Messages In This Digest (5 Messages)
- 1.1.
- Re: What am I missing? From: Andy Mayshar
- 1.2.
- Re: What am I missing? From: Adam Jensen
- 1.3.
- Re: What am I missing? From: tracymfriend
- 1.4.
- Re: What am I missing? From: Adam Jensen
- 2.1.
- Re: My trial of Medtronic and Dexcom CGM Systems From: Jeff Nathan, Award-Winning Author
Messages
- 1.1.
-
Re: What am I missing?
Posted by: "Andy Mayshar" andyma@charter.net necountryboy55
Sat Jan 2, 2010 7:50 am (PST)
Tom
Just curious why you find the Solo superior to the OmniPod. It doesn't autoinsert (Insulet has the patent on that). It does not have integrated BG meter. The cannula inserts at 90 degrees vers 45 for the OmniPod. It is a 4 part system vrs 1 for the OmniPod and as any engineer will tell you , the more parts the lower the reliability. Bolusing on the Pod may be nice, but I would imagine you would want to check your BG anyway before, something the OmniPod allows but would require a separate device with the Solo. I tried out the Solo demo and it fell off me due to the type of tape they use. I never loose OmniPods due to tape failure. I have never been able to use a set with 90 degree insertion (they just about always occlude).With the OmniPod shrinking 40% this year and upcoming integration with both Dexcom and Navigator, I think it will be a while before any other Patch Pump company catches up. Some of Insulet's investor information available on there web site makes reference to about 12 other companies working on Patch Pump technology. I love competation, it makes everything better.
Andy
---- tchafin99 <tchafin99@yahoo.com > wrote:
>
> --- In diabetescgms@yahoogroups. , "richard malinowski" <richard.malinowskicom @...> wrote:
> >
> > Hi Tracy
> >
> > Could you circulate the web sites/links please so we can all read about the "other cordless pumps"?
> >
> > Thanks
> >
> > Richard
> >
>
> Hi Richard,
>
> I'm not Tracy, but I am aware of 2 new pumps. This one is called the Solo, and was developed in Isreal by a company called Medingo. This is the one that is very similar to the Omnipod (Dan spoke briefly of it), but IMHO, it is superior for a number of reasons. It has been approved by the FDA, but is not available for sale yet. Here is the link: http://www.solo4you.com/
>
> The only other one I know of is Medtronic's patch pump in development. Here is the CEO of Medtronics talking about it, as well as the new pump they are marketing in Europe called the Veo. That is their first step to trying to 'close the loop': It suspends insulin delivery when the sensor glucose level falls below a certain level. Here is that video that was on CNBC in 6/09:
> http://www.cnbc.com/id/15840232? video=1145719342 &play=1
>
> I *think* that Roche is working on a patch pump in Switzerland, too, but I'm too lazy right now to find a link. If there are other patch pumps in development, I'd like to hear about them.
>
> Tom
>
- 1.2.
-
Re: What am I missing?
Posted by: "Adam Jensen" adam.jensen@gmail.com adamixoye
Sat Jan 2, 2010 8:01 am (PST)
Andy,
As someone who has never worn a patch pump, you raise a lot of good points.
However, I'll have difficulty accepting any pump where I have to change the
infusion set more often than three days, which would be the case with
OmniPod's 200u reservoir. Based on my cursory research of the Solo vs.
OmniPod, that's a huge difference for me (that you can disconnect the Solo
without removing the infusion set).
Adam
- 1.3.
-
Re: What am I missing?
Posted by: "tracymfriend" friendguardt-info@yahoo.com tracymfriend
Sat Jan 2, 2010 8:17 pm (PST)
Sure! Here they are.
