Thursday, December 5, 2013

My Experience With Medtronic's Enlite CGM System.

Because this post seems to be getting a lot of traffic via Google searches, I want to update it with a couple of thoughts:

  1. I am very aware that trying a medical device for two days may not be sufficient enough time to form a well-rounded opinion on it, and you should remember that while reading this. I wasn't willing to stab myself a seventh time just for blog fodder.
  2. Many other people are writing about their experiences with the Enlite CGM and the 530G system, and I hope what they're sharing will be useful to you. Christel, Karen, Scott, and Jeff are a few that come to mind.


tl;dr: I tried the Medtronic Enlite CGM and my experience was reminiscent of an internet meme.




I did a shorter-than-I-envisioned trial with Medtronic's new Enlite CGM system this week. Medtronic's marketing team contacted me after reading my post about looking for a new insulin pump and asked if I would like to try out the 530G with Enlite system, to aid my decision process.

I thanked them for the offer, but reiterated that I have no interest in switching to Medtronic's pump (as I mentioned in that post) but the opportunity to try out the new Enlite sensor intrigued me a bit. I've only ever been a Dexcom customer when it comes to CGM technology, and while Dexcom's Seven Plus, and now the G4 Platinum, come with their faults... I've grown very fond of them. It occurred to me that my opinion/crush/moderate-fangirldom of Dexcom's CGM wasn't really backed up by a well-rounded education - how could I know it was so great if I had nothing to compare it to? - and so would Medtronic maybe just let me try the sensor part of the system?

Yep, they would.

On Monday afternoon I went to my endocrinologist's office to meet with my local Medtronic rep and get hooked up to the Enlite CGM. Because Enlite doesn't have a separate "receiver" like Dexcom does, this meant that for two days I was wearing an Enlite sensor on my body (in addition to a Dexcom one) and then carrying around a Medtronic/Minimed pump that had no insulin, cartridge, or tubing in it - an empty pump whose screen let me view the CGM data (in addition to my Animas Ping, which I was actually pumping with). WEAR ALL THE DEVICES!

My initial impressions in those first few minutes of setup were good: oh, that sensor looks smaller than the one I remember seeing before; the wire part that stays under the skin feels a lot more flexible (read: comfortable) than the previous model; the real estate required to wear it is less than a Dexcom sensor; the rep said the Enlite is 31% more accurate. ("31% more accurate than.....?" "Our previous CGM." "So, still not as accurate as a Dexcom G4 Platinum sensor. Got it." ::awkward transition to next topic::)

We used the "improved" insertion device; a block of gray plastic with a bright green button on the side, whose main feature was that the CGM needle would not be visible while inserting the sensor - a plus for squeamish, I think. The insertion went smoothly - I was delighted to remark that the needle barely hurt (I would say it's comparable to what I feel with a Dexcom sensor insertion), and with a nurse's help, we got the inserter removed and the sensor taped down. After a few instructions on menus, alarms, and settings - I was off!



Within the first hour, my Enlite receiver was vibrating with a "LOST SENSOR" message. I think I must not have paid enough attention to the instructions, because it took me several tries to get the right combination of buttons (down arrow, esc, act) pressed in order to clear the error message and get the "pump" to stop vibrating. I called the rep to let him know, and he walked me through how to "find" the sensor again. The callibration period (two hours, just like with Dexcom) continued.

The Medtronic rep and I texted back and forth periodically throughout my trial, troubleshooting as needed. His availability was both reassuring and appreciated.

Throughout the rest of Monday evening, I watched the graph bounce higher than what my meter or Dexcom receiver were showing. Overnight was less than restful due to the combination of high alarms and "WEAK SIGNAL" alerts that buzzed from the Medtronic receiver every time I rolled onto the Enlite sensor.

Tuesday morning found more of the same - frequent error messages of "WEAK SIGNAL" or "LOST SENSOR", so when the rep texted me again to check in, I sent told him of the error messages and sent him a photo comparing the Enlite screen with that of my Dexcom and my meter.



I wasn't sure, and neither was he, why this sensor wasn't getting with the program. I've worn Dexcom sensors in this same area before with great results, and I wondered if perhaps the Enlite needed time to "marinate", just like a Dexcom sensor would - the first 12 to 24 hours are always off! (And to be fair, with time it did get more matchy-matchy with my other devices.)



But with so many error messages it seemed to suggest that either the sensor itself was bad, or perhaps I didn't have enough interstitial fluid in that location for proper readings (I really don't think that was the case). We made a plan for me to stop in the next day to swap out the buggy sensor for a new one.



I swung by my endo's office Wednesday after work; this time the rep was not there, but I met with a nurse I'm familiar with. We loaded up the insertion device, and she left the room so I could have some privacy. I lined up the device with a spot on the right side of my stomach, clicked the button and then let go (the letting go is what makes the needle plunge into you), waited five seconds, then once again pressed the button and lifted the insertion device straight off.

And the sensor came right with it.

"Well, crap!", I said. Not wanting to admit defeat, I used my finger to push the sensor back and click it into place, so that I could try again (DO NOT TRY THIS AT HOME). CLICK! SHUNK! CLICK! I lifted it once more.

And the sensor came right with it.

"Noooo! What?" I tried for a third time, but now I asked the nurse to come back in the room. I did the click-and-shunk before she came in the room; all she had to do was help me remove the insertion device.

"Make sure you're pressing down with two fingers.... and then just lift straight off." I did.

