Well here I am again just one year out from replacing my pump.
At least now there is a choice. I see that the Animas Vibe has integrated CGM. Three Years ago I went with minimed because it was really the only option. I like the minimed pump and the new sensors are fine,but I miss the dexcom,
I always liked the dex sensors better.
I am a little worried about the new system though. Has anyone use the Vibe and Dex combo?
Minimed says next year the pump will be stripped down and totally controlled by a smart phone. I like the idea but I know there is no way its coming in a year.
Pros and cons of the Vibe anyone?
I wont even consider a pump without CGM the other companies have to step it up and get a CGM built in or I am not even looking at them on principal.
Tim, Type 1 26 years, no complications to speak of
The new Vibe is interesting but doesn't have the current top-of-the line Dexcom (sorry,I'm not 100% sure of the nomenclature...) and isn't upgradeable, I guess the current best one can get upgraded algorithms or something like that but that doesn't work with the Vibe dexcom unit, because the geniuses at the FDA take so long to approve things, they can't keep up with pump manufacturers. I don't think the Medtronic 640i or whatever that's called has a cell phone but it might make the data available there or something?
There is a "homegrown" rig called Nightscout or CGM in the Cloud for both Dexcom and very recently Medtronic. That isn't approved by the manufacturers but uses a phone to rip the RF signal from the transmitter to a phone which, in turn, uses an app (I think?) to make the data viewable remotely so parents can keep an eye on their kid's BG.
I also heard that the T-Slim Dex combo should be available in the not too distant future, possibly as early as this summer.
Unfortunately the t:slim will also be tied into the Dexcom G4 platform. I spent the last two years convinced that I wanted my pump integrated with my CGM, but I am starting to reconsider. Dexcom seems to be constantly improving and adding more features, so why do I want to be restricted to an old platform?
I am considering canceling my upgrade to the Vibe, but haven’t totally decided yet. Many people have received their Vibes but I haven’t heard a peep from Animas. The longer it takes, the more apt I am to cancel.
I am somewhat baffled when you say "Minimed says next year the pump will be stripped down and totally controlled by a smart phone." That does not seem to fit in with what I have read so far about the upcoming Minimed 640G (not sure about the Minimed 670G supposedly coming after the 640G.)
-irrational john T1 LADA since ~1978; first pump: Minimed 507 ~1997, currently using Minimed 723 + CGM
The ability to upgrade the built-in CGM on the Vibe has virtually nothing to do with the FDA and much more to do with how the HW and SW work on each of the main components (pump/CGM).
It's also interesting to see how some pump manufacturers have gained FDA approval in much shorter time frames than others. So, if the FDA can move quickly with some companies, why can't they do so with others? Could there be a different mindset in play, where some companies expect to have a high barrier to cross and therefore get one?
I would stay with your current pump for another 6 months + if you possibly can.
Tandem is supposed to come out with their integrated T-SLim + Dexcom unit this year. They have been ready to do it but due to a time limited exclusivity clause, Animas has 6 months before Tandem can release it.
This means that most likely, the new Tandem pump will be available in July-August of 2015.
The fact that Tandem has the highest dosing precision and resolution on the market along with a host of other incredibly useful features means that they are also the most suited to benefit from this upgrade, in my opinion this makes them a perfect fit since like Dexcom they are also striving to evolve their product to better help people with D.
Also of note, Dexcom is able to move more quickly through the various approvals and regulations as well as making iterative improvements over the life of their product because it is a passive device. It is not putting anything into your body that is potentially harmful (like insulin) so things will naturally go smoother.
One last thing to consider: Dexcom is making the move to eliminate their hardware very shortly and switch over to smartphones as their receivers. This means that you will only need the main sensor and transmitter itself and then your cell phone. They did say that they will still have available the main receiver units like they do now as a "backup" though for any that are concerned. This is still a couple (hopefully short) iterations away, so most likely a 2 year time frame. The last part of the puzzle with Dexcom is that they for some reason insist on only supporting IOS devices and have made no move toward openly supporting the Android platform yet.
Except, in terms of the integrated pump, you are buying like last year's, or maybe a couple years removed Dexcom. I though too that in the same timeframe, 6-12 months, there's another new Dexcom which is also in the works so then your pump will be chained to a Dexcom that's 2G old. I suppose that if the old ones work well enough, they are ok but also think that many people want the latest gizmo to stick into our bodies. I have a very hard time deciding to do anything so, if something newer is coming, I will often sit on my hands...
These days, things are happening more quickly with diabetes hardware and software. The Animas Vibe took three years to come to the US market after it was introduced in Europe.
