Hooray!!...and more questions!

[rsmom]

:) Well, things can change quickly, can't they? Yesterday I was asking about possibly switching DS from an NPH/H regimen to a Lantus/H regimen while we wait to start pumping. The reason we were opting to wait was due to the fact that we were planning a vacation in mid-September, and DS was starting his first year of preschool then too. In addition to some summer activities, it just seemed like a lot going on, and we were concerned about going away only a couple of months into our pump therapy.

Well, due to some restrictions on our airmiles, we're now going away in November instead. DH and I were talking last night, and decided that maybe now is the best time to get started after all. We have our next team medical appt in June, so the timing is great - we'll be able to get our son well on his way before preschool starts, and by vacation time we'll be a lot more comfortable with everything. So - the GREAT news is that DH called his insurance company today, and they will cover 100% up to a max. of $6600!!!! I about died....I was sure that we would only get 70-80% max. I was literally in tears - all the pump supplies are covered 100% too. It's a good day! :)

I've been reading like a madwoman this afternoon - all along I had narrowed my preference to either the Animas 1250 or the MiniMed Paradigm. I will still need to speak with our endo, too - if he has a preference for one pump over another I'd like to know why. In the meantime, though, can anyone share with me why they opted for one of these two pumps over the other....what was the deciding factor for you when you made a choice?

Also - I really like the idea of the continuous glucose monitoring that the Paradigm advertises, but I'm a little unclear as to whether you can use this feature with children or not (DS is 3, turning 4 in December). Does anyone know? If not, are there plans to improve this feature so it IS usable for the little ones?

Does anyone know if other pump companies will be offering this feature?

Also - I'm a bit clueless about what happens as time passes and pumps get better. If you purchase a pump now, and then better pumps come along, can you upgrade, or do you need to fully re-purchase a new pump?

Another worry about the Paradigm is the need to use proprietary pump supplies.....for a 3 year old, is this something to be really concerned about? I want to be sure that DS is as comfortable as possible, and I'm thinking that we might need as many options for infusion sets, needles, etc. as possible.

I do know that the simple fact that the Animas can bolus in .25 increments might be the deciding factor - I'm just really taken with the idea of the continuous glucose monitoring, though, and the alarms for low sugars (or highs) that are a part of that system.

Thanks so much for any information you can share :) I'm sure there will be many more questions to come - can I say again how glad I am to have found these boards? :cool:

[lisamomtotwins]

Congrats on your decision!! I think you are making the right choice! WE went with the Animas. Because exactly like you said the ability to give less insulin. DH was on Minimed before Animas he likes both pumps alot but he feels the animas has some better features and controls his sugar a little better, for what ever reason he isnt having as many lows as before. (lows are a big problem with him)!! Anyway we were also trying to decide because of the continues glucose monitor but we figure since it isnt really covered yet by insurance and isnt really proven or tested very much yet and alot of contraversy on how effective it is we decided to go with Animas. The rep from Animas said they are prob going to have a product out soon as well, well with in the next 1 or 2. So that is good news. I am actually wearing a lender pump right now so i can see how it feels and get a better handle on things. I suggest doing that. Hailey will be on saline as of this weekend and on insulin come tuesday if all goes well! I CANT WAIT!!!!!!!!!! THey did say that is will take a good few months to have everything regulated and dosages correct so i look forward to that day!! :)
Good luck
Lisa

[Hollyb]

Hi and congrats -- wonderful news about your insurance company.

Minimed's continuous glucose monitoring system has been out for a little while here in Canada, and we have a young friend who went to a demo. She's 19, been diabetic since age 12, and has been finding it harder to keep her sugars controlled now that she's away at school so was very very excited about this product (she also tends to go low in the night, so the alarm would be fantastic for her). She's not so excited now, unfortunately. One problem is the cost -- you basically have a whole other infusion set to change every 3 days, with a built-in sensor and those sets cost a bundle and are not covered by insurance at this point. The other problem is the size of the sensor -- it's not just a flat infusion set, it's quite a good-sized unit taped to you. As a young woman she was worried about how much it would bulge out over her clothes, but for a young child I'd be worried about having her whole tummy covered in stuff. There aren't usually that many good sites for rotating on young ones and now you've got two at a time to worry about. Also, it would I think be quite uncomfortable to sleep on.