Sites for Patch pumps
http://www.diabetesmonitor.com/ patchp.htm
http://www.diabetesnet.com/diabetes _technology/ insulinpumps_ valeritas. php
http://www.diabetesnet.com/diabetes _technology/ insulinpumps_ future.php
http://www.diabetesmine.com/ 2009/11/insulin- patch-pump- co-opens- up-rd.html
http://jkontherun.com/2009/ 02/19/flex- insulin-pump- concept-with- promise/
http://www.diabetesnet.com/diabetes _treatments/ insulin_skin. php
http://www.solo4you.com/
http://www.nilimedix.com/?p= products. patch
Some really look exciting!
Tracy
--- In diabetescgms@yahoogroups. , "richard malinowski" <richard.malinowskicom @...> wrote:
>
> Hi Tracy
>
> Could you circulate the web sites/links please so we can all read about the "other cordless pumps"?
>
> Thanks
>
> Richard
- 1.4.
-
Re: What am I missing?
Posted by: "Adam Jensen" adam.jensen@gmail.com adamixoye
Sun Jan 3, 2010 4:02 am (PST)
Dovetailing with another recent thread, note this paragraph about the
"PicoSulin" pump and its development:
--------------
- *how full-featured this pump should be*. They're already creating a Type 1
version including Temp Basals and Carb Conversions, etc., along with a
simpler Type 2 version designed for a few set doses a day. But their initial
survey feedback seems to be saying: "simplify, simplify, simplify."
--------------
Obviously, people like me were not involved (or outnumbered) in that
"initial feedback survey."
I will be VERY interested to hear about the NiliMEDIX all in one patch when
things get a little further along.
Adam
On Sat, Jan 2, 2010 at 11:13 PM, tracymfriend
<friendguardt-info@yahoo. >wrote:com
>
>
> Sure! Here they are.
>
> Sites for Patch pumps
> http://www.diabetesmonitor.com/ patchp.htm
> http://www.diabetesnet.com/diabetes _technology/ insulinpumps_ valeritas. php
> http://www.diabetesnet.com/diabetes _technology/ insulinpumps_ future.php
> http://www.diabetesmine.com/ 2009/11/insulin- patch-pump- co-opens- up-rd.html
> http://jkontherun.com/2009/ 02/19/flex- insulin-pump- concept-with- promise/
> http://www.diabetesnet.com/diabetes _treatments/ insulin_skin. php
> http://www.solo4you.com/
> http://www.nilimedix.com/?p= products. patch
>
> Some really look exciting!
> Tracy
>
- 2.1.
-
Re: My trial of Medtronic and Dexcom CGM Systems
Posted by: "Jeff Nathan, Award-Winning Author" jeff@incredibleassemblies.com chucklejeff
Sat Jan 2, 2010 10:45 am (PST)
Thanks, Kimi. I’ll look it up.
-jeff toll-free: 1-888-967-3386
Award-Winning Children's Author, Jeff Nathan, presents
CurricuLaughs
Curriculum-tied Language Arts Education through HUMOR
"... by far, the best set of presentations I have seen in our school system ."
Dr. Marc Kerble Assistant Superintendent Winchester Schools Winchester, MA
"… a student said it best. "You Rock!" From the mouth of babes, Jeff you were sensational. Thank you ever so much!"
Kristine O. Murray Media Enrichment Specialist Maghakian Memorial School Brookline, NH
see these and other raving testimonials at <http://www.IncredibleAssemblies. > www.IncredibleAssemcom blies.com
From: diabetescgms@yahoogroups. [mailto:diabetescgms@com yahoogroups. ] On Behalf Of Jamie Weisbrodcom
Sent: Thursday, December 31, 2009 11:16 PM
To: diabetescgms@yahoogroups. com
Subject: Re: [diabetescgms] My trial of Medtronic and Dexcom CGM Systems
Hi Jeff,
My doctor recently gave me free samples of Bioclusive 4"x6" transparent dressing (Johnson & Johnson). It is breathable
and dries out after I shower. I have not tried to purchase it at the pharmacy yet so I don't know if it is
readily available. I like it better than opsite iv dressing - though they are good too.
