First Impressions: Asante's Snap Insulin Pump.

A very large box arrived on my doorstep and after spending a couple of hours on Skype with a CDE, I'm hooked up to the Snap insulin pump, made by Asante. I'm doing a four-week trial, which may be an option for you, too - if you'd like to try it yourself, I suggest you go inquire to see if you qualify. (I want you to think about that for a minute - they're letting patients try their pump, for free, for four weeks. Four! Weeks! You have to be pretty ballsy confident in your product to offer that.)

This pump looks (and acts) a little different than what I'm used to, so I wanted to post a few more pictures than what I put on Instagram last night, and share a few thoughts. I've only been wearing it for about 12 hours, so these are definitely "first impressions". 

Hooray:

• The pump utilizes pre-filled, glass insulin cartridges which is great for a few reasons: no wrestling with air bubbles trying to transfer insulin from vial to reservoir, no degradation of insulin due to being in a plastic reservoir, and you actually get to use all 300 units of insulin in the cartridge because the cartridges are filled to 315 units, and the prime only uses 15 - 16 units.
• Less parts - just a controller (the half of the pump that has all of the buttons and screen), the pump body (the part that houses the cartridge and battery - which means you get a new battery every time you change out the insulin), and the infusion set/tubing/connector. 
• Yeah, that auto-prime thing is pretty cool. It made me guffaw.
• You know how with an Animas pump (and maybe others, I don't know), when you want to bolus for carbs, you tell it how many carbs, it suggests a bolus, and then you have to dial up to that amount, confirm it, and then it boluses? There's no bolus dialing with this pump. Let me say that again: THERE IS NO BOLUS DIALING. I tell it how many carbs, it tells me a bolus suggestion, and I just tell it "yep" and it starts delivering it. 
• And you know how Animas pumps (and Medtronic, probs) have that cartridge cap that sticks out from the pump, where the tubing comes from - and sometimes when you sit down it jabs you in the stomach? Yeah, no cap on the Snap. Woo!
• The buttons have a very satisfactory resistance to them. Do you know what I mean? It's a tactile thing - I want buttons that really depress and then pop back when I let go. These feel nice.
• When I press the left-most button, an empty screen reminiscent of CGM graph appears. "Oh", I thought, "there must be some future integration efforts in the works". Well, that is true ("We'd love to be integrated with Dexcom") but also this graph plots all of the blood sugars you've entered for the previous 12 hours. (WHAT?!) Awesome!
• Basically, there are a lot of little thoughtful things designed in this pump, and I'm still discovering some of them. It's made me smirk with delight a few times already, which is a pretty lofty achievement for a medical device.

Are you serious:

• The pump's appearance... leaves something to be desired. Someone asked if "they are doing the 'hipster' pump look, cause it's really doing the old look/new gadget thing well". As you can see above, it's a pretty long pump, too. I'm not sure how pump-in-the-bra is going to work; I'll report back.
• The insulin-dispensing noises remind me of the noise your computer makes when you eject a CD. It's kind of loud.
• This is a huge one for me: the pump does not have a vibrate option for alerts and alarms. In my 8 years of pumping, I have always had my pump set to "vibrate only", so this is kind of upsetting for me. The sounds are adjustable, so I have it on the lowest setting, but it's going to beep every time I bolus, etc. I am really not pleased about that. When I asked about it, I was told that when they did their market research they found that people wanted a "lighter", less heavy pump - and taking out the vibrate capability helped shed some extra ounces. Let me tell you: I'd gladly wear a pump twice as heavy if it meant it could be QUIET, but maybe that's me. As the person who is wearing this thing all the time and in different social situations, I need to be the one who decides when I want to be out-and-proud, and when I want to be discreet. (Update: I've bolused a few times with it now and have the volume set to the lowest level. I generally put my pump back in my pocket while it's bolusing, and have noticed with the last two that I can't really hear the "end bolus" beeps. I am less worried now, but it may be more audible if you're just wearing the pump in a holster at your waist.)

I'll share more as Mr. Snaps and I go along, and try to avoid saying "aw, snap!" in every post about it.

No guarantees though.

Disclosure: Asante sent me a Snap insulin pump to try, for free, for up to four weeks. I am offering my thoughts and feedback to them and will be writing about my experience as I go, because that's what I want to do. I am not receiving financial compensation for my reviews, and opinions are, as always, my own.

#GiveAllTheThings: GlucoLift.

UPDATE: Congratulations, Heather/AuntlyH! You've won!

Auntly HDecember 6, 2013 at 12:42 PM

Last night's non-stop line in the 50's on my CGM graph leaves me in dire need of GlucoLift restocking. I would love a tart flavor - green apple from Dex4 is close (flavor-wise; other qualities lag far behind if you ask me), but I know GlucoLift can do better.