For sure it's a promising step -- but for us, we decided to wait until the next generation. One infusion site seemed enough to manage for beginners!

One other advantage of the Animas is you get a lot longer on the battery. Doesn't seem like much, but you know there is so much to remember anyway with this disease, anything like this helps. Aaron is heading into his 4th month on the same battery!

Anyhow,

[lmpkn5]

My son who is 5 1/2 started on his pump 7 weeks ago. We have had a very difficult time figuring out his basal rates. He is on the new pump from medtronic that has the continuous glucose monitoring system. We did not order it with our pump but have borrowed one from medtronic to see if we can sort this basal stuff out. A nurse is coming to our house on Monday to help us get started. Our plan is to only use it for a week or two and then give it back. He is a little guy, so I am concered about where we will put it and if it will be to much for him. I am hoping it gives us some good information to work with.

Cheryl
Mom to Nolan 12(not diabetic), Gillian 9(not diabetic)
Rhys 5 (diagnosed 09/03) pumping since 04/06

[rsmom]

Thanks for the information - I didn't realize that the glucose monitoring equipment was so bulky....I definitely don't want too much stuff on DS's belly, we really want this to be as comfortable and "normal" for him as possible.

I've been reading everything I can find - both hubby and I are really, really liking the Animas 1250....the non-volatile memory, the fact that it's waterproof, the non-proprietary infusion connection, the longer battery (as well as the readily available batteries it takes :) ).

I also didn't realize that there were portions of the continuous system that weren't covered by insurance - possibly worth it if it means no finger pokes, but I know that as new technology and due to DS's age, our PE would still want regular finger pokes.

[Hollyb]

Actually you still have to do two finger sticks a day to "calibrate" the monitor, and then they say any time it alarms high or low you should also check to confirm with a finger stick as well. So it really doesn't save you too many of those. What it would give you is a chance to see what's going on through the night -- I would LOVE that, even for a few days.

[ann-lolly]

we are in the process of deciding betweehn the 2 pumps also and met with both--we do like the aminas better but the minimed offers a meter that can be checked with the finger sticks and automatically tells the pump what your sugar is so it can help with the adjustments in insulin and that was part of the package. i think you can check their website it is a BP meter I believe. Anyway, we still have not decided so I think we will wait until our pump class to make the final decision and might even have it hooked to us before we decided for our daughter.

[hot_cheerleader_101]

:) Well, things can change quickly, can't they? Yesterday I was asking about possibly switching DS from an NPH/H regimen to a Lantus/H regimen while we wait to start pumping. The reason we were opting to wait was due to the fact that we were planning a vacation in mid-September, and DS was starting his first year of preschool then too. In addition to some summer activities, it just seemed like a lot going on, and we were concerned about going away only a couple of months into our pump therapy.

Well, due to some restrictions on our airmiles, we're now going away in November instead. DH and I were talking last night, and decided that maybe now is the best time to get started after all. We have our next team medical appt in June, so the timing is great - we'll be able to get our son well on his way before preschool starts, and by vacation time we'll be a lot more comfortable with everything. So - the GREAT news is that DH called his insurance company today, and they will cover 100% up to a max. of $6600!!!! I about died....I was sure that we would only get 70-80% max. I was literally in tears - all the pump supplies are covered 100% too. It's a good day! :)

I've been reading like a madwoman this afternoon - all along I had narrowed my preference to either the Animas 1250 or the MiniMed Paradigm. I will still need to speak with our endo, too - if he has a preference for one pump over another I'd like to know why. In the meantime, though, can anyone share with me why they opted for one of these two pumps over the other....what was the deciding factor for you when you made a choice?

