I have a Tandem X2. You can update it over the internet like you do your phone. The X2 and Dexcom G5 will hook up together this summer. They are planning a suspend low feature for the end of the year and a closed loop (with the G6 in 2018). All will use the X2 not the TFlex. So if you are considering Tandem you should consider the X2 not the T:Flex.
As for going out of business, they could or they could not. No way to call it. But if they do other pump companies will be vying for your business.
Good idea. I now have a working 523, and two backup 522ās, so I feel I should be able to keep DIY systems running through 2020ās and beyond, hopefully long enough for D-tech companies and regulators to sort things out and produce something acceptable 
I have the t:slim G4 and love it. Iād been a Medtronic customer for about 15 years prior to switching.
While I do experience a number of occlusion alarms, they are 99% related to boluses. So what Iāve learned to do is pay attention during the bolus delivery, because once I get the confirmation that itās complete I am confident I wonāt run into other occlusion alarms. Plus, they rarely represent a real issue with the site, but rather seem to be related to the tubing being coiled up.
Good luck with your decision and hopefully your insurance will change its stance on CGMs.
@Pipli. You are much more accepting of the t:slim occlusion alarms than I am. I have been on the X2 since mid-December and frequently get what I call #FakeNews occlusion alarms. Not once have I had a true occlusion and all I have to do is Resume Insulin. I have reduced , but not eliminated, the number of alarms by rarely keeping my pump in my pocket and using a Nite Ize Hip Clip to wear it on my waistband. In that I never had an occlusion alarm in my previous 12 years of pumping with Medtronic and Animas, I consider it a significant drawback to Tandem pumps. However, I do like the pump in most other ways.
I was on Accu chek combo. Although they didnāt go totally out of business, they quit selling pumps In the US. However, I was told that pump manufacturers have to service users with suppliesome for 7 years.
By the way I went with T flex and Love it!!! Very compact easy to use.
Laddie, as a medicare 630G patient/customer, I think I can add a little info to what is a somewhat complicated process about eligible upgrades.
First: No matter what brand, or (approved) model, Medicare actually leases the pump, in your name, for 13 months. At the end of that time You are given ownership of the Pump itself. For the remainder of the 5 year contract period Medicare provides your supplies (Infusion Sets, Etc.) and your necessary insulin. Finally they, together with the manufacturer, provide a warranty that takes you out the full 5 years.
Even though the 670G may not be medicare approved yet, once you own the pump, then you are fully elegible to participate in the manufacturers Upgrade plan. As an example I am already registered in The Pathway Program for the 670G, and as soon as ownership transfers to me I will upgrade. Standard upgrade Fees will Apply.
In the case of the 630G to 670G upgrade, there is a further wrinkle. Like all Medicare clients I received only the Pump, none of the CGM materials. However, Medtronic wanted me to upgrade to a complete system. In other words, pump + CGM (630G) to match the mandatory pump + CGM of the 670G. This mandated that I purchase a complete Guardian-Link Transmitter Kit. Once I was recorded as purchasing the Guardian, I was placed on the priority wait-list for the 670, pending the final Medicare Lease payout. No sensor purchase was required, and that part of the system does not have to be operational, just fully capable. The Guardian transmitter is not an inconsequential purchase, so as someone who will be āself-fundingā I am now saving up for my first go round of Sensors. In my case, I want to use the current system to learn what CGM is operationally all about, so that when the 670G, with itās new advanced Guardian 3 Sensors are available, hopefully, I will know what I am doing.
Hope I have added a little bit of knowledge, and not muddied the waters too much. Please realize that all of this is one persons understanding of this particular set of circumstances, and if I am in error in any way I apologize in advance.
Best,
ALB
After a lot of back and fourth, we went with the Metronic 630G for our daughter as a standalone pump, sticking with Dexcom G5 CGM. For us monitoring a two-year-old with diabetes the Bluetooth Share feature of the Dexcom G5 was mandatory and something the Medtronic CGM does not offer. In addition, I really like the idea of being able to upgrade to the 670G for significantly less if itās approved for children in the near future.
Our insurance had no issue allowing us to get the Medronic 630G as a standalone and us continuing with the Dexcom CGM. Ironically we had to jump through all sorts of hoops, however, to get approved for the Contour NEXT glucose meter test strips, for the meter integrated with the 630. While I love the accuracy of the Contour NEXT, the test strips are significantly more expensive through our insurance, which I didnāt know, and our insurance didnāt originally want to approve it. After an appeal and some paperwork they eventually did; and as it goes with diabetes supplies allās well that ends well.