Happy New Year to everyone !
Kimi
_____
From: "Jeff Nathan, Award-Winning Author" <jeff@incredibleassemblies.com >
To: diabetescgms@yahoogroups. com
Sent: Thu, December 31, 2009 1:03:41 PM
Subject: RE: [diabetescgms] My trial of Medtronic and Dexcom CGM Systems
Hi, Kimi â€"
I agree with you completely. It is an individual issue. I do find the Dex much more comfortable, as well, but others may not feel that way. My issue is keeping it taped down. The paper tape I used has given me a rash. I am going to try the flexifix stuff that was mentioned on this list and hopefully that will work.
Warm regards,
-jeff toll-free: 1-888-967-3386
Award-Winning Children's Author, Jeff Nathan, presents
CurricuLaughs
Curriculum-tied Language Arts Education through HUMOR
"... by far, the best set of presentations I have seen in our school system ."
Dr. Marc Kerble Assistant Superintendent Winchester Schools Winchester, MA
"… a student said it best. "You Rock!" From the mouth of babes, Jeff you were sensational. Thank you ever so much!"
Kristine O. Murray Media Enrichment Specialist Maghakian Memorial School Brookline, NH
see these and other raving testimonials at www.IncredibleAssem <http://www.incredibleassemblies. > blies.comcom/
From: diabetescgms@ yahoogroups. com [mailto:diabetescgm s@yahoogroups. com] On Behalf Of Jamie Weisbrod
Sent: Tuesday, December 29, 2009 12:41 AM
To: diabetescgms@ yahoogroups. com
Subject: Re: [diabetescgms] My trial of Medtronic and Dexcom CGM Systems
Hi Jeff,
Thank you for providing a comparison of the systems.
I would like to comment on the comfort factor. I think this might be an individual issue.
The MM insertion needle is significantly larger than the the Dexcom. I have a MM pump so it would have been an
advantage for me to use MM. When the MM diabetes educator helped me with the first insertion, I bleed profusely,
I was unable to wear it for even a day. I am a brand new Dexcom user, the initial insertion was successful and I have been wearing
the sensor for 10 days. I have cut tags out of my clothes because they bother me so this means a lot to me.
Regards,
Kimi
From: "Jeff Nathan, Award-Winning Author" <jeff@incredibleasse mblies.com <http://mblies. com/ > >
To: diabetescgms@ yahoogroups. com
Sent: Mon, December 28, 2009 12:20:39 AM
Subject: [diabetescgms] My trial of Medtronic and Dexcom CGM Systems
I just completed a trial of the Dexcom Seven Plus and the Medtronic Paradigm CGMS. I chose not to evaluate the Navigator because of its size. I was asked to provide a report on my findings here when I was done, so here goes:
Comparing CGM systems
Before starting a trial, you need to ask yourself, “What is the MOST CRITICAL assistance that YOU need from a system?â€
For me, that was pretty easy. I have hypoglycemic unawareness and, after finding myself behind the steering wheel on one of Boston’s busiest highways during rush hour with a blood glucose level of 24 mg/dL, I knew I needed help. (Actually, I didn’t know I needed help then â€" I had to raise my blood glucose level first.) My most dangerous scenarios are when I am driving and when I am sleeping.
My top 5 priorities fell like this:
1) Accuracy, especially in low range
a. I need to know that I am about to be unfit to drive BEFORE I am unfit to drive. I need to be woken up and told that I am in danger of hitting a low from which I will NOT wake up---BEFORE I get to that point.
2) Consistent discernable warning when sugar falls below 50
a. False alarms are better than missed alarms
b. Easy to understand, even if I’m very low
c. Ability to ignore future alarms, if it is stable or trending upwards
d. Warning for highs, but accuracy there is not as important as it is for the lows
3) Good use model for sleeping
a. No loss of transmission while sleeping. Alarm if that happens, but I don’t want extra wake-ups if it can be avoided.
b. Alarm that will wake me
4) Not too uncomfortable
a. I don’t want to feel it day in and day out
b. Low insertion pain (Okay, I’m a wimp and I like to avoid pain whenever possible.)
