Dive In!

At 2 am, take a dive into cold open water, full of jelly fish, debris, and heavy ship traffic.   Plan to swim a relay with a team of 6 people, and anticipate the entire event to take somewhere between 12 - 15 hours.  Weather and tide conditions will be unveiled along the journey, and the risk for hypothermia is very high.  You will not be permitted to wear anything that offers thermal or buoyancy protection. You might get seasick while out of the water, but a very precise nutrition plan will be in place, and you'll need to adhere to it regardless of how your stomach is feeling.  You cannot be assisted by another person or flotation device at any point while you're in the water, and an observer will be watching closely to make sure that all rules are followed to a T.


Now do all of that with Type 1 Diabetes.


On July 21, 2011 a 6 member relay team set off to cross the English Channel.  Three team members live with Type 1 Diabetes, and were sporting their Animas Vibe insulin pumps.  The team saw victory in 13 hours and 26 minutes!


I am honored to share this first person account from the team's Captain, Mark Blewitt.


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By: Mark Blewitt

The Animas Channel Swim team of Matt Cox, Claire Duncan and myself, with type 1 diabetes plus Lorcan, Pawel and Boris started when we met up in the marina car park in the early hours of Thursday morning. It was a hive of activity and our specialist diabetes nurse, Vreni was there ready to accompany us on our challenge to cross the channel. Family and friends - Lucy, Deborah and Emma from Animas came down to see us off and the photographer was dispatched to record events for posterity. 

We started the swim just before 2am. It was dark and we needed two strong, experienced swimmers to lead us out to a good start. So out of the harbour, in the black of night, I was swimming first. I slipped into the inky sea with the aid of a “million candle” spotlight on the beach at Samphire Hoe, off we went. We learnt that seven escort boats were out at the same time meaning a busy day in the Channel. All had chosen our same start location with the hope of finishing at the Cap Gris Nez.

Once back on board after my opening stint, I managed to get a couple of hours sleep, whilst Lorcan and Pawel swam. Happily I woke up just in time to see Claire get into the water.  Claire looked very relaxed and had lovely effortless strokes - making good progress. Next into the water came Matt.  Matt was swimming breaststroke and the team were all in awe simply because as freestyle swimmers we all appreciate that swimming breaststroke is slower, colder and hence harder in open water.  At this point it should be noted that Matt’s namesake, Captain Matthew Webb swam breaststroke back in 1875 when he became the first person ever to swim the channel.  Little did Webb realize what he would be starting.

In between our turns in the water, we followed the team’s progress on the real time satellite maps, sending the Animas team on shore text, picture and location updates as often as possible.  We were making good progress and for a long while there was much speculation about whether we would finish in under twelve hours. 

During the course of the swim, the team on board the boat avidly listened to Claire and Vreni discuss diabetes management.  The non-type 1 members of the team know that channel swimming requires a fine balance between expending energy and intake of food whilst swimming.  The other team members showed their admiration that our metabolic condition does not stop us completing such challenges and competing in demanding sporting activities.

Matt was showing off his waterproof, real time Continuous Glucose Monitoring enabled, Animas Vibe pump, while Vreni lead a good discussion about what BGs actually are whilst Lorcan made good work of his second swim. We later had some unexpected excitement when Pawel came close to a very large, NYK container ship! Claire’s second swim was as relaxed as her first and Matt too executed a glide that Captain Webb himself would have been proud of.  As I prepared for my final spell in the water I knew this was the time to give it everything.

   

We arrived at Cap Gris Nez in 13hrs 26mins, a fantastic result! We’d done it!  We popped open a well earned bottle of champagne to celebrate and enjoyed a leisurely cruise back to Dover. 

We had a great time in the channel.  Thanks to Eddy Spelling and the Anastasia support boat crew.  Thanks to Jill our observer, Nick Adams and Kevin Murphy, Secretary of the Channel Swimming and Piloting federation (CSPF) for his patience in allowing us to make changes to the team at a late stage.  