And do you want to guess how that went?

She looked just as perplexed as I was. "I've never seen that happen! Let's get a different sensor." I switched to the other side of my stomach, just in case. Loaded it up, click, shunk, click, lift.

Sensor came with it.

Let's try another new sensor! (So now we're on the third sensor try of the day, and the fifth insertion attempt.) Back to the right side of my stomach, because the left side HURT when that needle went in.

Load, click, shunk, click, lift, OMGWTFBBQ.

I was now bleeding out of five different holes in my stomach, with no new hardware to show for it.

"I think we're done here", I told her. I peeled the two-day old "bad" sensor off, and proclaimed my trial period over. (The sensor is approved for six days of continuous use, so I could have worn it the whole week.)



In summary, I think the insertion device isn't very well designed. I understand the importance of "hiding" the needle, but either the sensor needs a wider adhesive area or you need to be able to actually touch the tape (the inserter completely covers it when using it) to hold it down while lifting off the inserter.

And when you combine this problem with all of the WEAK SIGNAL! and LOST SENSOR! alerts I got, the artificially high results and not-always-matching trend arrows, and the tiny black-and-white screen...

My skepticism going into the trial was not unfounded. I'm still firmly planted on Team Dexcom.



80 comments:

  1. I'm sorry, I'm not laughing at you. Just the sounds you have for this. I am sorry you had such a hug sensor fail.

    ReplyDelete
    Replies
    1. Wondering about people who use the Medtronic pump and the Dexcom CGM. My daughter tried the Dexcom and hated it a couple of years ago - (she used it with the Minimed. ) The "professionals" tell you that it's gotten much better. Looking for any feedback - I'd love for her to start using it..

      Delete
  2. I was formerly using a Deltec Cozmo pump (sigh, miss that little green monster) when I got set up using the Dexcom seven plus CGM. When the Cozmo went kaput and I had to switch to the Minimed pump, the rep tried to get me to get on board with Minimed's CGM that was the companion to it. WAY too difficult, didn't last as long on a site as the Dexcom, and readings were way wonky. I've now graduated to the Dexcom G4 and LOVE it as well. I think Minimed makes great pumps....CGMs? Not so much.

    ReplyDelete
  3. Thorough. Nice work.

    Hypothetical: If this experience was all rainbows and unicorns, would you consider an all-out switch or simply file this experience away as a positive one in case other PWDs inquired about new tech?

    ReplyDelete
    Replies
    1. It was mostly done for posterity - I wanted to know how Medtronic's CGM compared to Dexcom, for myself. Going in, I didn't expect to want to switch based on what I already knew about Enlite (the study I linked to above suggests that the G4 gives more accurate readings than the Enlite, by a fairly significant margin).

      Delete
  4. We love the dex g4 and do not pump. He has no desire to pump..does not want the tubing. We use nano needles and pens. Keep the lantus a bit higher to cover small snacks. We dont cgm all the time, but it is awesome. A1c always in the 7's which i think is great for a teenager. Anyway.. That medtronic screen looks so low tech and crude! Thanks for sharing.

    ReplyDelete
    Replies
    1. Sorry - this made me laugh. I'm no fan of Minimed, but for someone who is still using needles instead of pumping to call any pump low-tech and crude is just freaking hilarious!

      Delete
  5. I don't have the Enlite, but I have been....less than pleased with Medtronic the last couple of months. I've been meaning to blog about it but just haven't gotten around to it. The first day of the sensor is very touch and go. Sometimes it's fine, and other times it's terrible. My first day with the current sensor involved readings off by more than 100 points and two calibration errors. When I complained a couple of months ago about how off the sensor was, they wanted me to send in the rest of that box and they said they'd replace them. So, I sent them in and six weeks later I'm still waiting for my replacements since their sensor - a product they make themselves! - is on back order and has been for months apparently!!

    ReplyDelete
  6. I appreciate the review. I must say I'm a little frustrated. I talked to a rep about two months ago and asked about doing a trial with the Enlite. I was told my local rep would call me . . . still waiting. I guess I have to be a popular blogger to test drive things. Switching to Dexcom is looking more promising every day.

    ReplyDelete
    Replies
    1. I switched from Medtronic devices 2 years ago and will NEVER look back. I'm not a popular blogger either, so my customer service was literally the worst.

      Not once, but twice I placed orders over the phone and they "forgot" to put them in.

      Delete
  7. Thanks for the recap Kim. It's only the second first-hand account I've read.

    I don't want to gang up on Medtronic... for me, the pump, while not eye-popping, is very functional and fairly indestructible so far. And when I've used the Dexcom G4 a couple of times in clinical trials, I have run into bad sensors & transmitters.

    But I have to wonder about the CGM: Why didn't Medtronic take a look at what Dexcom offers, which I find very user-friendly, easy to insert, and with a great range (I can be charging the receiver in one room while wearing the transmitter in another and still get readings), and try to design something with the same capabilities? Sometimes, I wonder if device makers are less siloed in development, but more ignorant of the rest of the marketplace.

    ReplyDelete
    Replies
    1. I have no desire to "gang up" on anyone, either. This is just my experience, and I recognize that it may not be a typical one. I feel very fortunate to have had the ability to try it out, but it's just not something I'd be comfortable using full-time, myself.

      Yep, every device has the potential for errors. I've been lucky that in the 14+ months I've used the G4 system, I've had relatively few issues.