Also - I really like the idea of the continuous glucose monitoring that the Paradigm advertises, but I'm a little unclear as to whether you can use this feature with children or not (DS is 3, turning 4 in December). Does anyone know? If not, are there plans to improve this feature so it IS usable for the little ones?

Does anyone know if other pump companies will be offering this feature?

Also - I'm a bit clueless about what happens as time passes and pumps get better. If you purchase a pump now, and then better pumps come along, can you upgrade, or do you need to fully re-purchase a new pump?

Another worry about the Paradigm is the need to use proprietary pump supplies.....for a 3 year old, is this something to be really concerned about? I want to be sure that DS is as comfortable as possible, and I'm thinking that we might need as many options for infusion sets, needles, etc. as possible.

I do know that the simple fact that the Animas can bolus in .25 increments might be the deciding factor - I'm just really taken with the idea of the continuous glucose monitoring, though, and the alarms for low sugars (or highs) that are a part of that system.

Thanks so much for any information you can share :) I'm sure there will be many more questions to come - can I say again how glad I am to have found these boards? :cool:
I just went to a pump class and I just got my pump! There was a around 5 year old girl there and her mom was VER INTERESTED in the continuous glucose monitor, so I think you can use it on kids. I just got my pump and I have the paradigm. Its awsome! I really recomend it!

[faithe113001]

it is a BP meter I believe.

Sorry, but I just had to note that it is a BD meter. Good luck on your decision!

[selketine]

I don't think the CGMS is approved yet on kids - especially little kids at least. And as someone mentioned the unit looks VERY bulky. I agree I would love to have it though....

I think the Animas is the best choice for young kids cause of the smaller basal increments. It gives you SO much more flexibility with basal adjustments if your child is sensitive to insulin. William's basals are all adjusted in .025 increments (.175, .2, .225 are his basals generally) and it does make a big difference that little bit.

Rapid D's are an excellent set for little kids (metal needle so no cannula to crink). We have used those for the past year and a half. Most of all it is nice to have a choice.

[kiwikid]

I agree with Selketine (Hi Carol !!) that the Rapid D is a great set for littlies. We have had no trouble with it at all. Therefore being able to use the set of your choice with your pump is a BIG issue.

I was put off the MiniMed Pump when one mother posted in the chat room that her child had been down an enclosed (tubular) slide at a Playground and the static electricity had wiped the pumps memory and settings completely. :eek: Non - volatile memory for us!

Jane (Mum of Rachel,4 - pumping Cozmo)

[lisamomtotwins]

So decide which pump to go with? Hailey just went on the Animas. So far so good. We had a few problems with the site changes yestorday, but got it under control. Good luck.

[rsmom]

Thanks, everybody!

We're going to meet with reps from both companies - I definitely "feel" a preference for the Animas, but I want to be open to both and see how I feel once I actually see them, touch them, etc. We will be purchasing sometime in the next couple of months to get started in September - I'll definitely let you know what pump we ultimately decide on!

All of your information is greatly appreciated :)

[rickst29]

I don't work for a durable equipment company, but here is my impression.

Whether you get a discount (or freebie) upgrade is generally up to the company. When Disetronic upgraded the DTron, new model was DTron+, they gave all of us original owners the enhanced version as a free trade in when our in-service-days came due to maintenance checks.

They weren't being nice. Rather, they didn't want to have the old ones out there anymore, and there were relatively few of them. Giving us freebies actually saved money, they didn't have to stock all of those old parts anymore (computer ROMs and etc.).

On the other hand, no one's gonna give you a pump for free if there's (a) a good chance that they can get money for it; and (b) it doesn't result in a special cost savings FOR THEM, like the Disetronic situation I just described.

