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[IP] Response Re: Disetronic v. Minimed pump comparison

Many of you have provide feedback/comments regarding my comparison
between the Disetronic H-Tron and MiniMed 507C pumps.  I appreciate the
feedback, and wanted to address some of your questions and comments
regarding my post.

1)  Regarding the MiniMed audio bolus - I got some negative feedback
when I posted my comparison to the diabetes.com site, and I probably
should have qualified my statement better before re-posting here.  I
stated "I find the audio bolus on the MiniMed pretty useless", which is
probably the wrong choice of words, though it is actually how I feel on
the topic.  It really is not difficult to set and use the audio bolus on
the MiniMed.  But with the way I use and wear the pump, I found the
Disetronic audio bolus feature was much more convenient (for me).  I
usually wear my insulin pump in my front jeans pocket, and I found it
much easier to find the buttons of the Disetronic through my jeans than
on the MiniMed because of the design (buttons on top and dome shaped).
Also the button squence was easier to follow. I did try to use the audio
bolus on my MiniMed for a while, but I guess I was used to the way the
Disetronic worked and didn't like the way the MiniMed was set up (for
audio bolus, that is).  So I turned the audio bolus off and haven't used
it since.  Not trying to bash the MiniMed pump... it has lots of other
features that I like, just not the audio bolus.

2)  Timing of insulin bolus delivery - got some conflicting feedback on
this topic.  I have to admit, it has been a couple years since I used my
Disetronic, so I was just throwing out a ballpark figure.  Looking back,
I think the Disetronic does actually deliver faster than the 10 minutes
for 20 units I stated.  As for comparisons to other MiniMed pumps, the
timing I gave IS acurate for my 507C.  From the feedback it would appear
that there is quite a variation in how fast different MiniMed pumps will
deliver a bolus.  I am surprised to hear that some are at .1 units per
second... that just seems a bit fast to me (that would be 6 units per
minute!).  I just now sat down and timed how long my MiniMed took to
deliver a 10 unit bolus... it took about 8 min 20 sec, which would put
my 20 unit bolus example at about 16 min 40 sec, which supports my
previous post.  It would be interesting to find out what kind of
variability there actually is.  Perhaps others can post timings of their
MiniMed so we can compare notes and see how much this varies from pump
to pump.  If you are going to time a bolus, it would be best to post a
timing from a larger one, say from lunch or dinner, rather than timing
an individual click or two and extrapolating up from that (timing a
larger bolus will give a more accurate figure).

It is interesting to note here that you will find varying opinions on
which method is better... a faster or slower bolus delivery.  I actually
think that with LisPro (Humalog) insulin, the way the MiniMed delivers
might be a little better.  But to be honest I really never noticed much
difference in my 2 hour sugars between my Disetronic and my MiniMed.  I
suppose even if the Disetronic delivers the insulin more quickly, the
body still has to absorb it.

4) Why upgrade? - With the Disetronic H-Tron pumps, you get two pumps,
each with a two year time limit built in (that is two years of USE, not
an arbitrary date of expiriaion) for a total of four years.  At the end
of that four years, you can either get the pumps inspected and
re-programmed for another four years of use, or you can upgrade to a
newer model by trading in your old pumps, usually for a 20% discount
(which corresponds to the co-pay amount most people have to pay after
insurance).  I think both companies will accept the other's model as a
trade-in.  So it was a question of either keeping my old pumps, or
upgrading to a new model.  I am the type of person who likes to have the
latest-and-greatest, so I figured as long as my insurance would pay 80%
for the upgrade, I would go for it (plus both the newer models had
features which I thought would enhance my ability to manage my
diabetes).  I did get aproval from insurance for getting a new pump, so
I went from there to decide which company/model to go with.  Also,
anything with moving parts wears out over time (although the life
expectancy for an insulin pump is, I am sure, much greater than 4
years), so I figured why risk it.  For someone who was happy with their
pump and not interested in the new features offered, or if they couldn't
afford it or their insurance company would not approve it, the upgrade
might not interest them.

4)  Occlusion (or "no delivery") alarms - occlusions can occur from more
than just crimped tubing... they can occur with insulin crystalization,
blood clotting in the canula, canula damage (such as kinks), end of
canula pressed against scar tissue or muscle tissue, or a stuck
reservoir plunger.  When I performed the test on my pumps by crimping
the tubing with a slide-on lock, I was simulating a strong occlusion
(which could be caused by any one of the above factors).  It is
dangerous to rely only the occlusion alarm to tell you if there is a
problem, no matter how sensitive it is (although having a more sensitive
alarm might give you more peace of mind).  Regular blood sugar tests
should tell you there is a problem before you need to rely on an
occlusion alarm.  An exception to this might be if there is a strong
occlusion and a large bolus is being delivered... the alarm might go off
in that situation before your blood sugar results would show the
problem.  It sounds like the Disetronic D-Tron might have a more
sensitive occlusion alarm than its predecessor.

Best Regards,


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