      Delete
    2. Stephen - my understanding being part of clinical trails through two Universities in CA and speaking with their researchers is not so much that they don't compare to others on the market, but more that things are in the works YEARS before we ever see them. So at the time they start developing they may not know what is going to be out there. Also I know if they change things too much the FDA (at least in the US) has a lot more hoops to jump through as it may be viewed as a NEW item rather than an improvement. Not sure if that makes sense. :-)

      Delete
    3. Stephen - unfortunately that has to do with the business end of things. Every device company has a series of patents out their on design technology (and not just over physical hardware I believe). Patent infringment is something lots of people take very seriously. Things can be similar but not identical. I wish that weren't the case, although that might lead to a numerous array of custom pumps with particular sets of features for particular users (like cars...). The future is on it's way, right?

      Delete
  8. I'm sorry it was such a fail for you, Kim. Totally agree it wouldn't be worth it, and I'd have thrown in the towel to avoid that hassle. Sadly, you're not alone in this - I've heard others who have started on the new system experiencing these exact same frustrations, except they they all haven't had as much response from the local reps. Unfortunate. But just as unfortunate, it's not surprising. And of course, then, with all these issues, just how great is the Low Glucose Suspend (or threshold, as they like to call it here Stateside) that is the big bad part of this.

    ReplyDelete
    Replies
    1. Frankly, with a CGM that isn't as sensitive and accurate as it should be, I think the Low Glucose Suspend concept is a dangerous one and it frightens me a little. My Minimed sensors have been up to 200 points off at times. If that things suspends when it shouldn't because I'm a heavy sleeper, I'm dead. I don't know what Minimed's problem is and why they can't seem to make a sensor that does its job well for the life of them. I also don't know what the problem is with all of the other pump companies and why they can't get it together and make a pump with an integrated CGM. I'm really annoyed with the entire pump industry right now.

      Delete
    2. I use the MM 530G and Enlite sensors, and I've never been confident enough in the CGM values to use the low glucose suspend feature.

      Delete
  9. Ahhh, so not fun with the insertion device. The BF has the new sensor and Medtronic pump. He has offered to let me try it a few times, and I still think "No THANK you." At least not yet....

    From what I can tell, the new sensor is a little more accurate than the old one and smaller, but it still needs marination time. The "inserter" still looks like a medieval torture device. I cringe when I hear him pressing the buttons. Don't get me started on the auto-suspend stuff. Instead of just a few alarms here and there, it seems as if his pump is going off every 10 or 15 minutes despite creating wide margins to accomodate for the sensor inaccuracy.

    ReplyDelete
  10. I'm totally a Dexcom fanatic. We love our Dex and can't imagine life without it. I'm more tied to it than I am to the pump... So yeah...
    However, I love new technology and trying out new stuff! So this really interests me. It was discussed in a research update I was at last night (that actually felt more like a commercial for Medtronic but whatevs) and people were really excited. I sat there thinking... But Dex is more accurate. And we can get a good 14 plus days (do not try this at home), and she can take the receiver off as soon as she gets home from school and I can keep it. No asking her what her bg is. I can look. I can look when she's asleep and I'm downstairs. I can look when she is across the gym at gymnastics. I'm not sure I get the hype...
    Honestly, even if you had said the Enlite was the best thing ever in the world of diabetes management and nothing compares I still wouldn't give up our Dex. So I'm obviously biased. But I really do appreciate the perspective from someone whom I trust!

    ReplyDelete
  11. This is quite the thing to read on the day that my new Medtronic pump and CGM show up. I hope that my experience is better than yours.

    ReplyDelete
    Replies
    1. I'm sure it will be. Read my reply below. :-) I don't think Kim gave it a fair shot. Good luck.

      Delete
    2. Ugh. Me too. I just got mine on Saturday. Haven't tried it yet. I'm dreading it NOW and glad we have a month to return it if we need to.

      Delete
    3. Ours showed up yesterday too for our 12 year old son and we start pumping in a week. I feel sick now :( There were zero reps for any of the pumps when we went to pump class weeks ago and the nurses kind of pushed medtronic... so, that's what we went with out of lack of knowledge and exhaustion of trying to learn more. Ugh.

      Delete
    4. I finally got around to reviewing my first five months or so with the Enlite: http://jeffmatherphotography.com/dispatches/2014/05/medtronic-minimed-enlite-sensor/

      Delete
    5. Thank you for sharing that link, Jeff!

      Delete
    6. Been using my medtronics for several months now, the monitor always comes off, the insertion of the device is always hit or miss, in my humble opinion.

      Delete
  12. Wow, how am I not surprised that this was the result?!? Mine was the same except it was my 1st pump and their faulty system left me in the hospital! 3 times I moved my sensor in 2 days - all not even close to Dex! 2 times the needle wouldn't come out - this system is a joke...
    Btw I have a whole system if anyone wants it!! I think I'll stick to dex and shots - now you understand what I went thru!!!!

    xoxo from Trinidad

    ReplyDelete
    Replies
    1. I use the mini med 530 G and could really use any supplies you still have especially the enlite sensors and infusion sets. 2 of my sensors were bad this week and I am short 12 days. Please reply to scooter 1m@gmail.com. Thank you! Scott

      Delete
    2. My trainer for the Enlite system told me that I could call the Medtronic helpline if my sensor stopped working and they'd send me a new one. I tried it last week when I was getting super faulty numbers and they had me change it, and they sent one right in! Maybe you could try that?