I have had the pleasure of several relay swims over the years but I can honestly say this was one of the happiest I have been on.

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CONGRATS, ANIMAS TEAM!  

You are an inspiration and an incredible example that 

life with Type 1 doesn't have any limits!

Introducing the Animas Vibe!

Mark this date in history.  

IT HAS ARRIVED TO THE U.K.!!!!!

Animas Corporation is announcing today 

that they have received CE Mark approval for Animas Vibe.  

Animas® Vibe™ marks the first integrated product offering from Animas Corporation, makers of high-performance insulin pump technology and Dexcom, Inc., the leader in continuous glucose sensing technologies. Now approved in Europe, the product will initially be available to people living with diabetes in the United Kingdom, Germany, France, Italy and Sweden.

Animas® Vibe™ offers:

• The latest technology available from Dexcom – Dexcom G4™, a tiny, round and flexible sensor with the smallest introducer needle as compared to Abbott Freestyle Navigator® and Medtronic Sof-Sensor®
• Advanced high-contrast colour pump screen technology, that displays glucose trends with coloured arrows and lines showing where and how fast glucose levels are shifting
• Dexcom sensor technology approved for up to seven days of wear, delivering more days of CGM data than those approved for a shorter duration
• Waterproof durability up to 12 feet (3.6 metres) for 24 hours for the insulin pump, with a Dexcom G4™ Transmitter that is waterproof at 8 feet (2.4 metres) for 24 hours
• Customizable alarms to indicate high and low glucose levels including a hypo-safety alarm fixed at 55 mg/dL (3.1mmol/L)
• Low basal increment (0.025 U/hr) across all available ranges (0.025 U/hr to 25.00 U/hr) for precise dosing
• Compatibility with Diasend® communications software, enabling patients to store, review and print both CGM and insulin pump data

You can check out the entire press release HERE.

Welcome to the family, Vibe.

We can't wait for the chance to get to know you better here in the U.S. :)

Yo. This is how we roll the low.

Let me set the stage for ya.

I was making waffles for dinner.

Yes.  I said waffles.  Gluten-free pumpkin waffles, to be exact.

Anyway, I was hanging out with my batter, minding my own business and pondering the weekend ahead.

I guess I was tuned out a bit -- scoop, plop, close, wait, repeat.

As I was in the middle of my zone, I suddenly realized that Sugar was standing over the plate of waffles eating them as if she hadn't ever been fed before.

Hmmm.

I knew.  

"Let's check your blood sugar."

Sticks out hand while continuing to stand over plate of waffles eating like crazy.

44.

"Have some juice."

No words.  I think she sucked down the entire box in one gulp, and then went back to her waffle.

"Mom. I'm still hungry."  Reaches for a banana. 

"Let's test again."

92.

"I'm not coming up fast enough."  Grabs an apple.

110.

One of the things I've learned from the DOC, is that there are some lows that make my daughter feel as if she could eat an eight course meal in one sitting. 

I remember reading somewhere that, since brain cells don't store glucose, a few die with every low blood sugar.  The hunger instinct that kicks in is the brain sending out flare alerts to refuel the glucose necessary so that it can maintain function.

When she has a low like this, I let her have at it.  To be honest, I don't worry much about over-correcting.  I do, however, get insulin going as soon as her number is over 100.

I was about to deliver insulin for the 15c juice, 25c waffle, 20c banana, and 15c apple...then decided to take a picture of the delivery screen to explain how we manage lows around here. **Now, mind you, this is what works FOR US using the technology we've determined suits our family best.

Anyway, as I was saying, once her blood sugar tops 100, I give insulin by calculating the total carbs (INCLUDING THE INITIAL JUICE) and entering them into the pump...then I manually enter the original low blood sugar {in this case, 44}...and the pump makes all the adjustments necessary:

When I enter in that bottom number, I have the option to evaluate all the variables the pump doesn't know about -- activity level, illness, stress, etc.. -- and, if I choose to do so, I can subtract/add insulin as I see fit.  In this case, I entered the pump's recommended dose.

