DiabetesMine’s Mike Hoskins writes about his recent full day visit to the Bigfoot Biomedical facility in the San Francisco Bay Area.
In addition to the many user-friendly design features that Bigfoot is incorporating into its yet-to-be introduced products, it also intends to simplify the supply process using a subscription model. I, for one, would love to be relieved of this onerous, trying, thankless and yet crucial task.
For any fans of the now-defunct Asante Snap insulin pump, you might experience some nostalgia triggered by the Bigfoot pump hardware.
I really like the idea of using a pre-filled 300-unit insulin cartridge. I currently use an old Medtronic pump and fill its cartridge with 300 units of insulin. Since I use less than 30 units/day on average, I only need to refill the insulin cartridge every 10-12 days. I still change infusion sites every three days.
You wouldn’t think that reducing the insulin refill activity from every three days to every 10-12 days would seem like much of an advantage. I do sense and value reducing this task and it’s marginally improved my quality of life. Chasing and eliminating insulin cartridge bubbles wears me out! I like this Bigfoot design feature.
I recently had an appointment with a Medtronic rep about my frequent Sensor Updating messages, and one of the possible reasons they mentioned was the fact that I only change my reservoir/infusion set every 5-6 days (I have 300 unit reservoirs, but only use 40-50 units/day). They told me to only fill the reservoir with about 3-4 days so that the insulin is in the reservoir for as short a period of time as possible. I would love to be able to get pre-filled reservoirs, but that obviously wouldn’t work if I am forced to use all the insulin in a 300 unit reservoir (unless I am allowed to throw away 100 units or so every few days with every set change, and I don’t think my insurance would like that). When I still used the 530G (I now use the 670G), I had 180 unit reservoirs (I think my prescription was automatically changed to 300 unit reservoirs when my pump was upgraded), so I will pretty much need to start only filling my 300 unit reservoirs with about 180 units. It would be much easier to have prefilled reservoirs.
I think this is an argument intended to distract from the actual cause of the problem. They’re trying to troubleshoot a flawed pump design and put blame on something (a clogged infusion set due to a long exposure of insulin to a plastic cartridge) without any scientific evidence. The patient’s acceptance of this argument gets Med-T off the hook.
I’ve been filling 300-unit Med-T cartridges with 300 units of insulin for 28 months now and I haven’t experienced even one infusion set occlusion. It takes me 10-12 days to use that quantity of insulin. I believe that in most instances, the infusion site fails due to over use or mechanical kinking at the cannula tip. I don’t see insulin residence time as factor in my experience.
By the way, the Bigfoot system will use glass insulin cartridges and the whole insulin residence time/plastic/occlusion argument is moot.
The Snap used the same cartridges that are in pen injectors, and the model was that you’d still switch infusion sites every 3.5 days but reservoirs only every 7. So they provided a pair of infusion sets for each cartridge, one of which had a tube and one that lacked same, since you just needed to switch the same tube to the second set. They said it was the cartridges being glass that allowed this, because it’s inert, whereas insulin reacts with the plastic of standard reservoirs and loses efficacy over a few days. Clearly that doesn’t match with your experience, Terry, but for whatever reason I’ve never actually tried it, probably b/c it’s just one more system variable than I’ve felt like dealing with.
Since they basically bought Asante’s manufacturing assets when it cratered, yes, and why I’ve been viewing them with some interest and hope ever since then. Alas it’s starting to feel like a bit like that ever-receding “five years to a cure” I’ve been hearing about since 1983…
Turns out it was created originally for Asante Solutions by artist Andreina Davila, who with her husband (fellow T1D advocate Manny Hernandez) co-founded the Diabetes Hands Foundation and TuDiabetes. That stayed on the wall after Bigfoot acquired the former Asante facility, and it remains for a key reason: “It tells the story of the diabetes community growing together and connecting in the pursuit of better lives. Using semiology, the tree represents a growing diverse community of PWDs, industry and caregivers; while the blue circle (universal symbol for diabetes) represents global unity behind a common goal; and the abstractions of insulin crystals interconnect the tree and Blue Circle, representing the hope that technology can bring to the D-Community.”
I harbor more hope for the Bigfoot pump debut than I do for the eventual cure. Unfortunately, for those of us with skin-in-the-game stakes, these technology developments seem to emerge at a snail’s pace.
Thanks for the tip @Terry4. I just started with tandem and was a little concerned with the amount of insulin waste with each cartridge change (not as efficient as the medtronic pumps). So I went ahead and completely filled the cartridge with 300 units. Lasted about 10 days. BG’s were as expected so it didn’t seem like the insulin became less effective.