      Delete
  13. I have 2 weeks until my warranty is up and I get to decide if I want to upgrade my pump or not. I'm currently with Medtronic and the "old" Sof-Serter Sensor/CGM. I went with the brand purely based on my endo's advice and my insurance paid 100% of the initial costs. I hadn't been using the CGM all the time because insurance would only occasionally cover it and $400/month (or more if I get cal errors, failed insertions, etc) was impossible. I've been using it more recently to try to get my A1c down and keep better control, etc and I signed up for a new insurance that seems to cover it all. BUT this CGM is kinda making things miserable, especially at night with low alerts when I'm not low, and lost sensor, weak signal, and low battery alerts (the battery on the pump gets used faster with the CGM, especially with the alarms).

    It is my first pump and for what it is and what it has done to change my life with diabetes, I truly appreciate and adore it. After 20 years of injections it is a relief to just take out my pump and dial in what I need.
    But I feel I have to kick myself! I didn't even think about looking at research and figuring out the better products. I usually trust my doctor's advice but from reading what you have written here I will have to consider it. It is what I have to live with!

    The "old" Medtronic sensor does have insertion issues sometimes too. (Also the rep showed me to put it in at 90 degrees instead of 45 and then slowly bring the insertion device down to 45 degrees. Sounds like that cheat cannot be done with the new, shorter sensor which I doubt will work well!) At first I thought it was my thick skin from scar tissue, but then I noticed that the electrode isn't always flush with the needle insertion thingy. Medtronic won't reimburse/replace sensors that don't insert too.

    Thank you for all the information! :D

    ReplyDelete
  14. i am so grateful for this post! i have beed a mm user for many years. i also use the cgm with it. my warranty is up and my ins doesnt want to cover mm new system. i recently did a trial on the ping. i feel like my sugars were better (can that even happen or was it just a good diabetes week?) i have thought about calling my local dexcom rep to see if i can trial one (i dont know if they do that...) the two things i didnt like about the ping is that the monitor doesnt have a light like the verio i have been using and the smaller 2 ml cartridge. i am SO nervous to make a decision either way.... i keep changing my mind. ping/dex or mm? christina

    ReplyDelete
    Replies
    1. If you hold down the power button on the Ping meter, it lights up. Not sure if that's what you were looking for!

      Delete
    2. If you decide to get the new Minimed system, make sure your insurance will also cover the new test strips and sensors. The system is only approved for use with one specific type of blood glucose meter and one specific type of strips. My insurance company is giving me a problem getting the blood strips (I have a BC/BS PPO). If I use my old meter with the new system, the readings will be just as bad as they are now (I'm on a Minimed CGM system right now, just not the newest one... and the accuracy SUCKS). Supposedly, the improved accuracy of the new system has everything to do with the improved accuracy of the specific BG meter approved for use with it because this is what you use to calibrate the system. So, if my insurer won't cover the strips (my endo is trying to get an exception), I'm sending it back and getting something else. I am not going to pay out of pocket for the entire cost of BG strips for four years, that's for sure!!

      Delete
  15. Thank you so much for posting this! I've been wondering about the new Enlite compared to the Dexcom. I just got my Dexcom on Tuesday, this is my first CGM, but I have a Medtronic Minimed pump. After reading about how much you and others seem to like the Dexcom and since I haven't had the best experiences with Medtronic I really didn't want to go with their cgm even though I may have been able to upgrade to the Enlite. I've wondered if I made the right choice and I think that your post confirmed to me that I did. Even though I did have issues Tuesday night with a bad censor and then two others I couldn't get the applicator off of, but the fourth time was the charm and so far so good. Plus I loved Dexcom's customer service compared to Medtronics. Just my personal experience.

    ReplyDelete
  16. What a crappy experience! I too trialled both, finally ending with Dexcom as the system I wear. I never had these problems with insertion though and wonder if it was the inserter as opposed to the sensors. Although no matter what, had that been sensors you'd paid for that would have been one nasty wallet-sting.

    I would echo the trend arrows though. Although my trial was not at the same time, I never found the Enlite quite as precise as I would hope for £50 a sensor, and the alarms were going constantly, with every change in BGs.

    Well done for knowing when enough was enough and cutting loose!

    ReplyDelete
    Replies
    1. With Minimed, if anything is wrong with your sensor (and I mean anything at all), call them and ask for a replacement. They have always sent one. We shouldn't be forced to cough up $45 for a bad sensor that we couldn't even get a decent reading out of!!

      Delete
  17. I was on the Minimed pump from 2001 until 2010. The pump was great, but their CGM was horrible. It was painful to inject, difficult to operate, and very inaccurate. I only used for two changes before I deemed it useless. I have been on the Animas which I absolutely love, and the Dexcom which is so perfectly accurate and virtually pain free. Go team Dexcom!!!

    ReplyDelete
  18. I'm on the same team as most of the responses. I never could get the MM Sof-sensor to work well and have used Dexcom for several years. The G4 has been life-changing:-). I switched to Animas over a year ago and am still waiting (and waiting) for the Vibe release in the USA. I miss my MM Revel pump but am 100% on board with Dexcom.

    Thanks for the review and the affirmation that I didn't make a mistake when I jumped ship from Medtronic in 2012.