I JUST upgrade a week and a half ago from my old Revel 523 to the 630 which is really just the pathway plan to the 670. Honestly, itās been a week of frustration, tears, and ridiculous blood sugar levels (partly due to stress, partly due to the cgm not being ANY BETTER than it has been in the past). I hate it. hate it. hate it. Iāve been through 3 sensor failures in 10 days with 3 different calls to Medtronic. Iāve been using Enlites for almost two years now. Iām no stranger to calibrating and using a cgm. But itās been awful. Yesterday and today were the first good days Iāve had with the CGM. Iām writing everything down- my blood sugars according to my meter, and according to my CGM, and when Iām calibrating. Documenting everything. Honestly, I wish I had never upgraded. What I WISH I had done was stay on my 523. And switched my CGM from Medtronic to Dexcom. Iām giving this new pump until the end of this week and then mailing it back. I think I can within 30 days of purchasing it without being penalized. Although this is Medtronic weāre talking about. So Iām a smallish person and I donāt need the large pump that the 630 is and the 670 will be. Itās bulky, and heavier. I use 1.8 ml reservoirs which my smaller 523 accommodated quite nicely. Now Iām stuck with a device that is made for 3.0 ml reservoirs. I donāt need that much insulin in 3 days so now Iāve just got a lot more pump sticking out of my waistband.
I was SUPER excited about the new 670 and the new closed loop basal system, but you know what? ALL the pump companies are coming out with their own versions in the next couple of years. Also, I upgrade to the 630 in hopes of starting the 670 before the end of May (Iām moving to a different state), but it doesnāt look like that will happen. What I wish I had done was skip this whole stupid 630 step. Itās a crap pump. The 670 will be the exact same style so if the size doesnāt bother you and you are looking forward to the closed loop system my advice would be to wait it outā¦
Also, 4-5 nights in a row of my threshold suspend alarming me and shutting my pump off because it thought I was at 50 when really I was in the 80-90ās didnāt help my mood much either. Less alarms last night, but still work up 2-3 timesā¦
Now THAT was a really helpful post @Rphil2, thanks for the link. Iāve been going through the exact same set of criteria in trying to decide between the various options or hold off for a year or soāmy current old-style Paradigm is actually a replacement for one that broke down last August, so should be good for a while though some have said itās likely a refurbished one not a ānewā pump per se.
Your blog post helped me narrow it down to two choices: wait-and-see or go ahead and pull the trigger on the M-t deal. In particular Iām feeling a lot of resistance about switching from Dexcom to Enlites (and then to Guardian 3). Itās not just a question of accuracy though thatās a big part of it, but Iāve developed a lot of my D practice around the G5āhaving the readings on my phone, being able to watch them while biking, having that nifty GlucoGram app on my desktopās status barā¦ The M-t rep told me that, at least as regards monitoring my bg while biking, the 670G will eliminate the necessity, which is a nice promise and maybe true but thatās after I make the transition from the 630 and (presumably) spend weeks getting everything dialed in. And just the whole business of this degree of changeāin my experience it rarely if ever goes as smoothly as promised.
Sounds like youāre doing ok with it though, so thatās encouraging. They told me I basically have to decide this week in order for them to get everything processed w/my insurance company before the Apr. 27 deadline. In the end it may come down to a coin tossā¦
@DrBB ā What if you wait until the 670 is available to the general population? When do you think that might occur? You could avoid the 630 interim pump and also jump straight to the Guardian 3 sensor. Could that possibly include an upgrade path with incentive to the successor to the 670?
This is a complicated dance and I think the advantage is on the side of the buyer at this point. I could be wrong. Good luck with whatever you decide. Iāve always enjoyed taking delivery of new D-tech.
DrBB I have only used two of the current versions of the Enlite, but so far I have been extraordinarily pleased. I have been so skeptical, but honestly, this version of the transmitter has been doing really well. I am doing a 30-day head to head with the Dexcom and I will be surprised if there is a significant difference in the two.
In 9 days now I have used the sensor cross body with only one dropped signal and it picked right up and only required that I acknowledge it went offline.
As for the 670G, of course, I do not have first-hand knowledge, but I have visited with two people who are in the trial. If half of what they say is true, I am sold. I cannot wait to get the new 670G.
When the 670g was announced I was amazed at the possibility. But I reminded many it is the sensor / transmitter that had to improve. With what I have experienced so far with the current generation sensor/ transmitter I believe it is very possible that it has.
Ditto for me. Except the occlusion alarm bothered me enough that I returned the pump (new and in warranty) and think I have settled on the Omnipod. Nothing is as perfect as our childhood functioning pancreas but I do love not being tethered. A second back up old pump is great to have.
I just got off the phone with Medtronic apparently I can only get the MM 630g so I really got a choice of
MM 630g or TSlim X2
Medtronic told me the same thing - āyour warranty is up, so you need a new pumpā. Mine had been upgraded 4 months prior!! I suggest asking Medtronic to request approval only from your insurance company. That approval can sit there for who knows how long? That was enough warranty for me!!
I have had a pump fail, and went back to using Lantus for a period of time until it was replaced, which took less than a week. But think about it: if you have a new pump under warranty, and you lean over a campfire, and your pump falls into the fire, will your health insurance company pay for another new pump? NOPE. But if youāre out of warranty, and your insurance company has already approved you for a new one, then just pull the trigger when/if you need to. Medtronic is then motivated to send you a replacement pump asap (they donāt want you to jump ship!).
It was explained to me that Medtronic pumps do a self-check every 5 minutes - at least thatās what I recall. So, if it has a bug, youāll know. PLUS, thereās the added benefit of reducing the cost of your Healthcare expenses, which is (in my humble opinion) something we should all do.