And then I finished up my waffles.

Dexcom Review -- 2 Months Into the Game.

I wrote about our past CGM experience...and I shared my reservations about trying the CGM again...then I shared a review of our week long Dexcom trial.

If you've been reading Candy Hearts for awhile, then you already know that we completed the insurance process and obtained a Dexcom SEVEN PLUS of our own just before Christmas.  In the time since, I've discussed the Super Bolus and our shark's teeth phenomena.

It's been 2 months now.  Most of the time Dex and I get along okay.  Sometimes we don't.  But, at any rate, here's a few things I've learned:

1) Each sensor is a new ballgame. This is why I can't trust it. I feel like I have to build a new relationship every time we insert a new sensor.  Relationship drama is the WORST!

2) In my opinion, each sensor needs a 48 hour grace period before I rip into it about being unreliable. I think it takes time for it to "settle in" and start doing it's thing.

3) Her arms work better than her tummy. I realize it's only FDA approved for her belly, but I think she has more interstitial fluid in her arms. Not only that, when she lays on her tummy at night, it disperses the fluid under pressure and we end up with crazy overnight graphs.

4) It CAN be calibrated TOO MUCH! I had no idea! We were entering every number, but then I read that you were only SUPPOSED to enter a number if it's more than 20% off (actual BG divided by 5) OR if it prompts you to. The sensors and I are getting along much better now that we've been sticking to that rule.

5) The number is usually useless for rapid swings in either direction. The arrows, however, are not. If she's feeling low, I test and treat just like we did before Dex came along. 15 minutes later, I can retest and, while the numbers might still be inconsistent, the arrows usually point me in the right direction -- double arrows down turns into one arrow down turns into a slanted arrow down, etc... I do feel like I can use the arrows confidently to help me gauge what direction things are moving and whether or not additional treatment is necessary.

6) When placing the sensor (which, btw, I have never done -- Hubby handles all that jazz), it's important to get a good squeeze of fat and lift it as high as you comfortably can (again, we're using arms for Dex) to make sure the sensor doesn't get inserted to deep.

7) There are times that I actually **LIKE** having 2 devices...

** The first was when we took a New Year's Day trip to play in the snow.  It was about a 3.5 hour drive, and I sat up front with the Ping remote and Dexcom receiver.  It was SAWEET!  I could tell what was going on in the seat behind me plus point and shoot the remote over my head to give insulin!  

** I also appreciate being able to keep the remote on the charger at night.  It's SO NICE not to have to rumble around looking for her pump to see the CGM.  A quick glance is all we need for extra reassurance at night.

 8)  Each sensor consistently lasts between 10 - 14 days.  They may go longer, but we remove it when she starts to complain of itching.  We have yet to remove a sensor at the 7 day mark. Thus far, we just restart the sensor, wait for the 2 hour start up period, enter 2 BG's, and press on :)

On a side note, here's where I stand with those reservations I mentioned earlier:

Insurance:  So far, we haven't had a problem.  They approved the system and the sensor refills.  That being said, we haven't actually received our first refill order, so I do have to admit that I'm holding my breath a little.

Real Estate:  We're using her arms exclusively for CGM sites.  She never liked wearing pump sites in her arms, so it seems to be working well for now.  We rotate her pump sites between her bum and tummy and the CGM sites from one arm to the next.

Hypoglycemia Awareness:  She continues to feels her lows somewhere around the 60's.  That being said, her lows do NOT wake her up at night.  She didn't wake up from lows before Dexcom either, so we remain pretty vigilant at night.

Technology Updates: We're eagerly anticipating the Animas/Dex combo, but do not expect to see it anytime soon.  After reading this information, we decided to go ahead and renew her pump warranty and will play the rest by ear.  If we have to pay out of pocket for an upgrade later, we'll cross that bridge when we come to it.  Keeping her current pump under warranty is something that we just didn't want to risk.  As for other pump options, we can't base our decisions on what might or might not be part of the future in pump therapy.  We're happy with Animas today, and will just see where this road takes us tomorrow.

