Updates for Cozmo/Navigator

[Tamara Gamble]

I went to a meeting tonight for advanced pumpers. What a great night. We had a nurse from Smiths Medical leading the meeting with three or four dieticians there and several people like ourselves. You know T1 families.

The end of November 2006 Smiths Medical is releasing their new pump with some updates. For those of you who are already using this pump or just got it don't worry. It's free. If by the end of November you haven't heard from Smiths Medical give them a call. Your pump will be replace. Get that infrared reader you won't want to be with out it.

A few of the new features will be a day of the week schedule where you use your software and preprogram what your plans are for the week and it will transfer the data to your pump. For example: If you are in school at specific times or playing a sport at specific times or whatever all of your basal adjustments once entered into the computer system will be preset for the week by your software into your pump. So if you need different amounts for different activities. Whamo, no more messing around. It's already taking care of it for you. How's that for independence.

Basal program upgrades. Right now you can create four patterns in your unit. In November you can individualize foods as well. For example: you could preprogram pizza and attached to that have a 40/60 split extended. So when you just push pizza the rest is already done for you. Amazing.

There will be a hypo manager included. I'm sorry it was a long meeting and I thought I would remember the specifics but I don't.

We didn't get a sheet with specs or anything just listened to the trainer. We were so excited. My son was there and saw a picture of the very first pump and laughed he said it looked like a rocket pack or something. I think he felt a little more grateful for the advances in science.

The Navigator is due at any time as most of you already know. I couldn't nail down a date but was told that this unit is supposed to be so accurate that no blood glucose testing will be needed after the proven trials of coarse. Awesome news!

I can't believe the sadness I felt though for some of the people there. The man and his wife behind us said that their doctor did not feel a script for ketostix was neccesary. The conditions for his definition of use were rediculous, inaccurate and obsolete. He has had this disease for more than twenty years. To be clear he was not being advised to use the blood keto units.

I saw my son's face and knew he was about to say listen your doctor sucks find a new one. So I gave him the look and he held back but went into his bag and handed the man a box of ketostix at the end of the session. I'm so proud. We have plenty at home and could get more if we need them. True to form when we got into the car he repeated what I said he'd say and I thanked him for letting the trainer handle it as she was much more diplomatic in her approach but told him how proud I was of him for what he did and pointed out how lucky we are to be so well informed.

There was alot of hope for the future of this disease but so many still suffering from bad advice. So thanks to all of you that are working on this. Education being the key.

I was touched by a nineteen year old sitting next to me who had just gotten his pump three months ago he was diagnosed fourteen years ago. Hi Chris if you read this post welcome aboard. What an optimistic young man. I gave him the address for this site. I felt grateful to speak with him. He told me that they are predicting a cure within five years. Grinning ear to ear. What a gift to see such joy.

I just wanted to update you and hope you are as excited as I am about all of this. One of the dieticians stopped what she was doing and said look at her, she is just beaming. I can't help it. I feel like we are so close.

God Bless! Tami

[BrendaK]

Thanks for the update, Tami. We're having a support group meeting in a couple of weeks with a rep from Smith's medical and I really want to go, but I can't make it. Thanks to your great notes, I feel like I don't have to!! I'm really excited about all of those features on the pump.

Did they give you any sense of what the Navigator will cost and if it will be approved by insurance companies right away or not?

[Tamara Gamble]

No they didn't. The price is yet to be determined. The age is iffy. They still feel it will be subject to eighteen and older but we talked about the fact that there are people who are fighting the insurance co's on this and getting them to pay. So still a work in progress.

The unfortunate part is that alot of studies have shown that there is not typically permenant damage done at a young age with high and low numbers so most of the studies done are on older children. Bad thinking. We all know there is alot more to it than that and deserve a continuous blood glucose sensor for our kids.

To be clear I am not implicating that Abbott is doing this, I haven't seen their studies yet so I don't know, but from what I have read in the past all of the studies concur with this information in regards to research or our insurance would cover the cost. As of right now the people doing these studies have yet to prove that it would be of benefit because they haven't run the tests. So we need to keep pushing on this issue.

I think I pretty much told you all that I know about this so if any one has anything to add or has found a study that has been done that we should know about on our young one's please correct me I would love to read about it. My next plan of action will be to pursue this once the Navigator comes out.

Good Luck! God Bless! Tami

[Pammers]

Thanks so much for the info. I've been waiting anxiously for the Navigator and even considered Dexcom - but I really think Navigator will be the way to go. I'm ready for a fight!!!!!!

[Tamara Gamble]

Okay, I don't want anybody yelling at me because I am just repeating what I was told and have no doubt that the other two units out are very capable. What I was told was that in comparison the other two units don't even begin to hold a candle to this one. I was told out of the Dexcom and Gaurdian that the Dexcom was top dog.

The reason for the delay in the Navigator coming out is that Abbott went back to the table and is now seeking approval from the FDA to make this unit a replacement for finger pokes. This is how accurate it is supposed to be.