    ReplyDelete
  19. I am surprised that you are even considering this a trial, as you obviously had no intention of switching and therefore didn't give it a full shot. I'm waiting to see if my insurance will cover the new sensor and was able to try the Enlite and was VERY happy with it. I did not have a problem with the insertion on the two I got to use and found it to be much easier. It had a similar warm up to the SofSensor and Dexcom (of which I participated in a two week clinical study a few years ago). The Enlite had the same pain level at insertion of the Dexcom and the inserter made it easy. I was on the Animas pump before, but wanted to have everything in one. I didn't like carrying around a receiver in addition to the pump and all that goes with that.

    I'm sorry that you didn't have a great experience, but with anything new there is a learning curve and some trial and error. I'm thinking 2 days, work, and a new baby at home might not have allowed you enough time to work out the kinks. And, let's be honest, having a nurse who is not a trained rep might not have been the best person to be helping troubleshoot a brand new device.

    ReplyDelete
    Replies
    1. Hi Sarah - that's fair. I struggled with whether to use the term "trial", but did in the end as I wanted it to be clear that I had not purchased the system; it was just me trying it out. I did the best with what was available to me (including a nurse to help, instead of a Medtronic rep), and had we been able to get a new sensor to stay on me, I would have given it a more fair shot. That's just not, unfortunately, how it turned out.

      Delete
    2. I have had a Minimed employee teach me a new pump (the one I am wearing at the moment) and a diabetes educator teach me two new pumps (before the one I'm wearing now. I found the Minimed educator to be quite inferior to my own diabetes educator who does this all day, every day.

      Delete
  20. Dexcome for the win. Of course, my doc won't even prescribe the Medtronic CGM, he hates it that much. I would give up my pump before I gave up my Dex.

    ReplyDelete
  21. Did not mean to add the E to Dexcom. Whoopsie.

    Also, do not get me started on them calling this an "artificial pancreas." Grrrr.

    ReplyDelete
  22. Thank you so much for this information!!!

    ReplyDelete
  23. Been using Enlite for one week and LOVE it!! I did a one week blind study (sensor in no receiver) two weeks of detailed logs and a nurse educator and a rep from Medtronic worked together in conjunction with the data and helped me program the basal rates, carb and sensitivity ratios. We also set up the alarms that were appropriate and for me, that's below 65 and no alarm for highs. Yes there is a learning curve, but well worth the effort. Had to tweak two of the basal rates after a couple of days, but with the education I received felt confident making the changes. I expect for the first time in 27 years that I will see an a1c in the 6's.
    Sally

    ReplyDelete
  24. This is some really useful information. Thank you for sharing!

    ReplyDelete
  25. Thank you for this post. I guess it's another nail in the coffin of MM for us. Just don't feel comfortable getting stuck for 4 years with potentially inferior CGM technology.

    ReplyDelete
  26. I used the old Medtronic for 18 months before I decided to switch to the Dex. I was hoping that the Enlite would be better, but the stuff you experienced was pretty much the same as what I experienced. I think the Medtronic pump is a decent machine, and there are features on it that I wish the Dex had, but what good are the whistles and bells when the machine fails to provide you with the accurate information you need from it, when you need it?

    ReplyDelete
  27. I can appreciate the poor experience you had with the MM pump and Enlite sensor. That's too bad. My son in a clinical study using both. He's always pumped, but the CGM has been new to us.

    Regarding the enlites, we happen to love them. Yes, when inserting you have to press the green button, release the button to release the sensor, wait 10 seconds for the adhesive to stick, and then press the green button again to pull up. But, doing that, we've never had a sensor come up with the inserter. If we did, I understand MM is good about replacing them as they are definitely pricey.

    We've had maybe 5 times in the course of the last 2 months that the sensor reading has been more than just a little off of the meter reading. I attributed it to the calibration - they recommend calibrating when the graph is nice and even. I probably have calibrated more than a few times with double arrows up or down. I know better.

    It took us a while to really get the muscle memory down to be able to do a sensor change in moments instead of having to think it through. I would have to admit there are things I like about the Dexcom system that I miss not having. However, I'm sorry you had a frustrating experience. Please know that not everyone has. Thank you.

    Also, I'm signing this anonymous, not because I don't want to back up my post - I just am not a frequent poster and don't have any of the required accounts. My name is Sally

    ReplyDelete
  28. My daughter's Enlite arrives tomorrow so reading this blog is a little disheartening. This will be her 3rd Minimed pump. We had given up on their past sensor with too many errors, lost sensors etc. Now being a teenager, I am looking forward to the sensor but hopefully not as you described. We just happen to have her 3 month endo check up today and I questioned whether this was a good decision and she yes. I guess time will tell in the next few months.

    ReplyDelete
    Replies
    1. I hope your experience is much better than mine was!

      Delete
  29. My original Medtronics Mini-med pump warranty expired; the insurance company did an automatic upgrade. At that time Medtronics "offered" a "special deal" for folks to get an automatic upgrade when their newest model, the 530, was released with their new Enlite CGM. I'm not so sure how good this deal has been for me.

    Since getting the upgrade a month ago, i get terrible readings from the sensor. As you found, there are frequent error messages of "WEAK SIGNAL" or "LOST SENSOR". Readings are off between 30 to 50 points. Sometimes CGM indicates my BGs are going down drastically when they aren't, or racing up, when they aren't. I'm just about ready to ask for my old pump/CGM back.