* * * * *

What you can win: A glucose tab prize pack including one bottle of each flavor (Cherry, Wildberry, and Orange Cream), a travel tube, and some assorted stickers/tattoos!

Made possible by: GlucoLift (glucolift.com)

Why you want this: "Lows are horrible, but that doesn't mean that we have to accept a sub-par product just because it raises our blood sugar. We deserve something made from natural ingredients that tastes great, dissolves clean, and isn't chalky. And that works quickly and reliably. That's why I created GlucoLift All-Natural Glucose. Glucose tablets redesigned, by someone who actually has to use them."

-Christopher Angell, Founder, Type-1 since 2007

To enter today's contest: Use the Rafflecopter widget below to enter today's contest. Here's how it will work:

Leave a comment on this blog post telling me what the glucose tab flavor of your dreams is. (Mine is a tie: mint chocolate, or banana split.) This will earn you two entries.

You may also earn one entry each for a Facebook Like or Twitter follow for GlucoLift, which means you can have your name in the hat up to FOUR TIMES!

Rules: This contest ends tonight at midnight CST, and is open only to U.S. addresses. #GiveAllTheThings contests are intended for people with diabetes (or their caregivers) only.  Since the Rafflecopter widget requires you to share an email address, I'll be emailing the winner (as well as announcing them through an update on this post) Saturday morning - you'll need to respond to me by Sunday evening (let's say 7:00 pm CST) with your shipping address in order to claim your prize. If I don't hear from you, I'll pick a new winner.

Good luck, and happy weekend!



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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 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.

#GiveAllTheThings: Thirty-One Gifts.

UPDATE: This contest is now closed - congratulations, Cecilia!

Cecilia LDecember 5, 2013 at 1:00 PM

I was recently diagnosed, so I don't really have an organizational horror story yet... but I did come to work the other day without my insulin pen, which resulted in a long drive home and back to work. Maybe if it was in a cuter carry case, I wouldn't forget as easily :)

* * * * *

What you can win: Organizational goodness: one Mini Zipper Pouch (color is Taupe Wave), one Your Way Rectangle (color is Black Cross Pop) and a $25 gift certificate code good towards an online purchase - all for one lucky winner! Both products have a blue circle, as a nod to diabetes awareness.

Made possible by: Melissa Thorpe, independent consultant with Thirty-One Gifts.

Why you want this: Standard diabetes accessories can be boring (hello black meter cases!) and these products allow for personalized and fun storage solutions! The Mini Zipper Pouch is perfect for holding a meter, test trips, and lancet device, with extra room for glucose tabs, a few syringes, or a small village of DNA-laden used test strips. Additionally, the Your Way Rectangle can be used to keep all of your supplies organized.

If you'd like some of your own personalized, fun storage solutions (not just for diabetes!) you can order your own through Melissa's website www.mythirtyone.com/melissat031. Go to "My Parties" and click "Shop Now" next to #GiveAllTheThings. Proceeds from orders placed by the end of the day Sunday, December 8th (to ensure delivery before Christmas) will be donated to JDRF.

To enter today's contest: Use the Rafflecopter widget below to join this contest! You can be entered to win up to three times - two for a blog comment left on this post (required), and one for a Facebook Like for Melissa's Thirty-One Gifts page.

In your comment, tell me a diabetes organizational horror story. For example: I tend to stuff everything amongst a few drawers in our entertainment center, and a couple of weeks ago I found a tube of expired test strips from 2008.

Rules: This contest ends tonight at midnight CST, and is open only to U.S. addresses. #GiveAllTheThings contests are intended for people with diabetes (or their caregivers) only. Since the Rafflecopter widget requires you to share an email address, I'll be emailing the winner (as well as announcing them through an update on this post) Friday morning - you'll need to respond to me by Sunday evening (let's say 7:00 pm CST) with your shipping address in order to claim your prize. If I don't hear from you, I'll pick a new winner.


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#GiveAllTheThings: Jerry the Bear.

UPDATE: This contest is now closed. Congratulations to Heather (and by extension, the Insulliance program at Oakland's Children's Hospital)!

Heather GabelDecember 4, 2013 at 7:29 PM

Wow! What a fantastic giveaway! I have diabetes myself, but If I were to win the Jerry the Bear, I would donate it to the Children's Hospital Oakland, CA Insulliance program. Insulliance connects those who are newly diagnosed and youth with diabetes with young adult mentors who also have diabetes. I think Jerry would fit in perfectly with our model of mentorship and aid our efforts to help youth feel connected while in the hospital for a clinic visit, DKA, or when being diagnosed. :-) I'm crossing my fingers.

* * * * *

What you can win: One Jerry the Bear! (Prize value US$249.)