As with anything new it is my firm belief that only time will tell. Would I still do finger pokes? You betcha. At least for a while and with numbers that are questionable. Will Abbott get what they are seeking? I hope their unit is good enough that they do.

My only concern would be if our insurance started to limit the amount of test strips if finger pokes are eliminated. I don't think so. To risky. It will be to new and would have to be approved for everyone. I think by the time they got around to it we would be close or have a cure for this disease.

Good Luck and God Bless! Tami

[rickst29]

There had been rumours that Abbott's failure to get approval in the time frame which they had expected was due to getting a lot of "D" Clarke Grid readings at low bG. It's GREAT to hear that accuracy is good, not bad, and that the delay was due to requesting more aggressive usage.

Was your info from the Cozmo rep, or someone else?

Dexcom *is* a lot more accurate than MM in the hypo range, which is where you NEED accuracy. But Dexcom is also really sensitive to water and sweat, keeping the Sensor dry is a big hassle. For me, Navigator's waterproof Sensor offers a HUGE advantage.

Dexcom also doesn't have replaceable batteries, so there's big expenses ($250 every six months, PLUS $550 every 12 months) in replacing the Transmitter and Receiver units. Abbott wins here too.

Dexcom does have spectacular Sensor life, at least for me: I almost always get 17-19 days from each "72-hour" Sensor. So the cost for Sensors is very low. If Abbott Sensors don't last longer than 5 days, then I'll be paying a lot more with Abbott. But Abbott's a lot more convenient for taking a shower. If it's also more accurate and reliable, then I'm definitely gonna switch !

[Tamara Gamble]

It was a nurse who works for our rep in the area for Smiths Medical who was giving us the information. I didn't get the feeling that her top priority was working for them. It was clear she feels they are the best but I believe this is second to helping those dealing with this disease.

She has a daughter who is now 21 years of age and has had this disease for quite some time now. I saw her as a parent of a child with diabetes as she was willing to talk about the good points about other pumps, infusion sets as well as continuous blood glucose monitors from other companies without any negetivity what so ever.

She is excited about the advances being made no matter what they are if it gets the job done. She no longer has a child in the k-12 schools but still serves as an Advocate because she feels it's essential. She's lived through the difficulties and wants to help others. She also sits on the legislative board for the ADA here in Michigan and is trying to help get some laws passed.

I happened to call her find out about advanced pump training and relayed my big news of going to Chicago next month to become and advocate and being invited to sit on the board. This is when I found out that she is doing it already and I was thrilled that I was going to meet her. I had already worked with her with pump issues etc and got to know her a little bit before I went to the meeting. I felt that she is was very genuine.

I was extremely impressed that she had some dieticians attend armed with lap tops. They say down with each and every person to go over what they are doing, how it is working and how they can make it better. They helped them with the software issues they were having and showed them how to navigate the system for the infrared reader. It wasn't a sales pitch type meeting.

I have not used a continuous blood glucose system and cannot claim to know everything about them because I don't. I am only using what I was told in addition to some research that I did a while back so it's great to have your input as I am concerned about all of the costs involved as well. You are already using a system and your experience is extremely valuable here.

I still think time will tell and will wait to get on board until I'm comfortable with any product but I am so excited I can't stand it. My son is very brittle and night time readings are a norm for us. Two at least if not more. So this technology would be priceless for us. To bad my pocket book doesn't have the same feelings I do or there would be alot more money in it. This is a huge issue for most of us and I want our insurance co's to step up and pay so we can have the best treatment available whether it be for ourselves or our children.

I know this information is not as technical as what you are looking for but I hope it has some value for you as your information is valuable to us as well.

Good Luck! God Bless! Tami

[EmmasMom]

I need to do some more reading about this navigator! My concern about the claim of replacing finger sticks is, when you get a reading from interstitial fluid the numbers are behind, (as much as 10 minutes) and not the same as the reading you will get from capillary blood. Even if it is very accurate for interstitial it's not going to give the same reading as a finger stick, especially during a rapid rise or fall in blood sugar.
I'll be interested to see what happens...

On a side note, the MM sensor is completely waterproof as well. Emma bathed and swam with it, no problems.

[rmccully2000]

Amy, if you go to the ADA 2006 Scientific Sessions abstract page and search for navigator, there was a Directnet study using algorithms to calculate insulin doses from CGMS (specifically the navigator in this study). The algorithm needs some work on one of the two; either basal or boluses (can't remember right now) but I think this is where we are going with CGMS. Finding an algorithm using intersititial readings to accurately dose insulin. If I get some time, I'll find the link for you!! Pretty cool stuff though. The future really looks promising for our little ones.
Becky

Here is a link to the study:

http://scientificsessions.diabetes.org/Abstracts/index.cfm?fuseaction=Locator.PreviewAbstract&popup=yes&NoLayout=Yes&AbstractID=14960

[EmmasMom]

I did read that, and I hope it will help make them all more user friendly in the future!! I think the published studies show similar accuracy and "lag time" on all current CGMS technology, so maybe an algorithm could apply across the board.
For now we will just set our low alarms higher than needed and watch trends. :rolleyes: