After eight years of using Medtronic pumps, I switched to the Animas Ping in 2012 to be eligible for the $99 upgrade to the highly anticipated Animas Vibe. I am totally committed to Dexcom and the Vibe was in line to be the first pump released in the US with Dexcom integration. Two-plus years later the Vibe has finally been approved by the FDA and is actively shipping.
I ordered my upgrade before noon on the first day that Animas accepted orders. Many people are getting delivery of their pumps, but I haven’t heard a peep. Did everyone order before me or is it because my Ping was supplied through Edgepark rather than directly from Animas? I have no idea how Animas is determining shipping order, but I hope that I have not been lost in their system. “Call Animas” is on my To Do list.
Last week I picked up the phone to contact Animas and then stopped. Do I really want the Vibe?
The Vibe (as will the t:slim/Dex integrated pump) is based on the Dexcom G4. The recent G4AP (Artificial Pancreas algorithm) software update will not be included nor will any future improvements in the Dexcom platform.
Unfortunately when a pump/CGM combo is approved by the FDA, the device is “frozen” in time with the hardware configuration as approved. I don’t know how software updates are handled by the FDA, but one source told me that the Vibe as configured will not allow software changes. Now that Dexcom has multiple hardware and software upgrades in the pipeline, a 4-year (or for me a 2-year) commitment to an older version of the Dex might be a bad decision. In the short run I can keep using my Dex receiver to access the new software. The just-released Share receiver will also be an option because it is compatible with the current generation of transmitters.
Now a word on the “current generation of transmitters.” Vibe purchasers new to CGM are being sent the high-profile Dex transmitters that were replaced by smaller transmitters a few months ago. I assume that the Vibe was submitted to the FDA with the old transmitter and wonder if it will take another FDA submission to change that. Fortunately the only difference between the transmitters is size although I personally can’t wait to get the small transmitter when my warranty expires in February. The new transmitter is compatible with the Vibe.
Dexcom is already talking about the next generation G5 transmitter that will have the ability to communicate directly with cell phones without the use of a receiver. The G5 mobile system transmitter will not be compatible with the Vibe.
My Animas warranty expires in December 2016 and I should probably just get the Vibe. The fact that it will populate the recommended bolus rather than scrolling up from zero is a huge improvement. Because I will pay the upgrade fee out-of-pocket, technically my insurance company shouldn’t know that I have the Vibe and then potentially refuse reimbursement for a Dexcom receiver when that warranty expires in August.
Unfortunately it seems that nothing is private when it comes to medical things. My doctor has to write orders for the Vibe and I wonder if Edgepark will be the shipper rather than Animas. Somehow I believe my insurance company will end up knowing about the switch. Maybe I am just being paranoid. Everyone else has been assuming that they will have no problems continuing to use the Dex receiver if that is their choice. But I think that many of us will see the day when insurance companies refuse to cover the cost of CGM receivers because we have pumps functioning as receivers.
I have not yet read one review of the Vibe that is overwhelmingly positive and I know of one person who has already returned it. Kerri Sparling’s preliminary review was the closest to being positive because she didn’t address any of the negatives. She promised a more complete review later and I will be interested to see what she writes. She is upfront about her sponsorship relationship with Animas and you can trust her when she says that her opinions are not for sale. Another Ping user, Sara at Moments of Wonderful also wrote about looking forward to receiving her Vibe. In my opinion anyone who has been using the Ping (except for fans of the Ping meter/remote) will most likely see the Vibe in a more positive light than users of other pumps. There is a definite learning curve to adjusting to the idiosyncrasies of Animas pumps.
Most non-Ping reviewers of the Vibe have been highly critical of the poor menu system, the low resolution color screen, the lag time of button pushes, and other negatives. I believe that Johnson & Johnson missed the boat by not starting from scratch when designing this pump. IMO Mike Hoskins of Diabetes Mine summed it up best:
my honest final verdict is this: the Vibe feels like an outdated, counter-intuitive medical device that seems like it would have been more relevant if released several years ago as promised. Today, it doesn’t feel innovative, but rather like a device that’s filling a market need for choice only because it promised that a long time ago, and it’s “better late than never.”
When I purchased the Ping, I underestimated how much I would hate the menu system and how long I would regret the decision. Because I have no option to change pumps until 2016, my feelings about the Ping are inconsequential as I make my upgrade decision. Frankly two years after the purchase, I have to admit that I have become a whiz at moving through the menus; the scrolling and button pushes have become second nature and I rarely think about them anymore. But it took a long time. The Ping has been a workhorse for me with no technical problems in two years. (I had my pump replaced once due to cracking of the battery compartment, but it was a quick process with good customer service.) Another important feature of the Ping is the waterproof guarantee. With the Vibe I like the idea of having a waterproof CGM receiver.