    ReplyDelete
  30. Is it true that there is a survey that anyone who is wearing an Enlite, has to take every 2 months? An educator told me the nurse from MiniMed would be calling in 2 months. What questions are they asking?
    Kathy

    (I don't have a facebook account to register with)

    ReplyDelete
    Replies
    1. Yes, it is true. (I believe it was mandated by the FDA as part of the low glucose suspend feature's approval.)

      The survey is very simple and can be done electronically. Did you have any problems with the device? Did these problems require medical assistance? Did you contact Medtronic about the problem?

      I did have some problems with my 530G pump--a couple of motor errors, probably due to TSA X-ray screening--and a Medtronic support rep called me after I took the survey. They sent me a new pump next-day, even though I hadn't had any errors in a couple of months. They also told me (quite earnestly) to feel free to report any device issues to them and the FDA between surveys.

      (Honestly, I've never had a bad Minimed customer service experience. Based on what I've read here, I wish others were as lucky.)

      Delete
  31. Been trying to get used to the enlite sensor for more than 3 months now and am ready to surrender due to frequent false alarms (mostly lows), large inaccuracies (often 50 plus points, sometimes up to over 100% difference from bg) poor company support (help line waits of 30-90mins) , xs cost due to frequent cgm site changes (an average of 2-4 days)...I would recommend thinking carefully before committing to the enlite over the proven reliability of the dexcomm, especially with the vibe on the horizon

    ReplyDelete
    Replies
    1. I have also had many, many issues and the help lines have provided conflicting information. The last call I made had a response that they were "learning about this device as they went along." Ii expressed concerns about the dangerous implications of the accuracy regarding highs/ lows, etc. Last night, I removed the sensor and am using the 530G as just a pump and not a fully integrated system. I truly wanted it to work; however, the logistics of weak signals, calibrations, and accuracy have made it very difficult. So, I have a pump for a few years until the warranty expires and I'll go to the open market and do better research next time.

      Delete
  32. I've been a MiniMed user for 15 years. I've had 4 pump versions and two sensors. I didn't really like the sof-sensor. It was usable, but it hurt and it was only a 3-day use (though you can take the transmitter off and restart it). The Enlite is fabulous. I've never had the insertion problems you had. And it doesn't hurt at all. I think it's still a little wonky with accuracy, but I absolutely love the Thresh Suspend feature. If you have problems feeling lows or have lows come on quickly, this is the penultimate feature in pumping/sensoring. About a year ago I had a severe low while wearing the sof-sensor. It was alarming, but I was already not coherent enough to treat myself. Thank goodness my kids know to go to the neighbor's if I can't wake up. With the Thresh Suspend, I might have had a fighting chance of coming out of the low without calling the paramedics. Thresh Suspend could save your life. (It might cause you to have a high sometime, but highs are much less scary/life threatening than unconscious lows.)

    ReplyDelete
    Replies
    1. I am so glad it works so well for you, Lacey!

      Delete
  33. I've been using the new 530G system for just over a month and the life of a box of sensors. The pump is intuitive to use and the new Bayer Contour bG meter that comes with the system is a real bonus, but the Enlite CGM is incredibly inaccurate, Yes, so inaccurate I can not comprehend why such an inferior product is even on the market.

    My pump must be kept close to the sensor to avoid 'weak signal' and 'lost sensor' alerts. I check my bG and calibrate 6x (or more) each day, avoiding times when I am dropping or rising fast, yet the CGM's readings are rarely close to my meter readings. There are constant low or high alerts when my bG is stable and within normal limits. A prime example of the issue was the night I woke to a threshold suspend alarm (set for 60), got up to check my bG and found it was 164, a 100-point difference. I calibrated the sensor and went back to bed. Once sound asleep, another threshold suspend alarmed. Another meter check showed a bG of 159. Despite another calibration, the alarms continued until I crawled out of bed to start my day exhausted.

    After reading various user blogs and forums, I'm finding that my experience apparently is more common than not. I understand the differences in interstitial glucose used by the CGM and the plasma glucose by the meter and lag times, etc., but isn't calibration designed to close those disparities?

    I really want and need continuous glucose monitoring, but it is worthless if it is less than reliable. I have turned the threshold suspend feature off. (How much did I pay for THAT feature?) I am getting tired, too, of the other ongoing false alarms and soon may be silencing them as well. That then will make my 530G no more than a $7K pump with an EtchASketch screen. The sensors then will be the next to go, because I'm not a glutton for trauma and scar tissue; infusion sets are perfectly adequate for that.

    Ultimately, my question is, how/why did the FDA approve this pump with a threshold suspend feature based solely on an inaccurate CGM? First step to an artificial pancreas, Medtronic? Not even close.

    ~CS

    ReplyDelete
    Replies
    1. I was told by my Medtronic rep that we aren't supposed to calibrate more than four times a day (3-4 is best). She said calibrating more than that can cause faulty readings.

      Delete
  34. On hold with medtronic to return my CGM. What a disaster. I have had it for 2 weeks and it's been like I am on the Omnipod all over again. False readings. I had a 26 BG and the sensor was reading 120. I had a 180 bg sensor was saying over 400. No alarms on either one. Every time I lay down I get a weak signal message. It loses the sensor every single night. When I was being trained the rep told me to shut half the features off because of the "annoying" alarms. Customer support keeps trying to blame me saying it's not a substitute for meter readings. I know this. I understand how CGM's work and what their intended use is. The closest meter/sensor reading I have seen in two weeks is 60 points. The up and down arrows seem to have no relationship to actual readings. I had a double arrow and a low predicted alarm sounding with a sensor reading of 118 and my bg was shockingly 320. I have just been told that sending it back must be approved by the regional rep. I feel a battle in my future.

