I am in the process of choosing a pump. I have met with all the reps and narrowed down my decision to Medtronic or Animas, but I'm stuck. My nurse feels that Medtronic would be a good choice for me, she says I am insulin sensitive. My Endo said both would be good choices :)
I don't fully understand how much of a difference Medtronic's smaller bolus increment would make. I was leaning towards the Animas pump, but this may be the deciding factor. Can anyone shed some light on this for me?
I believe that Animas actually has the smallest possible increments for basal dose which is .025. Someone correct me if that is not the case but that's what I found when I was researching which to get.
Are you asking about basal or bolus increment? I'm pretty sure they have the same basal increment as Zoe says of 0.025. I don't know the bolus increment but a 0.1u increment is pretty tiny. What is your insulin to carb ratio? For me that is equal to 2g of carbs based on my IC of 20.
My personal opinion is the biggest advantage to micro tuning rates applies to basal far more than to bolus. A .05 bolus increment compared to .025 increment for a bolus just doesn't sem to me would be very advantageous unless tour TDD is 10 units or less.
To put it into perspective:
Lets say your insulin to Carb ratio is 1:50 (this is pretty insulin sensitive). If you do the math, a dose of .05 units of insulin would correspond to a carbohydrate intake of 2.5 grams of carbs. A dose of .025 would be for 1.25 grams of carbohydrate. The finer dosing in this case doesn't seem like it would make that much of a difference.
If Animas is what YOU want I can't see that you would get worse control using it vs a Medtronic.
**I believe Medtronic and Animas can both dose basal up to .025 but I believe only Medtronic can dose that fine for bolus whereas Animas can only bolus dose as fine as .05***
Here is a link with a good comparison.
One thing to note is that both companies have newer pumps/features pending FDA approval, with hopes to be available this year. (Minimed Veo and Animas Vibe). They are both available in UK, so if you check out the UK websites, you can find out more about them. Since not FDA approved in US, the sales reps can't officially talk about them. Both companies will likely offer upgrade options if you purchase current model now.
If CGMS is important, that could be key deciding point. For example, the next MM Veo with CGMS will include low glucose suspend. But many find Dexcom to be a more accurate. MM Veo with newer CGMS sensors is thought to be a big improvement over current MM CGMS.
I think the key difference in MM and Animas for the basal is not the rate that is set (both have .025 as minimum increment), but how it is delivered. But I don't think that makes a difference for most people. If your hourly basal rate was very low ( < .2/hr), then it might make a difference.
Thanks for the info. As a PP stated Medtronic & Animas now have the same basal increments, but Medtronic also has the lowest bolus delivery at .025.
My I:C ratios are 1:8 - break 1:9- lunch & 1:5.5 - supp. I use a 1/2 unit pen and do have this pattern of needing to make adjustments, especially basal. It seems like we can't get it quite right, I go 1/2 unit and it's too much, back down and it's too little. I think that's what the nurse means by insulin sensitive??
With those insulin to carbohydrate ratio's the finer increment of .025 will not make much a difference to you at all. If your ratios were more like 1:50 I still do not think it makes enough of a difference that it should be your deciding factor. If you insulin to carbohydrate ratio was 1:100 maybe????? it would make enough of a difference it would be a deciding factor???
Yeah with the I:C ratios below I do not think there would be a basal rate <.2 u/hour......
I think you should ask Animas if and which upgrade path they can offer you toward their new micro Vibe. It will take 1 year or more to get approved, but if they give you an upgrade chance, that would be a good reason to prefer Animas.
Otherwise they are pretty similar, IMHO
With those IC ratios, I doubt the bolus increment difference is important. IMO, get whatever pump appeals to you most. As far as having trouble dialing in the right amount of basal with your pen, you will probably find like most of us pumpers that a pump makes covering your basal much, much easier with far less lows or highs. That is part of the magic of a pump that somehow the constant trickle of short-acting insulin covers your basal requirement much better.
Wow, does anyone have an IC of 100?
I think the small increments are very useful. If you get close to where you want to be, a "nudge" in the direction you want to go can make a difference of 20-30 points it seems like to me. While that's not a big deal on a test by test basis, if it feeds your average, it's like .75=1 on your A1C so I would consider that useful. I'll be like "damn, my after lunches are running up to 150 and hit it w/ .2G/U to make an adjustment and it'll run back down to 110 where I want it to.
I also agree with Don that the pumped basal is really excellent. I had no idea that it would be as awesome as it is but it is.
I have never seen one that crazy but I have seen some children on shots who have to dilute their insulin so I suppose if they were using u100 insulin they may have been somewhere in there.
I would agree with those who have said that the smaller bolus increment won't make that much difference. Can you really estimate (or measure) your total carbohydrates that accurately? There are lots of small differences between the two pumps, including the choice of infusion sets and if on balance those small differences add up to choosing Animus, I would go with it.
Maurie
I don’t think that the bolus increment will make any difference. Carb counting and bolusing are just not that accurate that a .025 gap makes any difference.
