I’ve decided it’s not for me, but I’ve been toying with the idea of trying it, knowing I’d likely return it. I’m very curious, but know full well I’m not the target audience. I respond very well to evidence, though. My mind can be changed when I see it work.
I don’t understand the choices they made and the marketing that makes it seem even more unappealing. Like, the CEO has done a few interviews, and he flat out refuses to discuss glycemic statistics. He says he doesn’t even know them. (I call BS on that one, instant negative karma points.) He says if you’re worried about the numbers, then this pump isn’t for you. How many of us don’t care about the numbers??? He’s really pushing the system as “easy”, but not “good”. That certainly doesn’t groom excitement! At least not where I’m sitting. Except I’ve read the study, and the numbers really aren’t that bad. They’re pretty much on par with all the other systems.
The reality is that no clinical trial of a commercial AID system has gotten the average person into the 70% TIR and HbA1c below 7 goal yet. Not even my preferred one. They’re all hovering just above the target. Every single one. Of course, if the statistical average is just above target, it means that slightly less than half of the users are actually IN TARGET and having great success. It makes it pretty easy to cherry pick pretty examples to show how great it works.
I think you’ve really got to look at the nuances of a pump and see what makes them different. What do they offer that can take you from the wrong side of average and put you into the successful side of the equation? And what if you have loftier personal goals than 70%/<7? Do any of them have features that can help you excel, not merely succeed?
I’m what they call “brittle”. My insulin needs change drastically day to day. I believe the ability to set basal rates, and more importantly change them, is paramount for my personal success. I will never choose a pump that takes that away from me. I believe insulin delivered BEFORE it’s needed will always be most effective. I believe I know more about my diabetes and insulin needs faster than a feedback loop of sensor data does. I want MORE control of my devices, not less.
The other deal breaker for me is the fact that you can’t bolus at all, even if you want to. You’re completely at the mercy of the automation. Sure, if you want to correct, you could tell it you’re eating (just like entering phantom carbs on Medtronic), but that waters down the algorithm. That’s teaches the pump your meal input isn’t actually worth much, since you didn’t have a spike in insulin need. I can’t just sit there and suffer while hoping the pump figures me out someday.
I don’t need easy. I need the darned things to do exactly what I tell them to do and have to have my back when I’m not paying attention. I hate when professionals and product designers treat me like an imbecile. I’ve actually been told on the phone by my insurance company “oh honey, that’s not for you to worry about,” when trying to advocate for myself and what I need. The h3ll it’s not! It’s my body, my diabetes, and my life. I feel like this pump speaks to me in that same patronizing voice. “Oh honey, we’ll do all the thinking for you, just shut up, sit back and take what we give you.”
In my personal opinion, AndroidAPS with unannounced meals and dynamic ISF is algorithm perfection. Unfortunately, there’s limited options to pair it with. In the US, only Omnipod Dash, which doesn’t work for me. Control-IQ is the closest commercial algorithm, but by a long shot. I’ve seriously got my fingers crossed that Control-IQ 2.0, which is just wrapping up clinical trials now, will bring a lot of those AndroidAPS benefits to the table. Or that the upcoming Mobi will be AAPS compatible and I can go back.