5) Durable and abuse-able
a. Survives my school visit floor-diving, etc.
b. Survives in basketball and winter ultimate
So, how did they do? They both did fairly well and I’ll include additional categories in addition to MY top 5.
1) Accuracy, especially in low range: advantage DEXCOM
Medtronic explained that the technology measures the interstitial fluid glucose level, which lags the blood glucose level. If that were the whole story, I would expect to see the 2 systems with the same delayed response. I did not see that. I’m not going to deal with the difference in lag time, per se. As users, the time domain needs to tell us trends, but that needs to be coupled with the key question, “where am I at RIGHT NOW?†One could argue that this information comes from a blood glucose measurement, while the trending information comes from the CGMS. I would argue that it would be nice to get both pieces from 1 source and use the blood testing as the reality tether. That is exactly how I plan to use my new DEXCOM system.
I am including data from my trial. BE CAREFUL NOT TO INFER THAT THIS REPRESENTS HOW THE SYSTEMS WILL PERFORM IN YOUR BODY. Everyone is different.
Data (all readings are mg/dL):
DexCom Medtronic Blood test finger stick Time
46 92 63 5:17P D1
51 78 46 6:30
166 118 171 8:00
61 84 71 10:27
173 142 192 5:15A D2
151 131 157 8:00A (recal. MM only)
51 76 32 4:40P
60 65 57 5:32P
224 165 221 9:12P (recal. MM only)
63 104 40 10:29P
59 84 60 11:16P (recal. MM only)
54 91 45 11:52P
80 85 62 12:40A D3
47 77 44 6:14 (recal. MM only)
86 74 77 10:07 (no recalibration)
53 67 43 11:40
70 60 66 12:20 (no recalibration)
97 75 84 2:25P
49 66 43 10:03P
117 115 109 7:49A D4 (no recalibration)
51 75 52 8:35 (recal. MM only)
68 69 50 10:20
59 81 64 12:20 (recal. MM only)
52 68 52 12:40 (recal. MM only)
42 57 49 1:22 (no recalibration)
2) Consistent discernable warning when sugar falls below 50: advantage DEXCOM
Though both systems were set to alarm when I hit 60 or below, I got low warnings from the Dexcom system before the Medtronic EVERY SINGLE TIME. In fact, I got no warnings from the Minimed system until after recalibrating a couple of times because it didn’t think I had gone that low. Both systems were easy enough to understand. The Dexcom system offered a simple adjustment of the “snooze†feature (not bothering me for another half-hour or another 5 hours if my sugar is still low).
3) Good use model for sleeping: advantage DEXCOM
I was able to lose transmission with BOTH systems while in bed, pushing the transmitter into the mattress by laying directly on it and, for Dexcom, putting the receiver between 2 pillows. Communication problems seem to be plausible for both systems. The Dex automatically reconnected as soon as it could. The Minimed would have wanted me to go through a “find lost sensor†routine while I was sleeping.
Both alarms can wake me up, but I found the Dexcom combination of sound with vibration to be the best solution.
4) Not too uncomfortable: advantage DEXCOM (daily), advantage Medtronic (insertion)
This is definitely an individual issue. You need to try this for yourself.
For me, the Minimed sensor started itching the 2nd day it was in, and it was a very bothersome annoyance until I took it out on day 4. The Dexcom sensor started itching on day 8 but the itching was mild, recurring maybe once or twice in a day.
Minimed had the insertion advantage. Insertion angle is critical for Minimed, but they have a spring-loaded inserter. Dexcom expects you to push theirs in like a syringe. The Dexcom sensor is a smaller gauge needle, making it less painful, but the Minimed inserter makes things easier and reduces the pain.