So what am I going to do? Today I am meeting with an Animas rep to get a hands-on look at the Vibe. Some early reviews have criticized how many button pushes it takes to access the CGM info and how slow the pump moves from screen to screen. The display is small and a different shape than the Dexcom receiver. If I upgrade, will I even use the CGM part of the pump except on an occasional basis? Is it worth $99 to populate the bolus recommendation with the push of one button? Will I be able to see the Vibe CGM in the sunlight because I find it impossible to see my Ping screen when hiking? (The Dexcom is bad in the sun; the Ping is worse.) Is there a risk that when my Dexcom receiver goes out of warranty that my insurance will not approve a new one because the Vibe functions as a receiver?
Had Animas contacted me about shipping the Vibe a few weeks ago, I would have jumped on board immediately. Now I am not so sure.
I’ll keep you updated on what I decide. I wish that I felt excited about getting the Vibe and maybe I will be once I make the decision. At some point I need to contact Animas. Or maybe they will get in touch with me….
If you’d like to read recent reviews of the Vibe, here are some to check out:
Kerri Sparling at Six Until Me
Melissa Lee at A Sweet Life
Adam Brown at Diatribe
Mike Hoskins at Diabetes Mine
Manny Hernandez at Ask Manny
Sara Nicastro at Moments of Wonderful
Seems to me that you could always get your endo to write medical need for a receiver. I know that many people don’t hear the alarms when they are sleeping and the pump is under the covers. I was thinking that Melissa would need a stand alone receiver regardless of the integration with the tSlim, but since the Share and the fact that she is living back home, it really won’t be necessary. I think in your place I would do the upgrade. One less thing to carry around would be nice. By 2016, I’m betting you will have many options to consider! One year later, we still LOVE the tSlim.
I suspect that I will get the t:slim in 2016. I would actually seriously consider the Snap, but currently that is not covered by Medicare.
I know that you wrote about eventually having to deal with Medicare. I don’t remember how long you said it will be until you do. Medicare does not cover CGM’s or pump that work with them as a “system”. I use a Medtronic 530g with enlite and none of it is currently being covered through Medicare. I must go through an appeal process with each denial and then it is hit or miss on the decision, based on the ALJ that hears your appeal at that step. If you are approaching Medicare, it may be something to keep in mind as you make your decisions so that your equipment is most up to date before you go on Medicare. Also, I was using Edgepark when I had my employer provided insurance as my primary coverage,. When Medicare became primary, I had to drop Edgepark because they do not accept Medicare.
Thanks for sharing your experiences, Sue L. I have 2 yrs 2 mos before Medicare. I will buy one more pump in late 2016 before Medicare. With the coming of the Dexcom 5 mobile system it looks as though by the time I get to Medicare I can access CGM data through my phone. I hope the Medicare CGM policy changes, but until then I am saving my pennies (OK, maybe my dollars and lots of them) in order to self-fund. I know seniors who are struggling to get pump supplies and insulin through Medicare and it is a frightening prospect:-(
Reading everyone’s reviews of the Vibe makes me happy that I made the decision to switch to the t:slim when my insurance changed. I ended up getting off the Ping a year “early” because of that insurance switch. I wouldn’t go back. Having a carb calculator, auto populating boluses, and no crazy menus to scroll through (among other things) takes a huge load off my mental output and makes my quality of life a lot better. Though that could be just me. The Vibe sure is a workable pump, but it doesn’t seem nearly as user-friendly as the t:slim and other more current pumps are.
I have recently switched insurance and never thought of the possibility of switching pumps. Just figured the new insurance would be able to find out my end of warranty date. I can’t argue that medically I need the t:slim versus what I am using.
Thanks for reading and commenting.
It’s worth a shot to ask and find out! If you have another pump you’d rather use, contact a rep or the company and see if they can submit it through your new insurance. I met a Tandem rep at the Insulindependence conference back in August 2013 when I was still on the Ping and asked about it. They way they explained it to me was since my new insurance hadn’t paid for a pump yet, they wouldn’t really know the difference. A month and a half later I was starting on the t:slim.
2016 is just a year away (or a year and 11 months, depending on how you look at it). Do you really want to jeopardize what may happen then?
I wouldn’t be so keen in the insurance company being none-the-wiser theory. When the Minimed 530G first came out, I looked into upgrading immediately. Although I hadn’t reached the allotted time to replace it, that was purchased under a different insurance plan from a different employer (same healthcare administrator, though). I figured they wouldn’t know and wouldn’t care, because it wasn’t in their records. Apparently, that wasn’t the case — they would contact those who got me my prior pump (doctor and supplier) to find out the date. So much for that.
So could a $99 upgrade set you back? It’s possible. But do your research to find out, and good luck with whatever you choose.
(Also, I wonder if that button lag is on both the Ping and the Vibe or just the Vibe. If it’s a new flaw, that would be a dealbreaker for me).
