pun) to my tubing. The Omnipod was quickly ruled out as an option. I needed to try out the Animas Ping so that I could make an informed decision.

With the aid of my friendly pump rep (hi Todd!), I was able to wear the Animas pump for about two weeks. There are definitely some features I like and some things I wish were different.

  • Just like the MiniMed pump, you can input the amount of carbs you are eating and your current blood glucose level and it will give you an estimated amount of insulin to take in response. Medtronic has a trademark on the bolus wizard, so with the Animas pump you have to dial in the value instead of simply confirming that is the dose you would like to take. A bit of a time waster.
  • Another trademark? The threaded reservoir. On the MiniMed pump, the top of the reservoir screws into the body of the pump. The other tubed pump companies have to use a luer-lock system. I was worried I would find the extra bump on the Animas pump annoying, but I did not notice it as much as I thought.
  • I am excited that the Ping is waterproof because it is annoying and worrisome to take it off every time I head to the water at the pool and the beach. I live in Florida – that happens a lot!
  • My goodness it is loud! If I held my MiniMed pump up to my ear while it was delivering a bolus, I could hear a faint clicking. I can hear EVERY delivery of insulin on the Animas Ping (even the basal clicks). No sneaking a bolus with that pump!
  • The Ping – the beloved Ping! The ability to deliver a bolus from the meter remote is amazing! I bought the remote with my original MiniMed pump and in eight years I think I have used it less than 5 times. With only a bolus, suspend, and act button you have to be able to hear the beeps or feel the vibrations (depending on your pump settings). Since I had to excuse myself to be sure the bolus delivered anyway, using the remote didn’t save me any inconvenience.

April 19, 2008 - diabetes365 - day 194

  • When the MiniMed pump indicates that the reservoir is empty, there is about another 20 units that will deliver (from the tubing) before you get a no delivery warning. On the Animas pump, no insulin means NO INSULIN and NO DELIVERY. During my trial, there was one dinner bolus that had to wait until after I ate because the bolus I tried to deliver wouldn’t go through because there wasn’t enough insulin in the pump.
  • I didn’t think it would matter to me, but I was able to fine tune my basal settings a little bit more by using the smaller basal increments that the Ping offers.
  • I use the dual-wave/combo bolus feature on my pump quite often. A nice feature of the Animas Ping is that it saves your last settings (percentages and length of delivery) in the combo bolus menu. As a creature of habit, I really enjoyed this feature.

There are clearly pros and cons with every insulin pump on the market. It isn’t a real pancreas so it isn’t going to be perfect. My original pancreas wasn’t perfect, so I guess that doesn’t matter anyway.

The potential integration with my preferred brand of continuous glucose monitoring system is what ultimately led me to the choice to switch to the Animas Ping pump. At this stage of my life, if I was somehow forced to pick between only using an insulin pump or only using a CGM, I would choose the CGM. Since I am able to and can afford to use both, I am choosing the pump with the biggest potential for future technology pay-off. Now I am just praying that it will go back on the market in the next two weeks so I can actually afford to buy it.

Animas Ping Pump

P.S. Hopefully I have made it clear that I am not anti-MiniMed – still scheduled for an appointment in about three weeks to hopefully enroll in a clinical trial where I will use their pump and CGM for about 6 months.

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