Made possible by: Jerry's family at Sproutel.

Why you want this: Jerry is an interactive teddy bear that teaches children with type 1 diabetes how to manage their blood glucose levels, recognize their symptoms, and maintain a healthy diet - all through play. Using games, positive reinforcement, and real world scenarios, Jerry allows children to learn the skills necessary to take care of themselves for the rest of their lives. Learn more about him on his website.

To enter today's contest: Use the Rafflecopter widget below to put your name in the running! You can be entered to win up to four times - two for a blog comment left on this post (required), and one each for a Facebook Like or Twitter follow for Jerry the Bear.

In your comment, tell me a little about who you're trying to win the bear for!

**Please note that Jerry is currently backordered, so your Bear would arrive sometime in early spring 2014.**

Rules: This contest ends tonight at midnight CST, and is open only to U.S. addresses. #GiveAllTheThings contests are intended for people with diabetes (or their caregivers) only. Since the Rafflecopter widget requires you to share an email address, I'll be emailing the winner (as well as announcing them through an update on this post) Thursday morning - you'll need to respond to me by Sunday evening (let's say 7:00 pm CST) with your shipping address in order to claim your prize. If I don't hear from you, I'll pick a new winner.

Good luck!


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Test Driving the VerioSync.

Disclosure: I was contacted by LifeScan, the makers of the One Touch VerioSync, who asked some people in the diabetes online community if they could send us the meter (for us to keep) ahead of its commercial launch so that we could try it and share our experiences online. I am not financially compensated for any reviews, and opinions are always my own.

If you follow me on Instagram or Twitter, you may have seen me share some photos of a new One Touch meter called VerioSync. I was able to see (a version of) this meter at last year's Friends For Life conference and had been looking forward to its release. (The bad news is that its still not commercially available - the materials sent with the meter indicate they expect that to happen in the first quarter of 2014.) While I've only been using it for a week or so, I seem to already be feeling a moderate amount of warm fuzzies towards it.

The "big deal" with this one is that the meter automatically syncs your readings with the complimentary One Touch Reveal app without needing to plug anything in - it transmits over Bluetooth.

Some first impressions:


The Good:

• The results I've had have been very happy-matchy with my previous Verio meter, as well as my Dexcom G4 Platinum data. I like consistency.
• Never needing a battery change - you just plug the thing in via USB cable (included). Supposedly, battery life lasts up to two weeks - I'm guessing it will be more like one, given how frequently I test.
• It uses the same strips as the VerioIQ, which according to LifeScan are "covered at the lowest co-pay on the most health plans and are always covered by Medicare Part B". 
• The meter is small, and could certainly pass for something not medically-related.
• It has an app, and I don't have to do anything past keeping the meter close to my phone when testing to get it to transmit. 
• Speaking of the app - it's easy to see at a glance how I'm averaging, what the distribution looks like (color-coded!), and any patterns that might be emerging. 
• It has a light at the top! That doesn't sound like a big deal, but when you're trying to test without waking up your four month-old... it's a big deal. This light isn't as big or bright as the VerioIQ's, but it's sufficient.

The "This Could Be Better":

• The battery drain on my phone - OMG. 
• Where'd my big, beautiful color meter screen go? :(  I realize most of the coolness moved to the app, but if you're using this as a stand-alone meter, there's much to be desired display-wise.
• It's weird that this meter has only one button, on the right side. 
• The app isn't entirely intuitive to use (took a few days, and several tweets, to finally figure out how to share the logbook), and my stubby fingers had a tough time setting up the low/high pie chart specifications.

The accuracy (compared to the VerioIQ meter and Dexcom results I already trust) I'm seeing has me feeling pretty comfortable with this one, and when I pair that with the realization that I could be paying half as much for test strips by switching back to One Touch meters, I come to the conclusion that I'm probably jumping ship on my iBGStar for a while.

#GiveAllTheThings: WDD Blue Circle Shoelaces.

UPDATE: This contest is closed. Congrats to Heidi and Jennifer!

* * * * *

What you can win: I have two pairs of World Diabetes Day Blue Circle shoelaces (old, scruffy sneakers not included). I'll ship to two lucky winners! (I was sent one pair for me, and asked for extras to share.)

Made possible by: Novo Nordisk

Why you want this: Here's Novo Nordisk's blurb:

#LaceUp4Diabetes is a campaign to raise awareness of diabetes in general as well as the issues facing the diabetes community. Novo Nordisk is distributing a limited number of custom WDD shoelaces throughout American Diabetes Month and asking people to take a step for diabetes awareness. 

To enter today's contest: Use the Rafflecopter widget below to put your name in the hat. Your entry = a blog comment left on this post (required).

