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Re: [IP] Medtronic Revel 523


 I've been using a Medtronic 723 since it first came out, along with the
Medtronic CGM. I've been using Medtronic CGM for 6 1/2 years. The 523 is the
same pump but with the 1.8 mL reservoir. The 723 can use either the 1.8 mL or
the 3.0 mL unit reservoir.

 Yes, you do have two sites to "worry" about, but that is true with any CGM. I
find the CGM really helpful, although it does require some extra work to get as
much from CGM as you'd like. The Medtronic CGM is FDA approved to use for 3
days, but many people do a new "start" at the end of 3 days and then use the CGM
sensor for 6 days. I do that and I also restart at the end of 6 days again and
use the sensor for a total of 7 days. Usually the sensor needs to be replaced at
the end of either day 6 or day 7.

 I use the infusion set for 4 or sometimes 5 days with the 300 unit reservoir.
Changing the infusion set and the CGM don't usually happen at the same time. I
can replace the infusion set in less than 5 minutes, while the CGM sensor takes
longer because the CGM transmitter battery takes about 20 minutes to recharge,
which slows the process. With the CGM sensor taped and covered correctly there
is no problem with it getting wet nor is there any redness at the site.

 Overall, having CGM is really worth it to me. There is a huge advantage in
knowing what your blood glucose is and where it is trending. On the Medtronic
pump you can set the CGM alarms anywhere you want and you can also turn them
totally off if you choose, or you can just choose to turn on part of the alarms.
You also set the rate of change alarm levels, so you can have the pump tell you
if your glucose is changing rapidly. I sometimes find the alarms annoying
because I set them to help me maintain tight control (high alarm at 160, low
alarm at 75). The alarms definitely alert me to situations where I might have
not done a big enough bolus, or if glucose is falling too rapidly where I have
done too large a bolus. I find it possible to be alerted to low glucose about a
half hour before it really gets low. If I get a high rate alarm while I'm eating
or right after, I know that I might have under bolused. The low alarm has
definitely helped at night while sleeping, but you can get some false alarms,

 If you really get tired of alarms, you can set different levels or shut them
off, but if you use them correctly the alarms are wonderful.

 I also love having glucose readings integrated into the pump so I don't have to
carry two sets of electronics with me. Makes for a more comfortable day. As a
guy I it is easy to just carry the pump in my pocket.

 I should also note that much of what I just said about Medtronic CGM also
directly applies to the Dexcom CGM. The Dexcom CGM is a generation newer than
the Medtronic one and is well liked. I'm "patiently" waiting for the next
generation Medtronic CGM which is under FDA review now. Don't get too excited
about that, though, because it may be 1-6 months or maybe longer. The Medtronic
CGM insertion needle is bigger than the Dexcom version, but I think the overall
CGM installation is lower in profile. Either will do a great job of giving you a
good set of data to work with. You just have to decide how much effort you're
willing to put into making it work.

 By the way, you can upload the Medtronic pump directly to the Medtronic site
and print your own reports. The report that comes most quickly looks back for
the past 2 weeks and is useful. You can do this stuff much more frequently than
waiting to see your doc and hoping that he or one of his staff can find a
pattern with a quick look.

 Definitely it would be a good idea to try the buttons on the pump. The
Medtronic pump screen is only one color but it can be seen easily in bright
sunlight when you're outside. With one button push I can see a screen that shows
my current blood glucose (CGM) and also shows a graph of the prior 3 hours of
glucose readings. With a second push I get to a screen that I can scroll down
through which shows what my last finger stick glucose was (and when), how much
insulin is still active from prior boluses, what my last bolus was (and when),
and how many units of insulin remain in the reservoir.

 This is an absolutely huge email, so I apologize, but I wanted to be sure you
got all the input that a Medtronic user can provide. Probably used my email
quota for a whole year. I think you can very well do the same things with other
pumps and other CGM systems, so don't exclude others. They all work and they all
take work to make that happen.

Good luck!

Bob Steele

On Dec 5, 2012, at 10:41 AM, Howard Pohl <email @ redacted> wrote:

 > Hello, my Animas 2020, with which I have been satisfied, is getting a bit
> in the tooth. My current doctor is a big fan of Medtronic and is touting the
 > Revel 523. I have read extensively about the pump and there is no question
 > I would benefit from a system that integrates the cgms and pump and alerts
 > oncoming lows and highs. The data can also be downloaded at my doctor's
> to analyze patterns. My concern is for the practical aspects of working the
 > Medtronic. The Animas system has always been smooth sailing for me; I have
> about Medtronic "no delivery" issues and excessive alarms. I am also not
 > thrilled about using two sites per change for the cgms and pump. If anyone
 > share their practical experiences with the Medtronic and make a
> I would appreciate it.
> .
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