Pump change questions, medtronic Pumps, cgms, and "New Technology Guarantee"?

Diabetes Technology Insulin Pumps
1

Hi,

I have just joined tudiabetes to try to get some info about pumps. My apologies if this post rambles a bit or is in the wrong place. I have had t1 for 12 years now, and currently use a minimed 722. My 722 is out of warranty and I have new insurance, so I had been thinking of getting a new pump. I had used the minimed cgm with the 722 for a while, but the transmitter battery died after its warranty expired and I was NOT going to pay out of pocket for a new one that also might only last a few months, so I have not used the CGM in a while.

Minimed called me out of the blue 2 days ago to offer to upgrade me to the revel. They said they would check with my insurance to figure out coverage for new durable medical goods and then call me back. They also mentioned a "New Technology Guarantee" that if new technology is released, you will be upgraded free of charge. But the first woman I spoke to was relatively vague on how this would work.

The next day another medtronic rep called me back and said something like "hi we got approval from your insurance and doctor, so we will send you your new pump tomorrow" and I responded that I had NOT agreed to get the pump yet, just to get more info, as I am not sure I want to stay with minimed and wasnt clear what this new technology guarantee is.The woman seemed annoyed that I was not just passively accepting this upgrade and so we agreed that she would email me info and we hung up. Her follow up email says that "You will have 60 days after the launch of new technology to do the exchange, whenever that is. There is no date at this time that this will become invalid. So, if we were to get new technology in the next 6 months, you will be eligible for the upgrade, as long as you do the exchange within 60 days of the launch of new technology, if that were to occur."

'There is no date, at this time, that this will become invalid' suggests that medtronic will just arbitrarily decide the program is no longer supported. Right? This seems like a sketchy program to get you to buy a pump NOW.

I found the 722 cgm system to be a big hassle to use. Sometimes it was very valuable, but I often found that its value did not exceed its annoyance (plus it stopped working and wasnt covered). The veo/enlite system that is being evaluated by the FDA right now seems like it might be an improvement. I would NOT want to get locked into essentially the same cgm again, with the revel, and then not be able to upgrade for years. If Im potentially not going to have access to the new systems, Id rather wait with my current paradigm, which works fine, and upgrade when the new one comes out.

I know very little about other pumps. So if I wanted to explore other pump options, Id love some recommendations? I worry that if I went to the dexcom cgm Id lose the receiver. Id definitely forget my pump sometimes if it were not attached to me. What pumps do people find convenient to use with the dexcom?

Thanks for any help!
-Chad

2

hi Chad, I'd like to invite you to join us this afternoon for a live interview with the CEO of Dexcom, if you have questions, you can ask them in advance on the invitation page here:
http://www.tudiabetes.org/events/live-interview-with-terry-gregg-president-and-ceo-of-dexcom-inc

3

Seems like the new technology guarantee is medtronic's way of assuring people to go ahead and buy now and not worry about missing out on the upcoming Veo (may launch later this year).

I think the CGM part only locks you in for a year but of course the upcoming Low Glucose Suspend feature won't work without it.

I carry my Dexcom receiver in a case on my belt so losing it is not a concern for me.

4

Typically MM has always offered an upgrade for 'new technology', that they call the Pathway Program, but it usually included a charge, and rebate back for turning in your old pump. It was also only valid for pumps under warranty.
They are not actually offering you an 'upgrade'. You are basically buying a new pump. The only difference seems to be no mention of cost to do the 'trade-in', that was previously called Pathway, and valid for only 60 days after the 'availability'. (Pathway was valid as long as you had an under-warranty pump).

Currently MM is the only company with a single device for pump and CGMS. That will soon change when the Dexcom / Animas Vibe is FDA approved. I think it sounds like MM is trying to get you to stay with MM, and not be tempted to wait for the Vibe, or other options.

But Animas is offering a similar program, in that if you purchase the current model (Ping), you can upgrade to the Vibe when it is released, I think for $99. They might also be offering a rebate if you are switching from another pump brand as incentive to switch.

There are many discussions on the various pros/cons of MM and Animas, and CGMS, under the Groups.
For many, having one device is a deal-breaker, so MM is the only current choice. For others, tubeless is the deal-breaker. And for requiring a waterproof pump, Animas or Omnipod is often chosen. Tslim is a new pump now available, and Roche Spirit is also available.

Most are equivalent in the actual pump features regarding insulin delivery. So each person needs to determine the 'extra' features that are most important to them. Insurance coverage may also be a deal-breaker, as some insurance plans may approve one brand but not another, or cover them at different rates.
There have been some who report their doctors will only prescribe a certain brand, which is the least important reason ! However, their opinion may be valid to consider, if they can back up their reasons of why a particular pump is or is not good match for you.

If possible, try to meet in person with a rep (or your Health care team) for a hands on demo of the products you are interested in. In some cases you may be able to get a trial period.

Personally, I use MM 523 with Dexcom G4, and prefer having 2 separate devices. I previously used MM CGMS for 2.5 years, but now use Dexcom and find it more accurate and convenient. I will consider the Animas Vibe when it becomes available, as my next pump.