5) Durable and abuse-able: advantage BOTH
Both systems were able to survive my floor diving and basketball clumsiness. I was unable to play winter ultimate during the trial to test that environment.
6) EASE OF USE: advantage DEXCOM
The ability to calibrate anytime, stable or unstable, is a distinct advantage for Dex. Medtronic advises to calibrate only when stable and that does help with their product, but the 7+ doesn’t care as much. I ran into calibration issues with both systems (calibrating Medtronic while unstable and calibrating Dexcom with very high BG and not recalibrating as I got lower).
Transmission loss: After 40 minutes or so, Medtronic requires a “find lost sensor†routine. Dex simply reconnects automatically and moves on.
Dex has no worries about ISIG numbers or insertion angles or stability for initial calibrations.
7) Customer support: advantage MEDTRONIC
Medtronic has a 24/7 help line, staffed, for the most part, with people who really want to help. In late hours, Dexcom has people on call. I tried this route and was unable to get a call back before I had to leave my house. Live people were helpful and courteous.
8) EASE OF EVALUATION: advantage MEDTRONIC
The first thing I want to say is that the Clinical Specialists who trained me on each of the systems were WONDERFUL. Both were very knowledgeable, friendly, and accommodating. Dexcom forced my doctor’s office into giving up a room (and they are very short on space) and I had to drive there. Medronic made it easy and came right to my house.
I did run into 2 bad DEXCOM sensors to start off the evaluation period. This turned out to be a blessing in disguise, as it forced me to evaluate the two systems head-to-head, or stomach-to-stomach, as it were.
The Medronic system had better transmission range. If you are going to perform a trial with both systems, isolate them on different sides of your body. I did find that the Dexcom receiver seemed to suffer from some interference when placed too closely to the Minimed transmitter (sensor). On opposite sides of the body, they each did fine.
The Dex transmitter has an internal “2 year†battery and does not have to be removed for recharging. The Dex receiver needs to be recharged every few days. It does function while it is charging but its range is reduced.
The Medtronic system means less hardware to carry around, but I find the accuracy difference worth the extra piece of hardware. One other interesting note: my Medtronic pump can receive data from my blood tester. I was told to turn this off when using their CGM (otherwise it would recalibrate at every reading, which is non-optimal) whereas I can use this Medtronic feature if I DON’T use their CGM. Had their engineers added an OPTION to use the transmitted value for calibration (as they have done for the hand-entered values), they would not have created an advantage for their competition.
Ideally, I would want an alarm that combines level and trend. Neither system offered that to me, but even just a level-based alarm is a huge life-saving leap over what I had before.
So that’s the info from my eval. Now, I am going to bed (with my Dex trial sensor still in â€" 12th day â€" telling me that I am at a stable 91 mg/dL and my finger stick reading just 3 mg/dL higher).
Warm regards to all,
-jeff toll-free: 1-888-967-3386
Award-Winning Children's Author, Jeff Nathan, presents
CurricuLaughs
Curriculum-tied Language Arts Education through HUMOR
"... by far, the best set of presentations I have seen in our school system ."
Dr. Marc Kerble Assistant Superintendent Winchester Schools Winchester, MA
"… a student said it best. "You Rock!" From the mouth of babes, Jeff you were sensational. Thank you ever so much!"
Kristine O. Murray Media Enrichment Specialist Maghakian Memorial School Brookline, NH
see these and other raving testimonials at www.IncredibleAssem <http://www.incredibleassemblies. > blies.comcom/
Need to Reply?
Click one of the "Reply" links to respond to a specific message in the Daily Digest.
Change settings via the Web (Yahoo! ID required)
Change settings via email: Switch delivery to Individual | Switch format to Traditional
Visit Your Group | Yahoo! Groups Terms of Use | Unsubscribe
No comments:
Post a Comment