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Re: [IPk] Pump upgrade - what are the options?

Thanks for the comments everyone, and especially the update on the 640G,
Melissa. I guess my clinic won't let me wait another year to update my pump
(not sure why they should care though, to be honest - it still works, even
if it is a little battered now!) but certainly an exciting idea to increase
and decrease insulin automatically based on CGM. I guess I need to get a
bit more used to a CGMS to take advantage of that (after a 2 week trial I
hated it and found teh results not fully trust-able (blood going down when
it said I was going up etc) and exceedingly uncomfortable - far more so
than an infusion set. Partly I think because the sensor had to be in my
stomach (which I don't use for infusion sets) and was always in the way of
waistbands etc).

Anyway, I'll talk to the DSN and see what they suggest too. Please keep us
updated after the Vienna conference, Melissa, I'd be interested to hear a
rough timescale.



Date: Mon, 13 Jan 2014 12:08:59 +0000
> From: Melissa Ford <email @ redacted>
> Subject: Re: [IPk] Pump upgrade - what are the options?
> Hi Joel
> I think it may be some time (at least a year rather than a matter of
> months) before the 640G is launched. All the MM pumps since the 511 have
> had a first digit of 5 or 7 to indicate reservoir size. It is significant
> that the 640G has a 6 rather than a 5 or 7 prefix: 640G will offer not only
> suspension of insulin delivery when hypo (as the Veo currently does outside
> the US and the 530G will do in the US) but also an automated *increase* in
> insulin delivery based on high glucose levels. Using CGM to allow a pump to
> deliver more insulin rather than less is a big step towards closing the
> loop and it carries different potential risks as well as potential
> benefits.
> In the UK, Peter Hindmarsh (UCL paeds diabetes consultant) and Pratik
> Choudhary (King's College Hospital adults diabetes consultant) will be
> involved in a clinical trial of it - see
> http://clinicaltrials.gov/ct2/show/NCT01991548
> I should be able to get an idea of when Medtronic expects to submit the
> 640G for European regulatory review at the ATTD meeting in Vienna in a few
> weeks (5-8 Feb). If anyone wants to see what's on the agenda there, the
> website for the conference is http://www2.kenes.com/attd/pages/home.aspx
> All best
> Melissa
> On Mon, Jan 13, 2014 at 9:37 AM, Joel Milner <email @ redacted
> >wrote:
> >  I have seen flyer with a picture of the new MM640G. It looks very
> "sharp"
> > -
> > like a modern smartphone. It might be worth waiting for even if it is a
> few
> > months before it is approved.
> >
> >  I recently replaced my 5 year old MM522 with an Animas Vibe. Here are
> my 2
> > pence worth.
> >
> >  Comparing the Veo and the Vibe. The Vibe has a nice clear colour screen
> > which
> > is much easier to read than the B&W screen on the MM pump (which reminds
> > me of
> > an old Nokia 3310 mobile phone). Despite this there are many aspects of
> the
> > operation and menu system on the Vibe that are very poorly thought out
> and
> > make
> > standard operations like bolusing both time consuming and irritating. The
> > have
> > been some recent discussions about this on IP-UK that you might search
> for.
> >
> >  IMO, if I were simply choosing on the basis of pump ease of use and
> > convenience, there is no way I would choose the Animas, I would either go
> > with
> > the Veo, or wait it out for the 640G. However, I self-fund CGM, and when
> > you
> > factor this in the picture changes completely. The Dexcom G4 system is
> > fantastic. I find it RELIABLY as accurate as a fingerstick, easy to set
> up
> > and
> > straightforward to use. You only have to look on line at some of the
> > discussion
> > groups to see that this cannot be said of the Enlites. Also, I have been
> > getting
> > 2-3 weeks out of a Dexcom G4 sensor - I don't know anyone who has managed
> > more
> > than around 8 days out of an Enlite. If you are self-funding this means a
> > saving
> > of around #1200 per year.
> >
> > Joel
> > .
> > Follow us at https://www.twitter.com/insulinpumpers
> > Make a long URL short at http://type1.org
> .
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