    ReplyDelete
  35. This comment has been removed by the author.

    ReplyDelete
    Replies
    1. Hi Tore,

      Thanks for your input.

      I used the Enlite CGM for as long as I could stand, and then I wrote about that experience. How I care for my diabetes, and the tools I use to do that, do not need to be justified to anyone but me and my healthcare team.

      I am glad the Medtronic system works for you. It didn't work for me. My blog certainly isn't the be-all, end-all of opinions - there are a multitude of them out there, and I suggest you keep Googling to find them.

      P.S. It's "Dexcom", not "Dexcomm".

      Delete
    2. I just removed my comment in order to correct several grammatical errors that I made in my quick response.

      Of course you don't need to justify it to anyone else besides your team. But, i do think its easier to complain about something new that you are not familiar with, especially when you have a working solution ready to be restarted at first frustration.

      I am out of warranty on my Medtronic device and contemplating a move to either the Enlite or the Dexcomm. Medtronic solution is a bit easier because it won't require another device for CGMS readings. Dexcomm seems to be winning over people for accuracy.

      What are you using for insulin delivery? And do you feel like carrying the Dexcomm handheld is annoying?

      The medtronic CGMS doesn't always work perfectly, but almost all my sensors work good and sometimes they work really good. Really good means that they last up to ten days and I have to charge the batteries multiple times and keep the same sensor.

      I actually think there is not alot of info on the Enlite sensor on the web yet because it is relatively new to the US and most reviews are done by frustrated individuals. It would be great if we had something similar to CNET(Consumer electronic reviews) for diabetes tech. This could compare products with qualitative and quantitative scores to help users choose the best solution. I am not aware of such an individual or organization. Right now our durable medical equipment decisions are largely influenced by our health care providers, insurance coverage, and personal networks.

      Delete
    3. Tore,

      As stated above in replies to other commenters, I sincerely hope my experience with the Enlite is not typical. I look forward to reading more reviews from those who try it, and I hope they're positive experiences. People with diabetes should be able to choose whatever system works best for them!

      My understanding from the third-party studies I've seen (linked to mention of one of them, above) is that the MARD of the Dexcom G4 is significantly lower than the Enlite. The only study I'm aware of that shows the two systems being similar in that measure is the one that Medtronic cites in their own materials.

      I use a t:slim insulin pump. While carrying an additional device is not ideal (would love to be able to access Dexcom data from my smartphone, for example), I find it worth the trouble right now.

      I love the "Diabetes CNET" idea! I know some HCPs have posted reviews of devices (I'm thinking of Gary Scheiner, specifically) that come close to what you're asking for, but those posts are not centralized.

      Delete
    4. Hi Kim - I just wanted to let you know I bravely transitioned to the Dexcom Platinum a few months ago!
      I could be happier with the device after spending several years with the Medtronic. I am telling everyone I know the greatness of this device and strongly recommending that all diabetics get a Dexcom ASAP

      What I Like:
      (1) Accuracy, Accuracy, Accuracy! Usually my meter readings are withing 20mg/dl. I know this doesnt sound spectacular, but with medtronic I was seeing 50-75mg/dl variations, and sometimes even more
      (2) Consistency! My sensor readings are very consistent through the life of the sensor. With the medtronic I would see a gradual drifting of my CGM readings downward in relation to my true BG. This could be monitored quite easily on the Medtronic because it gave an ISIG reading. Finally as each sensor died, the ISIG reading would plummet and give me a false low BG warning. The Dexcom holds its readings throughout its sensor life. So far i've been getting 7-14 days on a sensor. I'm losing them mostly because the adhesive gives out or I get and uncomfortable itching sensation around the sensor after about 10 days. My readings are usually still very accurate when I remove the sensor. I also am quite active with running and soccer, so this repetitive motion often loosens the adhesive quicker than if I were more sedative
      (3) Sexiness: my reader actually looks like a consumer electronic device made this century. I keep the reader out all the time. When I had the Medtronic sensor I had to reach into my pocket to remove the 1970's style pump to check my BG. The color screen also helps the experience
      (4) Wireless freedom: this is related to the point regarding less playing with my pump
      (5) Fewer and less annoying alarms. This is due to both the accuracy of the sensor (Less false alarms) and that the alarms are less annoying.
      (6) Battery Life. My battery life on my pump now last about three times as long as before. This means having to change the AAA pump battery less frequently. Also the Dexcom reader has a rechargable battery that lasts about a week

      Things I like less
      (1) Size. Transmitter is bigger. This is not a huge concern but it is definitely noticable when first switching
      (2) Extra device. This is mostly just a hassle when I'm playing soccer because I can't carry the reader with me
      (3) Insertion requires you to inflict pain on yourself. The part I don't like is when you're putting the sensor in, and then you feel the needle make contact, and you have to push the needle in. I prefer the spring loaded action.
      (4) non rechargable battery of sensor. So far this is not a problem but it is interesting that they did not design a rechargable sensor and instead opted for a lithium ion battery that is supposed to last about 6 months.

      That's all i can think of right now... I just had to share the news

      Delete
  36. Hi Kim!! Just found ur blog. It's awesome!! Keep up the good work!!

