Animas Vibe with integreated Dexcom CGM or Medtronic Paradigm Veo with CGM

Hi,

I'm a MDI diabetic with insulin/carb ratios of 1:3 (breakfast before 6 am), 1:4 (breakfast after 6 am) & 1:5 for lunch and dinner. I use Humalog for rapid acting & 35u of Lantus at bedtime. My endo highly encouraged me to go with a pump that has integrated CGM. So the OmniPod is out. There were some other concerns with the OmniPod that were leading me to discount it as an option.

As I'm in Canada I'm looking at the Animas Vibe and the Medtronic Paradigm Veo with the enhanced Enlite sensors (2nd generation of the Enlite sensors I believe). I've tried the Dexcom G4 as a separate unit and was satisfied with the performance. I don't know how much better the enhanced Enlite sensors will be over the original Enlite sensors.

Cost may be an issue if my insurance doesn't cover CGM. If I have to pay out of pocket then my decision will be based on cost. I know the Dexcom transmitter is said to be good for 6 months & the sensors good for 7 days (official statements from Dexcom). My personal experience with the G4 was 2 weeks before I had to remove the sensor because the adhesive was no longer adhering to my body. The Medtronic transmitter is warrantied for 1 year although the rep. said many people were getting 3 years out of the transmitters. The official statement is that the Medtronic sensors are effective for 6 days although some users have indicated they are able to squeeze 10-12 days from the sensors. I would appreciate if users could give me the actual usage they are getting from their transmitters and sensors.

I have read that the Enlite sensors are not nearly as accurate as the G4 sensors and the Enlite sensors have significant variances in performance and longevity vs the G4 sensors. Hopefully the enhance Enlite sensors don't have these same issues or the variances are significantly less. I've also read that the Medtronic gives a lot of false alarms and loses signal with the Enlite sensors. Is this true. What is the range for the G4 sensors with the Animas Vibe. Any insight on this would be appreciated.

Finally, there are aspects of the Medtronic that appear to be more appealing to me vs the Animas Vibe pump. Less button pushing and fewer menus with the Medtronic, better blood glucose meter integration (I've read the Bayer Contour Next Link USB is one of the more accurate meters out there and the ability to get the pump with 300u insulin capacity. In addition, I have read the Animas doesn't really hold 200u of insulin, more like 180-185u of insulin. Is that true. The Animas also isn't able to display carbs without actually going into the Diasend software. Is this also true. Finally, I think the Medtronic with a USB connection (Bluetooth?) to the computer is preferable to the Animas' infrared connection. How does the Animas software compare to the Medtronic software.

In addition, does anyone have any insight as to customer service/support, warranty coverage, upgrades, etc. for either company? Is there anything else I'm missing or should consider?

Finally, please note that I cannot try the pumps before buying although the Medtronic offers a 90-day return policy. Animas also does, but specifically with respect to the Ontario assisted devices program (don't know if I would qualify). However, the Animas rep was a bit non-committal regarding the 90-day return policy if the pump was bought through private insurance.

Sorry for the long post, but I asking for advice as to users' experience so that I can determine which pump with integrated CGM best meets my needs.

I use the Animas Ping + the Dex G4 CGM. I've used many different Medtronic pumps in the past. I know the G4 is more accurate than the MedT CGM. I've heard from MedT CGM users that the sensor diameter is larger and more painful. I've also heard from satisfied MedT CGM users here.

I upload my Ping, Dex, and Accu-Chek meter to Diasend, the web-based diabetes data aggregator. The reports are useful and help identify actionable data. MedT does not work with Diasend. That's a big influence for me but others may not value data or Diasend as much as I do.

Animas makes a durable and dependable product, even if the button pushing is a tad excessive. I can't read the screen in bright sunlight. but a lot of our D-tech gear fails that test.

I only use about 40 insulin units/day and I like to change set/sites every three days so I can handoff from one fully absorbing site to another. This makes the reduced reservoir size, about 170 units, a non-issue for me.

It's good that you spend some time with this decision since you have to live with it for at least four years. You could get the MedT pump and the separate Dex G4 CGM with external receiver. That might be a good combination for you. While awake and alert you could just use the Vibe and then at night you could use the Dex receiver. It would be the best of both worlds.

I like being able to position my G4 receiver so that I can hear it at night, rather than it being buried under layers of blankets. I've slept many hours while my insulin pump was beeping under the covers to let me know I was down to the 20 unit mark. I set my low BG threshold alarm low so I don't want to miss it when I go below.

Enjoy your new gear, whatever you decide.

The old Medtronic sensor was the one with the gnarly large needle. The Enlites are really easy to insert. I've had very nice results with the Medtronic although I have the 523 rather than the 530G w/ threshold suspend, which required an extra letter from my doc. I don't want my pump turning itself off. I don't use the meter integration either, as it engenders more button pushing on the pump so I turned it off. I think the Medtronic connection is via an RF USB receiver rather than plugging the pump directly into the computer. I think a lot of people get 14-21 days/ sensor with the Dexcom which might make a big difference over the lifetime of the sensor and contribute to a significantly lower cost. If I were out of pocket, I would probably calculate it out with a spreadsheet or something. Even if they "only" last 14 days, if they were the same price per sensor, tht could be a big difference.

There have been studies and tons of posts showing the Dex to be more accurate but I am very skeptical that the difference is much more than say a .285 hitter vs. a .300 hitter. I have gone days of +/- 10 mg/ dl with my meter and don't see a Dexcom being a huge game changer there. I'd like to try a Dex and see if it might work better but I've been saying that for years and never get around to it.

The Enlite had been replaced in Canada with the enhanced Enlite. FDA approval will probably delay its release in the USA.

The cost saved by using of Dexcon sensors beyond the rated 7 days is absorbed by the additional cost for the transmitters in relation to the costs associated with Medtronics CGM.

In order for the Dexcom to be cheaper using a 5 year cycle equal to government & private insurance coverage in Ontario the Dexcom transmitter would have to be good for at least 9 months and the Dexcom sensors would have to last at least 14 days. This is assuming 2 Medtronic transmitters & only 6 days for the Medtronic sensors. However, if the Medtronic sensors are good for an average of 9 days then Dexcon sensors would have to be good for 21 days on average, assuming all other variables remain constant.

Both are solid pumps although I must put in a plug for the Dexcom. I really like the Express Bolus button of my medtronic but when it comes to CGM, accuracy is the whole ballgame, so overall I recommend the Ping for an integrated pump/CGM system.

actually, given your daily insulin requirements, you may really appreciate the larger reservoir of the medtronic

Hello, Crazyivan. I selected the Dexcom over Medtronic after wearing both sensors at the same time and comparing the results. I was after accuracy as the critical decision in which one I would select.

As you know, the Vibe is still not available in the US where I am. So I'm waiting for it anxiously.

I found a site that you might want to read. It is written by Gary Scheiner and he compares both sensors (Vibe vs Veo.) Hopefully you will find it helpful in your decision-making. http://integrateddiabetes.com/sensor-vs-sensor/

Thanks. I have read the report on the quoted website. I was hoping that by posting there would be some insight as to the new enhanced Enlite sensor. I'm leaning towards the Vibe because of the Dexcom CGM - longer lasting sensors practically speaking & sensors that are more accurate & with less variances in quality control. Basically, I still think I would prefer the functionality of the Medtronic, but the Animas is winning for its CGM integration and the web based software.

The Animas rep. stated I could simply refill the insulin storage with more insulin and still use the same infusion site, although it would be nice to just get a larger capacity reservoir.

A nod to Dexcom which has just been approved to use even more accurate algorithms.