Click HERE to read other CGM posts at Candy Hearts.

PS -- If you have concerns about skin sensitivity and adhesion issues, Lorraine has a great post that addresses those concerns HERE.

DexCom CEO Discusses Q3 2010 Results

First of all, don't ask me what the heck this is.  I'm not a financial guru.  I know nothing about stocks, bonds, and trading.  


All I know is that our Animas warranty is set to expire soon. 


Like...


REAL soon.


I started thinking about the fact that I'd better get on the ball to get her renewal process rolling after the Ping remote fell out of her diabetes bag yesterday afternoon...

Well darn.


That ominous streak down the center of Santa-Ping is NOT good.  


Sigh.


At least we can bolus from the pump itself so she doesn't have to go back to shots until the replacement arrives.  (ETA:  Wednesday, btw)  But still.  I've gotten lazy in my old age and I LOVE THAT STINKIN' REMOTE!


OH, yeah....back to the Dexcom thing I'm posting about today...


So, ANYway...before I make the call to get a new pump warranty, I wanted to make sure that I haven't missed anything about the release of the Animas/Dex combo pump.  You know...brush up...Google around a little.


And that's how I found THIS...


Apparently it's a transcript of the Dexcom 3rd Quarter 2010 earnings conference call, dated 11/9/10.


Hmmmm....very interesting....


It starts off with a little introduction followed by a cautionary statement basically stating that the statements made are "forward-looking" and essentially subject to change.


It goes on to give a financial statement about revenues...yada, yada, yada...  By the way, it's worth mentioning the fact that this section reports Flextronics (the contract manufacturer) is relocating the Dexcom production line from California to China...as a result, the internal sensor manufacturing line is expected to be shutdown for 2 weeks during the 1st Quarter of 2011.  It looks like they're increasing sensor production during the 4th Quarter of 2010 to prepare for this shutdown. 


Moving on...


The next section talks about the fact that the FDA is "undergoing sweeping changes to its review and approval policies and procedures, and has set forth as a priority an effort to improve the level of regulatory science the agency applies to all medical devices to better assess, evaluate, and review products." 


and


"As a result, the medical device industry is in the midst of a sudden and dramatic shift in the requirements for product approvals. This has created an atmosphere of unpredictability and uncertainty surrounding the submissions process and in many instances it is not altogether clear what the agency will require or expect of new submissions, particularly for companies seeking clearance under the 510(k) regime."


Then they begin to address the Gen4 sensor, stating..."In fact, we believe we have identified an opportunity to accelerate review of our next-generation hardware platform as part of an amended Gen4 filing. Specifically, when we conducted the pivotal trial to support our Gen4 sensor filing, our next-generation hardware platform, which includes a smaller receiver form factor with a color screen and a modified transmitter with more robust transmission frequency, were still in the development stage. Due primarily to the manufacturability and scalability benefits provided by the Gen4 sensor, we elected to move forward with the trial and subsequent filing of the Gen4 sensor paired with our legacy hardware platform. Now, as part of a comprehensive response to the FDA, we intend to include not only the additional information requested by the agency concerning the Gen4 sensor, we expect to include data to support approval of our next-generation hardware platform. This would enable us to launch a more robust fourth generation system."


And this section also says "So while our timeline for launching the Gen4 system will be slightly delayed, through an open and transparent dialog with the agency, we believe we will be in a position to provide the additional information requested of us regarding the Gen4 sensor, and at the same time, accelerate review of our next-generation hardware platform, which would position us to launch yet another best-in-class CGM system during the second half of the year."


Then we get to the nitty gritty...


"Shifting to our combination product, the regulatory uncertainty facing the insulin pump market is particularly daunting. Insulin pump companies today are faced with the likely prospect of having their pump products regulated under a new subset of class two devices where approval standards are in a state of flux and human clinical data requirements are unclear.