    I'm new to the whole T1D world & started on my medtronics Revel March 2013 & started the sof-sensor by Medtronics April 1, 2013. I kept using the sof-sensor despite difficult insertions & crazy inaccuracies & even updated to the Enlite in Nov 2013. I finally gave up when my transmitter was out of warranty & moved to Dexcom. Best change I could have made!!

    I've been using Dexcom G4 for a little over a month now & I LOVE it!!! It rarely vibrates an alarm to me & it's not as annoying when it wants a calibration. I do dislike carrying the extra piece of hardware but hve adjusted to it & now it's not as bad as I had imagined.

    Thanks for sharing your experience. I was thinking it was just me...operator error but I'm reading more & more people are making the switch. Makes me feel better that I'm not the technologic dummy I was thinking I was.

    Just curios, where did u get ur Dexcom case?? It's very cute & I've been looking for something like it.

    Thanks again!!
    Sandy

    ReplyDelete
    Replies
    1. Hi Sandy! My Dexcom case is from tallygear.com. :)

      Delete
  37. I really wish I had found your blog a lot sooner. I have been a Dexcom customer for about 2 years, did the whole 7 Plus to G4 transition. Very solid CGM and in hindsight a much better product than the Enlite CGM. I had lost my transmitter while I was changing clothes after some exercise and didn't notice until it was too late it was no where to be found. Long story, but I contend that Dexcom changed their adhesive on the sensor tape and it doesn't last as long as the previous tape.

    Anyhow, looking at a $600 to $800 replacement cost for the transmitter (not covered by insurance), it was enough to push me to finally use a pump, and with the Medtronic 530G, I had the opportunity to have CGM and a pump in one device. Done deal. Well not so fast.

    Ever since switching, the CGM part of the 530g has been an absolute nightmare, and Medtronic's suggested solution to the constant "weak signal" and "lost sensor" error messages was for me to a) either change the way I sleep, or only wear the sensor on my right side and not roll over, and b) only use the sensor on the same side of my body as the infusion set and not put the pump in my front pants pocket. Really? With my Dexcom, I could put my sensor anywhere on my abdomen, and leave my receiver in the next room and it could still read the sensor. Apparently the Medtronic Enlite sensor cannot be more than 30 inches away from the pump, and there cannot be any bulky fabrics in the way, much less your own body.

    I wish I'd had the opportunity for a trial. I'm going to push Medtronic to take this system back and refund my money. Obviously they have a serious design flaw that they have not been able to fix in the past 4 months since you did your trial.

    Thanks for your blog, great information.

    ReplyDelete
  38. I have been a MM user for 12 years and have used the CGM on and off for about 2 years. I have not yet tried the enlite, but I am going to get set up with it in the next couple of weeks. For people who are stating the readings are really far off from the CGM to your meter, you are not supposed to calibrate it 6 times a day. Optimal is 3-4. No More. That is what tends to make the readings so off. My readings can be off even calibrating it the suggested number of times, but I use the CGM for trends and approximations. If the reading is 30 points off, that is not great, but it is not the end of the world either.

    ReplyDelete
  39. I've never used Dexcom's CGM, so I can't compare them (although I've heard lots of anecdotal and clinical data suggesting that Dexcom is more accurate). What I will say is that the Enlite is very accurate when it's accurate--which is often--and completely unbelievable when it's not. I wrote a little bit about it (with data!) on my own site.

    ReplyDelete
  40. Question for anyone that can help....I'm a Paramedic, crawling in and out of cars, in and out of small houses and nasty houses and just generally moving and lifting all day long. Between the Dexcom and Minimed 530G CGM which one would you recommend? Thanks

    ReplyDelete
    Replies
    1. I think you should try them both out to see for yourself. I think it's the only way to know for sure, although most of the evidence I've seen points to Dexcom.

      Delete
  41. wow! So you mean after TWO WHOLE DAYS you were not an Enlite expert? What is wrong with Medtronic? Geez..I thought they made insulin pumps that anyone can use completely and fail-safe within TWO WHOLE DAYS, this is ridiculous! Geez. For real though, my honest opinion is this: WHAT A DUMBASS.

    ReplyDelete
  42. I've been using the 530G & Enlite for about 7 months and wish I knew of Dexcom before! I have exactly the same problem inserting the sensor - it just will not stay in. When I do succeed it works pretty well for about 4 days - never for 6 days as they claim. Support is a JOKE - one call to report a failing sensor usually takes about 25 minutes of absorbing worthless advice which I find insulting. I've had to have about 6 sensors replaced in this time due to the injector not ejecting or the sensors not sticking. SHOP ELSEWHERE - Mini Med STINKS!

    ReplyDelete
  43. switched to what? and why?

    ReplyDelete
  44. Glad to see that I'm not the only one with problems using the Enlite sensor. I'm new to Enlite, but have used Medtronic pumps (508 and Paradigm) for years. I've been pretty satisfied with the performance of the pumps. The 508 was destroyed in a motorcycle accident and the Paradigm's battery cover began do come apart after years of service, it was time to update and try the CGM. I have to say the mechanical design of both the 'serter and the sensor retention is truly subpar. The insertion device is over-engineered to prevent the operator from seeing anything. As a result, it's prone to malfunction. Either holding on to the sensor when it should release it, or jamming up entirely and not firing at all. This whole gadget could be a lot simpler, like the infusion set inserter (Silhouette) and the sensor should have a larger adhesive patch. In the meantime, they should give you 3 sensors for the price of one because you're gonna waste two trying to install the one.

    ReplyDelete