What to replace my 523 with? (warranty up)

Diabetes Technology
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tl;dr Has anyone replaced their 500 series MiniMed pump recently and have any advice?

Background:

The warranty on my second MiniMed 523 just expired on Sunday, and normally I’d just get another one… but obviously Medtronic discontinued the 500 series.

I have and love my Dexcom G6 (and I will never part with it, no matter what) so I have no need for Medtronic’s CGM… and therefore have no loyalty to Medtronic or anything.

A year after I was correctly diagnosed as LADA (Type 1.5), I picked the 523g because I really just wanted a reliable pump and my CDE described it as “the Toyota Corolla of pumps”… nothing fancy, no bells and whistles, but reliable.

Overall, it had been reliable, despite some issues (I even found & reported a major flaw that resulted in a reservoir recall in 2013) but overall I can’t complain.

I have tried 2 other pumps, the Asante Snap (which I almost switched to, just before they went bankrupt!) and the T-slim: each time I participated in the Bionic Pancreas clinical trial at MGH in Boston.

I liked the T-slim a lot, but could not get over the arduous process for refilling it with insulin… that was basically a deal breaker for me.

I have never tried the OmniPod… but think it’s a great idea. I am a really slim guy, however, and my Dexcom G4 used to get caught on stuff all the time back in the day.

Anyone replaced their 500 series MiniMed pump recently and have any advice? Thanks!

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Early on, when wearing pods on my arms, I would round a corner and bump/tear it off, owie! I moved to my belly and until I developed scar tissue there, the belly worked. Back to my arm, thighs, and other places which didn’t work well. My arms, I must say are working out great. The past year or so I’ve kept them there and (knock on wood ten times over!) I haven’t lost one pod yet to rounding a corner too tightly. I guess I learned how to stay … centered! LOL. (Edited to add: OmniPod replaced any pod I lost due to bumping it off and today they will reimburse you for lost insulin. My advise is … I would ask OmniPod for a few sample pods, so you can try wearing it to see what it feels like and if you think you can manage it.)

I’m strongly considering the T-slim (control iq). Can you (or anyone who uses T-slim) explain the arduous process which kept you from switching to it?

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I have been on the T.slim x2 since August 2019 after previously using several Animas Pings, which I loved. Yes, filling the cartridge on the t.slim IS quite a process that includes extracting air from the cartridge with a syringe. But I quickly mastered the process and find that it is all worthwhile. The insulin goes into a plastic bag inside the cartridge. That is what makes the pump so slim. Also, the internet updatable feature of the pump is a huge plus. Recharging the battery every two days while I sit at the computer saves me a lot of money and also saves on disposing all those batteries. I have been using Control IQ for a couple of months now and find it to be amazing. Frankly, now that I am used to this very different pump, I believe I made the right choice, considering the choices available today in the U.S.

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Thank you both!

Indeed, the Control IQ is a huge draw for me… since I love Dexcom.
How do you feel about Basal-IQ? Is it pretty useful as well?

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I used Basal IQ for 6 months before Control IQ was available to me. It was alright. You do realize that you won’t get Basal IQ with your new pump. They are shipping only Control IQ. When I downloaded CIQ, it eradicated the BIQ. No going back. But that is OK with me because CIQ does an even better job of controlling lows than BIQ did. I am now running CIQ’s Sleep Mode 24/7 and it has made a tremendous difference. Still tweaking a bit here and there but am very happy with it.

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The direction for pump and cgms is to become interoperable, as explained here.

T-slim X2 comes closest to this, but future will have more choices to pick iPump, iCgm independently for AID (automated insulin delivery) systems.

There will be a Medtronic+Dexcom AID in a future Medtronics pump ( after 780?).

I will be switching from 523 minimed to Tslim soon.

You may have heard the big news late last week that FDA has created a new classification for insulin pumps designed specifically to be interoperable with different devices, and granted the first such designation to Tandem’s t:slim X2 pump.

This new category of “iPumps,” officially named Alternate Controller Enabled (ACE) infusion pumpsTrusted Source, aims to accelerate regulatory review and pave the way for new connected systems in which patients can pick and choose their pump, CGM (continuous glucose monitor) and even control algorithm.

For many of us, this is a super-exciting development (!) because it gets us one step closer to Automated Insulin Delivery (AID) systems nearing market (aka ‘Closed Loop,’ or ‘Artificial Pancreas’Trusted Source if you dare use the term) that have already been proven to help patients achieve far better glucose control with less guesswork.

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While this news is exciting, the details can be pretty confusing if you don’t know the lingo, and/or if you’re not exactly clear on how this could change the world for people whose lives depend on insulin.

There are also many questions about these modular, connected systems going forward: How will FDA review a system made up of a bunch of different components from different manufacturers? And what about Customer Support – will you know who to call if something goes wrong?

No doubt, there’s a lot to unpack here…

iCGM, iPump, iController

An AID system is made up of an insulin pump, CGM, and software (algorithm) to control the system. There’s currently only one company in the world that owns all three of those components so can put out a complete package under one brand – Medtronic, of course. Their 670G is a first early version, and their next-gen Minimed 780G closed loop system is expected by April 2020.

Meanwhile, everyone else is partnering up to create these systems:

  • Tandem with Dexcom and TypeZero Technologies (Tandem Control-IQ)
  • Insulet with Dexcom and Tidepool Loop (OmniPod Horizon)
  • Bigfoot with Abbott FreeStyle Libre (Bigfoot Loop & Bigfoot Inject)
  • Beta Bionics with Dexcom and Eversense (iLet bionic pancreas)
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I thought I was in the same position. I went to the Minimed sight and it said my warrantee was up 02/2020 which was 4 years after purchase. But what i learned was that Medicare requires pump companies to cover their pumps for 5 year so I have to wait till 02/2021 to get the Tandem Pump.

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Is your current pump purchased under medicare? I thought medicare considered year 1 as a rental, while you make monthly payments. Followed by 4 years with pump warranty from mfg. So in effect, 5 years before new pump is covered.

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Thanks for the report!

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I can’t wait for the iLet, as that was the clinical trial I participated in!

Thanks everyone, my endo approved the Tandem Control-IQ for me… so now it’s onto the insurance bureaucracy. Fun, fun, fun!

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I’d love to hear what you thought about it. It worries me that it might deliver too much insulin because it’s throwing glucagon to balance it. How long were you on it? Did you gain weight? How well did it keep you in range? We’re you able to set a specific target? How did it respond to high carb meals, and the difficult ones like pizza?How flat or crazy were your glucose graphs? I know you supposedly don’t enter anything but your weight, but CAN you adjust other things, like duration of insulin action? How big was it compared to the X2 (credit card sized)?

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Sorry for getting your hopes up, but I was referring to the earlier clinical trials that I had with Beta Bionics:

I have tried … the T-slim: each time I participated in the Bionic Pancreas clinical trial at MGH in Boston.

Believe me that I would have mentioned that I tried the iLet in my first post! :slight_smile:

For most of the trials I did, they gave us:

2 t-slims (one for insulin and one for glucagon) and an iPhone welded to a Dexcom receiver.
They were mostly 2 week trials (where there was some variation between week 1 and week 2).

I don’t think my feedback about my experience would be fair, as this was the early prototype for the iLet.

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Sorry, I misunderstood. I got excited for a moment! Lol

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My current Medtronic pump was purchased under Medicare. Tandem a few years ago had a program where you could basically rent a pump for one year for $1,000 dollars if you wanted the Tandem that badly. No longer have this program.

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