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

From:          "Eric W. Schmidt" <email @ redacted>

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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