In December I switched from my out-of-warranty 523 Revel to the Animas Ping. I did that solely because Animas will be the first pump paired with the Dexcom G4 CGMS. To tell you the truth, I absolutely hate the Ping compared to the Revel. The only thing I like better about the Ping is that the color of my pink pump is prettier than the Revel colors.
I am extremely insulin sensitive and I think that both pumps will serve you equally well in that department. Any differences between the two are minimal and frankly I didn’t even remember that my Revel bolused by .025 increments rather than the .05 increment of the Animas.
The Animas menu system is awkward and very frustrating. There is no back button so if you make a goof on input, you can’t just press back and move on from where you made your mistake. You have to do a lot of scrolling to get back to the main menu and then you have to start over.
The thing I hate the most is that once you use the EZ Carb or BG Correction feature to determine a recommended bolus, it shows you the recommended amount and then makes you scroll to input it again. When Medronic gives you the recommended amount, if it is correct, all you have to do is press enter or else adjust it starting from the recommended amount rather than zero. Over the course of a day, this makes a huge difference. Rather than making the animas pump safer as some would argue, I consider it to be more dangerous for me. If I’m in a hurry I find the scrolling inaccurate and frustrating. Sometimes when I get near the right number, I find that even though I quit scrolling, the pump still goes up a few more tents of a unit, so I have to take the time to .05 by .05 get back to the right number. Once in a while if it’s close to the right number, I say the heck with it and just bolus that number.
I find that I can more accurately scroll on the pump than the remote. The remote tends to crawl at first and then all of a sudden speed up to a number that is way too high. Also bolusing from the remote is an incredibly slow process, probably twice as slow as doing it on the pump using a One Touch Verio meter rather than the Ping meter.
People who start on an Animas pump don’t tend to hate these things as much as I do coming from a faster and more sophisticated pump. I find the Animas remote too slow to use, but if I liked to wear my pump in my bra, chances are I’d learn to live with the remote.
Am I sorry I switched to Animas? No, because I think that the Vibe whenever it gets approved will correct a lot of the things I hate. There will be no more remote and supposedly the recommended bolus amount will become active in the pump by accepting it rather than having to re-enter it by scrolling. I am a huge Dexcom fan and absolutely hated the Medtronic CGM system. Medtronic will have a new sensor system (the Enlite), but without the ability to try it out, I was unwilling to switch from Dexcom.
If I were you, I would also look at the Tandem t-Slim pump. Tandem will also be pairing with Dexcom, but it will be at a later time. At the point I needed to make my decision, Tandem was not offering an upgrade program to the next generation pump that will be paired with Dexcom. I was not willing to take the risk of having to wait four years to get a combo pump/CGM. Chances are that they will have an upgrade program, but in the fall they did not.
I have been tempted to go back to my Medtronic pump until the Animas Vibe is released, but I’ll probably just wait it out. If CGM was not part of the equation, I would never in a hundred years buy a Ping instead of the Revel. I have had no difference in customer service between the two companies and actually probably had better service with Medtronic.
But in the end, both my Revel and Ping have been reliable and both give me my insulin safely. There are tons of happy Animas users. I am actually surprised that in my fifth month of using the Ping I haven’t accepted the slow menu system and I still hate it, but I still trust it to give me my insulin safely. So whatever decision you make, it will work fine for you.
I've found the smaller bolus increments do make an appreciable difference. Maybe not here and there but, if you want to correct your experience a small amount, the smallest corrections will show up in the big picture type of data. Or at least they do for me. I'm very conservative during the day during the week but I think that my general success when I let 'er rip evenings and weekends stems from the fact that I'm very fussy and precise about the carb counting and pump tuning I do during the day during the week.
This conversation actually prompted me to take my Revel out of storage. Not only did I have to put a battery in it, I actually had to put some insulin in a reservoir to get it to come back to life. It still has my settings.
I tried to bolus using the Bolus Wizard and then just scroll in a normal bolus. I never could get it to bolus by smaller than a .1 unit increment which is larger than the Ping increment of .05.
So if you enter in a bolus, do you actually go from .025 to .05 to .075 and then to .1? I have a Revel 523 which is as far as I know the most recent model. Maybe the newer ones have a newer version software, but I would think a bolus increment change would have to go through the FDA?
Actually just curious, so let me know what you can do on your pump?
I do know that the basals go up by .025 because I did use that increment in my basal profile.
If I go to bonus, say for 5g @ 85 mg/DL, it will set up to pump .625U but is scrollable to .025U increments. I find this useful for correcting when I'm exercising, etc. I don't adjust boluses by that much often but, when I do, say in the middle of the night when I wake up and something's out of whack, or when I'm on a long run and it runs up a shade and I just want a whiff of insulin, I like it a lot.
That’s very interesting, but I know that your Revel is newer than mine. You’re still the 523/723 series aren’t you? Mine definitely will not bolus in increments smaller than .1, so obviously some software changes have been made.
There's a setting to change it. My pump blew up and I got another one and it took me a few days to figure out where to adjust it. If you go to "bolus setup" and then "scroll rate" you may be able to find the smaller increments.