In the meantime, Dexcom has been moving forward. The company introduced the 505 software upgrade to its stand alone CGM. It was free for all US Dex G4 CGM users. The 505 upgrade was rated with a 9% MARD (mean absolute relative difference), a measure of accuracy where lower is better. The CGM embedded into the Vibe has a MARD of 13%. Thirteen percent is still a respectable number but Dexcom shoots for FDA approval to use the Dex 505 system to make dosing decisions. Many people are in fact using the Dex number to treat lows and take insulin to correct.
When you think about upgrading your pump, I'm sure you realize that people that depend on insurance coverage to finance the purchase will be making a four-year commitment to that platform. You may feel trapped in an older technology as the marketplace speeds ahead in the next few years.
Dexcom, just last week, announced that they will be releasing the next iteration of the Dexcom Share technology called Dexcom Direct. As I understand it, the Direct system will allow Blue Tooth radio waves to talk to an iPhone and display your BG readings and bypassing an investment in the "share cradle." This will permit up to five people to follow your realtime BG trace. Dexcom expects deliveries of this tech in March 2015. There is even talk of Dexcom releasing it's G5 product this year.
To summarize, D-tech is changing more quickly, especially on the CGM side. While the Vibe may be adequate to do the job for you, you may want to hold back and maintain some flexibility to choose a more attractive and newer tech in the not-too-distant-future.
I canceled mine because I called several times and they could not give me a delivery date. Also just met with my diabetes nurse and she said they have not seen an Animas Rep and does not know who or if they have one now.
I am thinking about leaving Animas for the TSlim when my pump is due to be replaced. It is too bad because the Ping has been rock solid. My first Ping lasted over 5 years with out an issue. The current Ping was just replaced due to a clock issue - that did not really affect the pump function. Everytime I took out the battery, I would lose the time and date.
I have the Dexcom G4 and love it - and also like the fact I do not have to use if I decide not too.... and will get any software upgrades.
I got my vibe yesterday and I don't hate it. I don't love it, either, but it doesn't bother me and it's nice to not worry about forgetting my dex receiver at home/in the car/in my jacket. If I wasn't already on the ping before switching over to the vibe, I probably wouldn't bother with it, but it's a solid machine.
As a Dex user and Medtronic pumper, I am concerned about going to smart phone management. Phones are bigger and clumsier (for my small hand). I like punching the pump and the Dex cgm as they are--small and easy to use. Call me 'out of date' if you want but I can see many problems with using a smart phone. I am guessing that not all pumpers have smart phones. I know at least one! I have been 'planning' to get an iPhone for a year but the larger size keeps me vacillating. And I don't want an older version.
I do not want an integrated pump/cgm system. From what I read, the T:slim requires a lot more steps to use than Medtonic. I think the pump/cgm world is passing me by.....!
Not to mention, some people still do not have smart phones! I hope that they continue to offer stand alone hardware devices. I know that someday I will not have a Verizon account and will be using the pay as you go phones...Plus - what would this do to data charges, etc. I see a whole host of issues. Plus - everyone seems to be starting with IPhones. Many of us are Android based phone users. So - there are lots of issues.
I know that someday I will not have a Verizon account and will be using the pay as you go phones...
This is a complete digression from the topic but ...
I currently have what I originally thought would be a "Pay As You Go" mobile phone account with Verizon. In hindsight it appears there is an uncorrected typo in that description.
The account is actually a "Pay Or You Go" account.
Apparently the only way Verizon can know that they should keep your account open is by billing you periodically. While this makes no sense to me, certainly Verizon would not misrepresent the situation, would they? For Verizon is an honorable corporation, right?
So even if you don't use the phone you need to keep paying into the account to prevent Verizon from closing it. I'm sure it all makes perfect sense in some way that I am just unable to understand. At. All.
Call me 'out of date' if you want but I can see many problems with using a smart phone. I am guessing that not all pumpers have smart phones.
To clarify, what a potential future Dexcom G5 might be able to communicate with and utilize is not a smartphone in the sense that it is not limited to a smartphone.
The Dexcom G5 transmitter might include an embedded low power Bluetooth chip which would enable it to communicate with another Bluetooth device which is running an "app" which could connect to & read data from the sensor. This app could store & display the data & potentially could also forward the data to "the cloud" as a way of sharing it.
Think of it as embedding the capability currently available using the "Dexcom Share" device directly into the G5 sensor transmitter. This would allow, but I expect not require, one to use a Bluetooth device either instead of or possibly in addition to a Dexcom handheld monitor device.
Certainly an Apple iPhone + app is another possible Bluetooth monitoring device, but definitely not the only possible pairing. Any of the other Apple ... and potentially Android or Windows ... devices could connect assuming someone writes an app which could "talk to" the Dexcom sensor's Bluetooth. In other words, you could also use a tablet or a laptop computer or a whatever.
Of course, exactly what options Dexcom plans to make available with the G5 won't really be known for sure until they start selling one. My guess would be that they will convert their current handheld monitors to use Bluetooth from whatever wireless connection scheme is currently used to connect to the Dexcom transmitter. But the truth is the only way to know is to wait and see what happens.