Rules: This contest ends tonight at midnight CST, and is open only to U.S. addresses. #GiveAllTheThings contests are intended for people with diabetes (or their caregivers) only. Since the Rafflecopter widget requires you to share an email address, I'll be emailing the winner (as well as announcing them through an update on this post) Wednesday morning - you'll need to respond to me by Friday evening (let's say 7:00 pm CST) with your shipping address in order to claim your prize. If I don't hear from you, I'll pick a new winner.

Good luck!


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#GiveAllTheThings: Hanky Pancreas.

UPDATE: This contest is closed. Congrats to Brenda!

Brenda C. BoylanDecember 2, 2013 at 12:52 PM

I would give this to my 12 year old daughter who would wear it to school. She LOVES scarves and this is a great product!

* * * * *

It begins! :) (Wondering what #GiveAllTheThings is? Click here.)

What you can win: One Hanky Wrap (Coral or Charcoal) Insulin Pump Accessory - an ultra soft and comfy wrap that one pump-wieldin' winner will hold dear to their heart (and plastic pancreas!). Valued at US$42!

Made possible by: Jessica Floeh of Hanky Pancreas (hankypancreas.com)

Why you want this: They're one of my favorite ways to wear my insulin pump when I don't have a pocket handy - I've bought two!

This wrap has a special sewn-in pocket made to hold your insulin pump - simply slide the pump in the pocket and place where you normally wear it. Jessica is featured in the December issue of Diabetes Forecast magazine (like the badass she is).

How To Wear:

• Tie it around your neck and tuck it in your bra 
• Tie it around your waist and tuck it in your pants/pocket

Features: 

• Lightweight high quality rayon lycra 
• Micromesh pocket front for button and touchscreen accessibility
• Neoprene pocket back for protection and shock absorption
• Handmade in USA by Jessica Floeh (sew like the wind, Jessica!)
• Strategic tassel draping for device counterbalance; “pump-lump” camouflage

To enter today's contest: Use the Rafflecopter widget below to enter today's contest. Here's how it will work:

Leave a comment on this blog post telling me which color choice you'd prefer, and where/how you'd wear your wrap if you won! This will earn you two entries.

You may also earn one entry each for a Facebook Like or Twitter follow for Ms. Hanky, which means you can have your name in the hat up to FOUR TIMES!

Rules: This contest ends tonight at midnight CST, and is open only to U.S. addresses. #GiveAllTheThings contests are intended for people with diabetes (or their caregivers), and this one really only makes sense if you wear a tubed insulin pump. Since the Rafflecopter widget requires you to share an email address, I'll be emailing the winner (as well as announcing them through an update on this post) Tuesday morning - you'll need to respond to me by Friday evening (let's say 7:00 pm CST) with your shipping address in order to claim your prize. If I don't hear from you, I'll pick a new winner.

Good luck!


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Choosing An Insulin Pump, Continued.

[Find the first post here.]

Wheels have been turning! Here's where things stand.

After checking with my insurance carrier, I got the first-round standard answer that the pumps they're willing to cover amount to the four "more established" brands: Animas, Medtronic, Insulet (Omnipod) and Accu-chek.

But, in talking with the remaining two companies (Tandem and Asante), those options could potentially be back on the table coverage-wise. Paperwork has been submitted for both (solely for insurance verification purposes) because I'd like to know if my choices are less limited than that since I don't have $6,000-ish just laying around to buy a pump at full retail cost. Like just about everyone else with diabetes, my options are limited to what my insurance carrier decides. (And luckily for us PWDs, those device manufacturers are willing to do most of the heavy lifting with insurance companies to ensure coverage - less work for me!)

That said, I'm fairly sure that I've narrowed my decision (insurance coverage pending) to three: Ping, t:slim, or Snap.

I've been in the fortunate position where some of these companies have reached out to me to see how they could help me decide, and as a result I'll be trying some stuff out. I've already met with my local Tandem rep (Hi Nathan!) to ask more questions and experience the t:slim up close again, and I'm looking into seeing Medtronic's new "530G with Enlite" LGS system (notice how I'm NOT calling it an "artificial pancreas"?) in person. I'm waiting to hear back from my endo, but things should be in place to do a short trial with the Snap pump, as well. (And I'm definitely planning to share my experiences with the Snap, as soon as I can get my mitts on one.)

And speaking of devices - I hadn't realized that I was already out of warranty with my Dexcom system, but that's all straightened out now and I have my new system (black receiver this time!) sitting in the living room, waiting to be unboxed.

To add to the chaos, I'm also seriously considering a switch to Verio meters over my well-loved iBGStar. More on that later.

Apparently I like to overhaul all of my diabetes gear at the same time.

Go big or go home, or something.

World Diabetes Day 2013.

We're marking World Diabetes Day a couple of days late... you'll forgive us, yes?