Pin the Tail on the Donkey: Buying a New Pump

This post is my June entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2013/june-dsma-blog-carnival-3/ The topic is: How do you select the diabetes devices you use? To others looking into new or replacement devices, what would be your best advice to someone shopping around?

Laddie_Head SquareWhen I select medical devices, I put on a blindfold, turn around 3 times, and pin the tail on the donkey.  Oops, wrong game.  But that is what it felt like when I bought my last pump in December 2012.

When I began my pump search, I was using an out-of-warranty Medtronic Revel pump and a Dexcom CGM (continuous glucose monitor).  I had previously used the Medtronic CGM and found it to be painful and inaccurate.  But I loved having a sensor augmented pump and only having to carry one device.  So a pump/CGM combo was my #1 criteria for my next pump.  Unfortunately there was no device on the market that had the features I desired given that I was unwilling to use the Medtronic CGM.

Medical device companies are prohibited from giving detailed information about pumps in development and they have no control over how long FDA approval will take.  So ultimately I had to make my purchase decision based on my best guess of which future pump would have the features I wanted along with a guess of how soon it would get to market.  So I put on my blindfold and went to work.

Pin the TailI was very happy with my Medtronic pump and I knew that their improved Enlite sensor system would “soon” be available in the USA.  Animas was on track to release a pump that would be combined with the newest Dexcom G4 Platinum CGM.  The new kid on the block, the Tandem t:slim, was a touchscreen rechargeable pump that would also eventually link up with Dexcom.  I didn’t have any reason to consider the Accu-Chek pump, so I ignored it in my decision.  I don’t mind tubes and was not interested in the Omnipod.

Normally I would love to make a chart and compare features pump by pump.  But I didn’t have sufficient information to do that with my most important decision points. I had no way to evaluate the Medtronic Enlite sensor system, and I wasn’t willing to leave Dexcom to take a chance on it.  I found the Tandem pump intriguing, but they had no upgrade program in place and I wasn’t willing to risk not having an affordable pathway to buy their future sensor integrated pump.  I chose Animas because it will be the first pump released with an integrated Dexcom CGM and I am guaranteed a $99 upgrade fee to get that pump.

Am I happy with my Animas Ping pump?  Not really.  I knew that I would hate the menu system, but I actually underestimated how much I dislike it.  But it’s a good pump and it does the job of delivering my insulin safely.  Do I regret my decision?  No, because I made the decision based on the future which has not arrived yet.  I am still waiting for the Animas Vibe to come to market and I think that it will fix the things I don’t like about the Ping.  It will definitely give me the pump/Dexcom combo that was and is my #1 requirement.

My advice to others who are shopping for their first pump or a new pump?

Do your homework:

  • With yourself.  Decide which features are most important to you.  Do you want tubeless?  Do you require a large reservoir?  Do you want a Pump/CGM combo?  In most cases you won’t get everything on your wish list, so be open to considering several brands of pumps.
  • With the pump companies.  Visit their websites and request their brochures.  If a local rep is available, meet with him/her to see the pump and learn more about it.  Omnipod even has a non-operational sample pod that allows you to try it out on your body.
  • With your medical team.  If this is your first pump, your medical team may require classes about pumping and carb counting before prescribing a pump.  I think it’s valuable to ask for your team’s opinions on pumps, although ultimately you should get what you want not what your doctor likes.  Your doctor’s office might also have demo pumps and infusion set samples.
  • With your insurance company.  Many insurance companies will cover all pump brands.  But if they don’t, it’s good to know that up front.  For example, Medicare will not pay for the Omnipod at this time.  Also, it’s a good idea to determine your financial responsibility for the pump purchase and the ongoing supply expense.
  • With other pumpers and the online community.  Message boards and blogs are a wonderful source of information and opinions on pumps.  Fortunately most people end up happy with the pump that they choose, but it’s still helpful to learn as much as you can about the pros and cons of each brand.

It has been six months since I purchased my pump.  The questions I would have liked answered then are still unanswered.  The Animas/Dexcom pump has been submitted to the FDA, so there has been progress.  I have some regret that I did not go with the t:slim, but for the most part I think I made the right decision.  And if you think about it, it’s only 3-1/2 years until I go shopping for my next pump!