This changing landscape will certainly impact approval timelines in the United States for integrated systems with Animas and Insulet as I suspect it will for Medtronic and the numerous small privately funded pump companies seeking to bring new pump products to market.

As you know, we filed a PMA supplement seeking approval of an integrated insulin pump continuous glucose monitoring system with Insulet Corporation earlier this year. We've now received a formal written response from the agency regarding our submission, and much like the response to our Gen4 submission, the FDA has requested substantial additional information including additional human clinical trials data concerning the safety of insulin delivery by the system.

We are working with Insulet to formulate an appropriate response to the agency, but due to the time and expense associated with conducting an additional clinical trial, Insulet is evaluating whether it makes sense to move forward with the existing combination product that uses our SEVEN Plus, and the current OmniPod, or whether it would be more beneficial for potential patients to incorporate our current or future generation CGM technology into Insulet's next-generation OmniPod platform and conduct a more expansive trial as requested by FDA.

We are also exploring the opportunity to submit an IDE relating to the existing combination product for research purposes, which would allow us use of the system in various artificial pancreas studies in the near term. With respect to our integrated system with Animas Corporation, we are pleased to report that we have concluded development, and are nearing completion of final systems testing.

However, in light of the uncertain clinical and regulatory landscape I just mentioned, and based on our review of the additional information requested by FDA in response to our PMA supplement filing with our combination product with Insulet, we are seeking a pre-IDE meeting with the agency to determine the best clinical path to support approval of our combination product with Animas in the United States.

While this path will not enable us to file a PMA supplement for the Animas system this calendar year, we believe that working on a collaborative basis with FDA prior to conducting a human clinical study is the most prudent course of action from a timing perspective, and certainly the most cost-effective way to proceed."

In the Q&A section, it would appear that Animas is contracted to release a combo product with the newest technology, currently awaiting FDA approval: the Gen4 sensor.  Obviously, that sensor needs to finish the FDA approval process and then the combo pump will have to go through the FDA process before it hits the market.

There's further discussion about Insulet's combo product with the Dexcom SEVEN Plus that is currently awaiting FDA approval.  The discussion seems to be whether or not Insulet is going to release it or wait to upgrade the technology, stating "Our current contract does not provide for access to our future technologies, but certainly we're open to discussing that with them." It would appear that this is a decision that Insulet needs to make.  The commenter does state "I'll just tell you my opinion is if I were driving the ship, I'd be launching with the SEVEN Plus, because I would certainly want to have some cannibalization going on of the existing pump combo by Medtronic. But I don't make that decision."

Anyway, I just found it all very interesting.  

And, in case you're wondering, I'll be calling to start the paperwork process to get our Animas pump warranty renewed ASAP.

Here's the link, once again, so you can read it all for yourself...

DexCom CEO Discusses Q3 2010 Results - Earnings Call Transcript

Animas PING - Our Pump Choice

I run into this question just about every other day.  It is, by far, THE most common inquiry I get from the diabetes social network realm (aka - Diabetes Online Community ... aka The DOC).  Honestly, I don't mind answering over and over and over again!  The problem I run into is that LIFE often prevents me from returning e-mails/FB messages as promptly as I'd like.  For this reason, I think it would be helpful to have a link available to provide folks with a pre-written answer.  

It's not that I don't ABSOLUTELY LOVE interacting with my readers (I DO!!!  Feel free to say hello anytime!!), but I feel bad when it takes me a few days to get back to someone who has come to me with a question that is important to them RIGHT NOW.  I remember the days of choosing a pump.  I remember wanting as much information as I could find, reading forum after forum, and just wanting to get the decision made so we could move to the next step.  It took me 15 months before I felt ready to tackle another learning curve...once I crossed that hurdle, I was ready to ROCK-N-ROLL and just wanted to DO IT!!!!!

