Tag Archives: insluin pumps

Device failures.

I’ve nearly had enough.

The past few weeks have been full of diabetes device failures, and I’m actually asking myself how much more I can take.

Dexcom sensor failures are frustrating me more than I can express here. Since January, roughly one out of every two sensors fail without working more than a day, or ever working at all. I mean, how long do you put up with that kind of unreliability before you chuck it into a box and give up?

And believe me, I’m doing the insertions exactly the way I’m supposed to. Every time I do an insertion, I’m still going back to the online tutorial to make sure I’m not missing anything. The failed CGM sensors have definitely become my biggest diabetes nightmare.

I’ve even stopped contacting Dexcom support about it. The calls are all the same: the support person goes through their script so they can cover everything they need to cover… I get that. Usually, after about half an hour on the phone, they agree to send me a new sensor. But… how much is the sensor, and what is my time worth? In addition, I’ve had to replace a transmitter and a receiver too. In a little over five months. It’s quickly becoming not worth it.

But my pump issues are still there too. I have an Animas Vibe pump where a 200 unit limit to my reservoir isn’t really an issue. But it’s not really 200 units. Because once the pump says the reservoir is at 0 units, the pump stops… even though there are usually around 20 units left in the reservoir. So, something that could last 3 ½ days (for me) winds up lasting barely 3 days, if I don’t have other issues. Why do I have to waste 20 units of insulin every few days?

Which I almost always do, because my Medtronic infusion sets can’t seem to go more than 2 to 2 ½ days before they just don’t want to work as well anymore. At that point, I still seem to get insulin, but instead of hovering between 80 mg/dL and 120 mg/dL, I suddenly go up to 220 to 320. So I have to bolus huge amounts of insulin to try to bring my glucose level down. When I change out the set my BGs go immediately down to a reasonable level again. Why can’t an infusion set be made well enough to last the FDA-mandated three day limit? Or greater?

These are all issues that I did not experience in the five years I was managing diabetes through my previous pump and no CGM. Let me put it another way: my A1c is climbing, due only to medical device failures. This leaves me asking even more questions. Like:

Why can’t device makers make something that is simple, and not as susceptible to breakdowns?

I understand the all-consuming need to develop the next special product with all the bells and whistles, but… why can’t there be a simple option that I can use? My previous pump seemed to do everything I needed it to do. Why can’t I just choose a new version of that?

I actually like my Dexcom when it works… why can’t it work more often, with fewer breakdowns of the individual parts?

I hate to pick on individual companies. But the truth is, if these were cars, I would probably choose not to drive as opposed to breaking down on the side of the road every few days.

Granted, there still aren’t many (in a trending sense) people who are managing their diabetes through pumps and CGMs. But I don’t think that should be a reason for me to settle for inferior products. It certainly isn’t a reason for me to continue to pay for said products without noting where they are coming up short.

And without saying that maybe some device companies need to go back and make their current products as reliable as they can before devoting resources toward the Next Big Thing.

Beginning a year (or less) of discovery.

That noise you hear is the sound of my pump warranty expiring. Didn’t think it sounded like that, did you?

My insulin pump is the Medtronic Minimed Paradigm® Revel 723 pump. It’s the only pump I’ve ever worn. It’s still going strong, pretty much like it was back in August of 2012 when I wrote this post. I’ve been more than satisfied with its performance.

That’s why I plan on keeping it for a while. Probably about a year. There are a few reasons why:

First, I have about a year’s worth of infusion sets and reservoirs to use up. I should have stopped that automatic 90 day refill of supplies, but I didn’t until now. Even if I go to Med-Ts newest offering, the 530g with Enlite, and I can use the same stuff (I think I can use the same stuff… anyone? Bueller?), I would like to start over with a clean slate of durable medical supplies. And if I don’t move to the latest Minimed product, I would hate to waste all of those reservoirs and sets. I don’t think that would be fair to my insurance plan, my employer (who pays most of the cost for that plan), or the larger cost of care for a chronic condition in America.

Which brings me to my second reason: Unlike the last time I chose a pump, I’d really like to do some shopping around to see if there’s a better option for me. Maybe the new Medtronic pump/CGM/With the Threshold Suspend Feature is just what I need. But I won’t know unless I try out other pumps too. If I give myself six to nine months to do some deep dives into functionality, ease of use, etc., I think I should be able to cover everything the market has to offer (and has available in the USA) right now.

Third reason: Giving myself that long to make a decision also gives me a little more time to get feedback on more recent entries into the market. Hopefully, several more months of reports and anecdotal evidence from my DOC peeps will help me make a more informed choice. You can’t always time these things out perfectly (where are you, Animas Vibe?), but if I see someone who’s recently chosen a product talking about how things are better or worse for them than when they started on said product, I’ll feel better about my choice.

The sales effort has already started with my current pump maker. I received a call from Leslie from Medtronic on Tuesday. She reminded me that the 530g “is the first pump moving toward the artificial pancreas with the threshold suspend feature”.
I thought I heard back in January that Medtronic heard the Diabetes Community when they expressed concern that the term Artificial Pancreas was a bridge too far. My conversation with Leslie (where I heard that phrase twice), a check to their website twice (in December and this week), and a call to their main diabetes line (1-800-Minimed) twice tells me there is still a disconnect. Not a good start.

Despite that, I haven’t made up my mind yet. I’m still listening.

Ideally, I’d like to actually try out each pump for a couple of days. My guess is that’s not possible. I was told by Leslie from Medtronic that I can’t do that, but if I want to have them submit the paperwork to my insurance, they can help me get the 530g system, and if I don’t like it, I can always send it back within 30 days. Sorry, but paying people to do lots of paperwork, get a prescription from my endocrinologist, package the goods, send it to me, and possibly pay to have me send it back is too much money just for one person to try it out.

Again, I would feel incredibly guilty about that. I just want to try it out for a few days before I make a commitment.

I’m hoping to try out everyone. Medtronic, Asante, Animas, Tandem, the whole works. Don’t worry, I’ll be reaching out to you. I don’t expect special consideration. According to The Great Spousal Unit, I have a highly-placed sense of fairness that I don’t relinquish easily. I suspect you’ll say I can’t try it out without a lot of money being spent either by you, or me, or my insurance, or all three. But understand this too:

I will not make my next insulin pump choice without at least seeing it in person. I want to touch it, see how the bolus feature works, see how the basal feature functions, how the reservoirs are filled, and what the infusion sets are like. I want to examine the cost, investigate the customer service, government recent recall notices, and anticipated FDA approvals.

And I want to read and hear present, and future feedback from my fellow members of the Diabetes Community.

The clock begins now. It ends when I make a decision.

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