So even though they have huge markups, the companies would die if they opened the door to deep discounting on a regular basis. (If lots of people get it for half price, then word gets out, then everyone refuses to pay more than half price. Including our own customers-- they tend to be loyal anyway, so it would KILL our revenues to discount upgrades "in the family".)

Discounting tends to occur only when (a) they want to terminate support on the particular old model you've got, or (b) they want to clear out the channel of a model which is being replaced, or (c) a "special on the q.t." offered to clinch a switch from a competitor's pump.

[rickst29]

First thing I want to point out: According to our comparison page,
http://www.childrenwithdiabetes.com/continuous.htm

the Guardian is "Available to adults and children...."

Even though it is not FDA-approved for use in Children, you can get it. This is similar to many regular drugs, they have a good record and are widely prescribed/used as treatments for "off-label" conditions. Not being FDA-approved could definitely throw a wrench into insurance reimbusement, but it shouldn't (by itself) be a show-stopping consideration.

It's between you and your Dr., whether he agrees that your child (of any age) would have a good benefit/cost ratio with this device. It takes considerable attention and skill to interpret the results, due to the the fact that ISF reading are usually 20-30 minutes behind actual bG.

Now the second thing:
Look at that page again, there are TWO currently approved CGMS systems.

** One costs $2400, and the other costs $500.

**The expensive one needs a docking station to see a graph of your history, the cheap one (Dexcom) doesn't even have a docking station: The nice graph is shown right on the monitor screen, in 1 hour, 3-hour, or 9-hour widths.

**The cheap one (Dexcom) is asking the FDA to approve their sensors for 7-day usage. And, it can be "tricked" RIGHT NOW into using the same sensor for a second 72-hour period, if you dare. (I'm not qualified to give medical advice! But the one I'm wearing at this moment is in it's 8th day, and the numbers are tracking my meter as good as they did on the FIRST day.) If you go "off-label", that means lots less stabbings and lots less $$$ for sensors.

The size of the Dexcom is large W*H, but it is only 1/2 inch thick. It's roughly the same as another pump, but there's no need to attach any tubing, and it's WAY lighter than a pump. (Unfortunately, the Dexcom belt clip kinda sucks.)

Our page is very misleading with regard to the sensor size. The 2-1/2 inch figure is the (maximum) length of the adhesive patch. The part which actually sticks up from your skin is less than 1-1/2 inches long, less than 3/4 inch wide, and it sticks up about 1/4 inch from your skin. That's only slightly larger than my Ultraflex infusion set. And with no tubing to drag on my clothes, I notice the sensor a lot less than the Ultraflex. That nasty looking "sensor" in the picture is 40% safety clip (the big, clear piece of plastic keeps the insertion spring from going off until it's removed); 50% insertion device (the fat round plunger and tube; and only about 10% "sensor" (the part which remains on your skin).

Hollyb: I think that your collegiate friend should get this one. The sensor life (in my experience) is over twice as good as currently stated, costing me less than 5 $US per day (not $12 per the current FDA approved usage). The sensor is small. my favorite place is my side, underneath my upper arm when standing with arms at sides.

If she's gotta have slinky clothes, maybe a place close to the beltline will be less obvious. But my sensor location is basically INVISIBLE with any normal shirt. (If she wants to control her bGs better, she should give up tank tops, I think.) And being on my side, it doesn't interfere, or get jostled, during the "rough stuff" me and my wife enjoy in bed.

It even survives the dog! I've got a mixed Rhodesian Ridgeback, I think there's a lot of Pit Bull in the mix. (The Rhodesian was invented for hunting/chewing on Cape Buffaloes and Lions... PLUS Pit Bull smarts and dominance instincts). He's whacked my sensor with his paw pretty hard a couple times, but it's still working.

I have no financial interest in Dexcom. I'm just an amazed, delighted customer. For $1900 less purchase cost, it's not merely "just as good", it's BETTER. I think that the only reason Guardian has market share is, they've been out for much longer and have a year of marketing momentum behind them.