Scott, your story is still a precautionary one for me and my understanding is your insurance never did cover the 530G. If I think I will rarely/never use the CGM portion of the pump, it might make sense to stay with my Ping. But then I would miss the opportunity to switch to a blue pump. LOL.
As always, thanks for your thoughtful comments.
You’re right in that they haven’t covered it. But that was the response when I made a more general question over whether I’m eligible for an upgrade at all.
Hi Laddie … I also heard that if you suspend your Vibe (for example, while showering), you are also suspending the CGM. I don’t know if it picks right back up when restarted or what happens to the data during that time. Just a thought!
I never suspend my pump except when I am downloading to Diasend. I often set temporary basals to Zero for a specified length of time. With temp basals, the CGM info is accessible. So that is a non-factor for me. But thanks for mentioning it.
It’s so interesting to read everyone’s comments and thoughts. Two things to consider: I tried the whole new insurance/new pump thing and it’s a no-go for most. I’m surprised it worked for someone. All I’ve heard (from myself and others) is that if you have a pump in warranty, they will not pay for a new pump – new insurance or not. I also got some clarification on the whole pump suspended/CGM info situation. It’s just that you can’t see it. It is still making its way to the pump and when you resume the pump it backfills on the screen. I’ve never suspended my pump except for Diasend so it’s a non-starter issue for me.
Very interesting topic Laddie. You do have a lot to think about before making your decision.
Laddie, interesting post. You’ve definitely put a lot of thought into this decision! I can sympathize!
I’m probably one of the more positive reviewers of it for one reason – integration and simplicity of one system. Honestly, it makes a big difference for me when I am out and about running/cycling in Newfoundland because rain and fog are a constant and having a receiver that’s vulnerable to rain makes the need to carry two extra things – the receiver and something to protect it in. 🙂 I am also a voracious sweater who managed to kill a phone in a ziploc bag in my shorts while running, so, you know – it’s an insurance policy. I guess I can see the hesitancy to upgrade (I definitely had it), but I think it fills a niche that is suiting for some. I’m out there running, cycling, etc in rain, snow, sun, night, morning – it doesn’t matter, and this made it easier.
Another big plus is not having to charge something! How many bloody devices do we have to charge these days. When I go back country camping for a few days that becomes a serious concern – yes, I have a goal zero, but I hate having to decide between charging a headlamp, a water purifying device, my CGMS receiver, my blood meter, etc. I’ve since simplified to lighten my load, trimming out as many unnecessary charges as possible. This is another convenience.
So for me, what I need is water proof, convenient and simple. And it has to be in Canada. Medtronic is not waterproof and I won’t get into CGMS accuracy or archaic menus. The omnipod doesn’t work for me because of the sweat factor (and the fact that the bump can snag on things, or get jammed crack climbing). The t:slim isn’t available in Canada, has to be charged and isn’t water proof – that’s too fragile for me. And don’t get me going on touch screens – I hate touch screens – try and use one in -20C while running, doesn’t happen. Tactile buttons just work – I don’t have to worry about water screwing up conductivity, breaking a screen, etc. It really boiled down to choosing between integrating and not. I’m happy with my choice, but definitely recognize the shortcomings involved in the Vibe.
To a couple of the comments above:
– Yes, when you suspend it shuts off the CGMS – annoying, but it does pick it up when you resume. My solution is to temp basal at 0%.
– When you change the battery – same deal, CGMS has to reconnect, but it just picks up
– Button lag seems to be timed with when the pump is delivering it’s basal – Animas pumps do little tiny boluses, not a constant stream. Anytime the system is doing that, it delays button presses.
It’s definitely not perfect, but it’s a compromise that I’m willing to live with. It’s made my active life easier and simplified my every day. Do I wish it was faster, sleeker, etc – yes, but not at the cost of complexity or reliance on charging. I want reliable and dependable, and I guess I’m willing to give up some innovation if that’s the cost. What I really wish it had was the ability to flash firmware, update software, etc. That’s what I really think was missed.
But in the end, it’s all about personal preference and choice – my needs are obviously driven by my lifestyle, and what I am willing to give up is not necessarily what someone else is. I’m glad we have the ability to discuss these choices. 🙂
In general, I think we all get used to what we have. You have definitely figured out that the Vibe works for you. My update post on my final decision on the Vibe will have a link to your recent blogpost (and probably also your previous blogpost on the subject). Although I think that each of us would love to design our “perfect” pump/CGM, the fact of the matter is that we have to live with what is on the market.
My time in the USA definitely shows how different each countries’ markets are. It’s quite amazing how different the access is – in fact I delayed my repatriation on the timing of the Dexcom release in Canada.
The regulatory hurdle is the biggest issue to why we have to choose between a tank but slow to an innovative beauty but fragile – in order to get it approved, decisions have to be made. I get that the process is there to protect us, but it also can hinder us.
But yeah, we have to get used to what we have – every 5 or whatever years 😉
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