I should note here that I'm going to share the things that are important **TO ME** when it comes to choosing technology to manage Sugar's diabetes.  You may have a completely different set of preferences.  And that's okay.  Just because I value something you don't, doesn't make either of us wrong.  We each know what our lives entail.  We each know what our individual needs are.  So take this information for what it's worth and delete it from the brain if you decide it's just taking up valuable space...deal?  

By the way, I'm going to be mentioning the top 3 insulin delivery technology options available in the United States.  This doesn't mean they will all be available in your area...nor does it mean there aren't other options out there. 

Oh, and one more thing.  I'm not a doctor.  I'm not a CDE.  I'm a mother doing the best she can to be a pancreas for her daughter.  What works for my child may not work for you or your child.  So don't misconstrue anything you read here as medical advice.  It's just our experience....not advice about how to manage yours.

All of that being said, and without further ado, here are the reasons we've chosen to manage Sugar's T1D using the Animas Ping Insulin Pump.

1)  Insulin On Board (IOB):  (Also known as "Bolus on Board" - BOB) If you've been reading Candy Hearts for awhile, you probably already know the value I place on this feature for Sugar's safety.  IOB (aka "Bolus on Board" {BOB}) keeps track of the unused/active insulin still circulating in the system.  Animas technology keeps track of active insulin for BOTH corrective doses AND insulin given to cover carbs.  This is something I consider essential, because Sugar does not necessarily need to be corrected everyday, but she DOES eat carbs everyday.

The Medtronic MiniMed insulin pump system offers a similar IOB feature.

The Insulet Omnipod offers an IOB feature for corrective boluses, but does not keep track of active insulin for boluses given to cover carbohydrates.

I should point out that, if you're on shots, the IOB is essentially the reason you probably do not correct more often than every 3 hours.  You don't have the IOB information at your fingertips and have learned to manage T1D this far.  Admittedly, IOB is something I've become dependent on.  She eats randomly, more on some days, grazes on others....often I'm checking a blood sugar within a 2 hour window from her last dose -- without IOB, I would NOT correct at those times...in fact, she would probably need to stick to a more regimented eating schedule for her overall management.  Having the security of IOB allows me to calculate a correction, regardless of why or when the previous dose of insulin was given.  Then, based on her current blood sugar, the pump will let me know whether a correction is or is NOT advised.  Being able to correct confidently sooner brings blood sugar spikes back to normal range more efficiently.

HERE is an excellent article about IOB written by Gary Scheiner, a renowned CDE and author of Think Like A Pancreas.

HERE is a brief overview and description of what IOB is from the CWD website.

HERE is another helpful article from DiabetesNet.com. 

HERE is a post from a PWD with the same IOB concerns I have.

HERE is a recent example where the IOB feature of Sugar's pump saved the day....it occurred when Sugar was in the care of a **NEW** babysitter while her dad and I were about 30 minutes away, and clearly demonstrates why it is important that an insulin pump keep track of active insulin for carb boluses.  It reiterates the reason I feel this type of IOB feature is an essential part of Sugar's overall safety and provides extra peace of mind when she is not in my immediate care -- whether that be at a playdate, church class, school, or just because she's in the other room trying to assert some independence without me standing over her shoulder. 

2)  0.025u Dosage Increments/0 Basal Option:  Let's face it.  A little insulin goes a long way, especially in little people.  Animas allows dosing increments to be programmed 0.025u at a time.  Try as you might, you will never be able to draw that up in a syringe -- even if you're using a syringe with half unit markings.  No matter how you look at it, you'll always be guessing....that's IF you can even get such a minute amount past the needle and into the syringe itself.

Additionally, I have found it necessary to program a ZERO basal from time to time to assist with managing a pattern of lows.  This typically happens overnight, but has also been the case for regular daily physical activity -- for example, she had some post activity lows when she was taking swimming lessons every day for 8 weeks.  I found it useful to keep her basal set at zero for an hour before the swim lessons and it helped.  I suppose a temp basal would do the same thing, but then you'd have to remember to program it every day.