The only informed speculation I am aware of at the moment is in this Dec 2014 (?) interview with Terry Gregg. (Can anyone point towards other sources of info?)
For whatever it's worth, that interview includes the following speculation:
MDO: What is your timeline for the Gen 5 product? Gregg: We are going to file the premarket submission with the FDA in the first quarter of 2015, so I would expect a product introduction late in 2015 or early in 2016.
While this seems rather optimistic, it is still a date you can "count down" to if you wish. ;-)
-iJohn
P.S. I also don't feel I can use a smartphone, but for the opposite problem. My hands & fingers are too big and the phones too small. I can't ever seem to "touch" the single point I want to and so find a phone sized device's interface really annoying to try to use.
If I read this correctly, Dexcom no longer sells the "Dexcom Share" dock for their monitors. Instead, they will be updating their monitors to include an embedded Bluetooth Low Energy (BLE) chip which can establish a secondary connection between the monitor & an app on a suitably software enabled device (e.g. an iPhone or iPad ?).
Neato. The excerpt below is quoted from the Dexcom news release & describes when & how the new Dexcom monitor with embedded Bluetooth capability will be available.
About Dexcom G4 Platinum with Share:
The Share receiver is anticipated to ship to new patients in early March 2015.
All patients who purchased a Share cradle will receive a free upgrade to the Share receiver.
All purchasers of a G4 Platinum receiver from January 1, 2015, until the Share receiver is shipped, will receive a free upgrade to the Share receiver.
There will be a low cost cash upgrade to the Share receiver for those patients who are still under warranty with their existing receiver.
The Share receiver will be compatible with future generation Dexcom sensor systems.
One of the things which impresses me most about Dexcom is how quickly they seem to be able to execute change. (I'm used to Medtronic where change seems to occur on a geologic time scale.)
I just got my Vibe a couple of days ago. I was a die hard Medtronic user/fan for 11 years, and then switched to the Ping in anticipation of the Vibe coming out soon (ha!). Then of course, Dexcom upgrades to the 505 system, and now has the new Share platform coming available next month. For now, I will be keeping my Dexcom receiver active as a backup to my Ping. My two cents on the Vibe: as rudimentary as the sounds/alerts/interface may seem to some on the Dex, the Vibe is even worse. I don't need a flashy system, but something that is intuitive to use would be nice. The Ping system is horribly inconvenient and clumsy, and the Vibe, while including a couple of new features, doesn't do much to improve upon the Ping. And the CGM is just plain annoying! There are no differentiating alarm sounds like on the Dex, where I could tell what my blood sugar was doing based on the vibration sounds alone; the pump screen is too small to see much on the extended graphs, and there are too many sounds with the alarms. I have had a terrible night's sleep the past two nights because the Vibe was constantly alarming and making so much noise! (Granted, that was partly my fault, because I could have turned off the alerts but wanted to see how it would go and I had a bad night of highs.) And every time you bolus, it asks if you want to use your current bs as a calibration point, even if you're rising or falling quickly. I actually miss the 12-hour calibration prompts from my Dex! You also have to confirm when it alerts you to rapidly rising or falling glucose instead of just being able to see it and move on. And don't even get me started on the fact that you can't see your Dex info when your pump has been suspended. WAY too much button pushing to be convenient. It feels like a constant hassle. So far, the only plus for me is having one device that's attached to me anyway, so I can have everything at-a-glance. Lucky for me, my insurance will cover a new pump every three years, so I've only got to live with this one for about 16 more months if I choose to go another direction.
I'm a newbie to CGM and I have a T Slim on the way that will be my first pump. I just want to ask you Guys and Gals if you use the Dexcom for making any adjustments to your pump, or only after a finger stick?
After almost one year with our beloved Dexcom, I use the data it generates far more often than than I use finger-stick info to adjust pump settings. Doesn’t everyone? A finger-stick gives you an isolated data point whereas the Dexcom gives you trends and timespan data, which is undeniably more useful in adjusting basals, ISF, I:C, DIA, etc. IMHO, the two best “things” that have happened in this wonderful world of diabetes(besides the discovery of insulin itself, of course) are Gary Scheiner and the Dexcom CGM.
I love my PING and decided to cancel my VIBE upgrade for many of the reasons you state here. I think if it came out 3 years ago, it would have been the latest and greatest technology. But three years later, it is actually old before its time. And not being able to see data when suspending insulin delivery is a total deal breaker for me.
Am going to see what the TSlim looks like with the integrated Dexcom. Should come out about the same time as my pump warranty ends on my PING. Hopefully they thought about some of these issues that the VIBE has.
As a runner, it would be nice to have an integrated unit.