THIS POST demonstrates the power of one little drop of insulin.

The newest Medtronic MiniMed Revel pump also offers 0.025u dosing.  You can also program a zero basal.

The Insulet Omnipod does not offer 0.0.25u dosages.  The smallest unit of dosage available is 0.05u.  Additionally, you CANNOT set a zero basal as part of the regular pattern.

3)   The Remote:  Simply put....I LOVE IT.  The PING remote acts as both a blood sugar meter using One Touch strips and a remote insulin delivery device.  I've bolused through the door while she's in the bathroom (Oh, yes, I have.  Nothing is sacred when you need to get a pre-bolus working and dinner is about to hit the table), from the hallway outside her bedroom, while she's in the backseat of the car, and across the table in restaurants.  I love the remote PERIOD.  It provides detailed information about blood sugar history and averages, including graphs and charts that break everything down according to the section of the day.

I've heard that the Medtronic MiniMed also offers a remote feature, but have never met anyone who is actually using it.  I've never seen it and do not know any specifics about it.

The Insulet Omnipod, uses a wireless PDM for managing all tasks.

4)  Pump Bolus:  Yes, I love the remote.  BUT, I have been stuck without it.  A time or two, it hasn't made the transition from the gym bag to the purse, it's been left on the countertop when loading the fam to the van in a hurry, once we accidentally left it in a doctor's office waiting room an hour from home...whatever....  We're not irresponsible people...but we have been caught without the remote unexpectedly from time to time.  In these moments, I appreciate the ability to administer a bolus from the pump itself.

The Medtronic MiniMed does deliver boluses from the pump.

The Insulet Omnipod only delivers a bolus from the PDM.  A carb/correction bolus cannot be administered if the PDM is not available.  The basal insulin, however, will continue to infuse, regardless of how far away the PDM may be.

5)  Sites:  When we first began our pumping journey in 2007, Sugar wore a different insulin pump that has since stopped manufacturing.  At that time, we were using the infusion sites that came from the same company as the pump.  Well....they didn't work us.  I couldn't get a site to last longer than 36 hours, no matter how meticulous I cared for it.  After a few frustrating weeks, I started shopping around in search of other infusion sets.  We found the Animas Inset (straight insertion) and have never gone back.  I appreciate that there's a small amount of adhesive as, sometimes, Sugar's skin gets irritated and itchy -- I don't like risking infection from skin breakdown and dirty fingernails in precious real estate areas that are used for her infusion sites.  The less adhesive with sturdy application, the better!

The Medtronic MiniMed offers a variety of infusion sets.  However, they use a proprietary system, so you cannot try products from other companies.  The amount of adhesive used is comparable to the Animas Insets.  In fact, the new MiniMed MIO infusion sets are practically identical to the old Animas Insets that we've been using for years.  I don't think this is by coincidence. 

The Insulet Omnipod obviously uses only the pods themselves.  The pods tend to be bulky and use a great deal of adhesive surface area.  Currently, the entire pumping community is awaiting the release of smaller pods...which are expected to reduce in size by about 40%.  Any day now???!!!???!!!

6)  Waterproof:  Sugar has been swimming, tubing on a lake, running through sprinklers, playing at splash parks, and caught in the rain with her pump on.  During the summer months, we usually disconnect the pump and store it in a cooler while at the pool.  I often keep it in a plastic bag and just toss it in with the drinks...there's been a time or two that water has leaked into the bag.  Suffice to say that I was very glad her pump was waterproof!  

(**NOTE**  The remote is NOT waterproof)

Looking back, I'm not sure that allowing the pump into the lake was the smartest idea, and I'm thinking we probably won't do it again.  If that sucker had fallen off....I shudder to think.....  It's probably a better idea to take it off before next summer's run on the tube and taking a dive to swim with the fish.  Even still, at the time her life jacket was covering the pump pack and....well....we were all just so excited to be out in the boat that we forgot about it.  You heard that correctly.  WE FORGOT ABOUT THE PUMP!!!!!  Oh well.  Hindsight is 20/20....all's well that ends well!!!!!

The Medtronic MiniMed is NOT waterproof.

The Insulet Omnipod is waterproof, but the PDM is NOT waterproof.


I guess those are the big reasons....there are other features that we like too -- combo boluses, temp basals, and other stuff like that -- but all of the pumps have these features, so it's really nothing that sets Animas apart.  While I'm on the topic of technology options, I'll answer a few other questions too...


WHAT ABOUT CGM?  Well, during our pumping days previous to Animas, we tried it.  Honestly, we didn't like it.  It was cumbersome to have 2 sites and I felt like it wasn't accurate enough to be worth the extra time, effort, and test strips.  I didn't know how to process all the extra data and couldn't bring myself to trust the dag-on thing.  That being said, there are LOTS of DOC bloggers who LOVE their CGM's.  I'm probably not the best person to talk to about CGM...sorry.  SEE THE UPDATE BELOW!

Medtronic MiniMed has a combined insulin/CGM pump -- there are still 2 sites, but only one device.

Both Animas and Insulet have contracts with Dexcom and combined pumps for both of these companies are expected soon.  Well, you know....as SOON as SOON gets with this stuff.

***UPDATE 2/11***   Since writing this post, we have started using the Dexcom continuous glucose monitor.  Most of the time we like it.  Sometimes we don't.  HERE is a review from our trial week, and HERE is a more comprehensive review after using it for 2 months.

WHAT ABOUT THE TUBING?  Well....what about it?  I suppose there have been times when the tubing is inconvenient, but it's really not in the way -- EVER.  No more inconvenient than placing a bulky pod on a diaper wearing baby, keeping it from wobbling on a small arm, or accommodating it under a tight shirt.  We can either be concerned with tubing that hardly ever causes an issue or worry about a pod getting bumped, deactivating, and having to waste excess insulin (which appears to be a pretty common issue that people get frustrated by...I could list example, after example, after another, and still more examples or 6 pages worth about the frustrating rate of pod failures, but I think you get the point.)  Pick your poison, ya know?  Now that we use the remote, Sugar can wear dresses without worrying about needing to access the pump (this was probably our biggest tubing inconvenience), and we've found some great pump packs that do a good job of keeping the tubing securely hidden.  The tubing is simply a non-issue.  It always has been.  When we first began pumping in 2007, the tubeless Omnipod wasn't even an option.  It was TUBING OR BUST, BABY!  We've never looked back.

WHAT ABOUT SITE PROBLEMS?  Honestly....they hardly ever happen for us.  Site dilemmas are part of the journey.  Not gonna lie.  Don't want to sugarcoat it.  You WILL have a site issue or 2 if you're a pumper/podder.  It's just reality.

HOW DO I GET READY FOR THE PUMP?  There are a few books that I've found quite helpful.  They both contain WAY more information than what you need in the beginning, but the intro to pumping sections are good reads, and it's nice to have a reference handy as you become more comfortable.

Think Like A Pancreas

Smart Pumping

Pumping Insulin

WHAT IF I HAVE MORE QUESTIONS?  Well, JUST ASK!  You can either leave a comment here or drop me an e-mail (candyheartsblog@gmail.com).  I'll get it answered as soon as I can.  If you leave a comment, I will it answer it in a follow up comment, so be sure to check back....and, if you're reading this for the first time, you may want to peruse the comments for more information.

In the meantime, be sure to check out Meri's Pump Parade, where she features a link to users of each pump option I've mentioned here.  The Pump Parade offers additional perspective, photos, and information regarding the 3 most popular insulin delivery technology options.

From My CANDY HEART to Yours,

PS -- Commenters, please leave your name and what pump/CGM you're using so folks can peruse your blogs for more information about other pumping experiences!