My notes from a pump club meeting about the Minimed 522/722

I was at a pump club meeting in mid-June when some information was presented about the new Minimed pump with realtime glucose monitoring. I realized that I should post this here, for those who are just gathering as much information as they can about the Minimed 522 and 722 pumps.

It turns out that about 10 patients in the Boston area have received insurance coverage for the pump and associated 'real-time' sensor. The Minimed rep sent me a template of a letter that Minimed is suggesting could be used to get coverage from insurance. E-mail me if you want a copy of it.

I joked that maybe all we need to do in order to get coverage is to have a few ambulance rides! It does turn out that problems with A1C level control or hospitalizations due to reactions or DKA are all likely to persuade an insurer to cover the sensor.

The sales rep mentioned that Minimed is actively talking with major insurers, including Aetna, about getting full coverage. Minimed will have some studies out in the fall that will provide more evidence of the benefits for using this type of system.

The sensor is a complete unit including power source. It needs to be returned to Minimed every year or so for a replacement. I don't know if there's a cost associated with that.

Even though Minimed says that the sensor needs to be changed every 3 days, it seems that it will work for up to 6 days (or more) in most people. Because it's just lying in the skin, and not delivering insulin, there seems to be less skin reaction problems with it. They do provide a spring loaded insertion device for the sensors.

The computer software to download the data is provided with the pump. I assume they also provide something to collect the data (don't know if that's wireless or some wired connection to the pump).

A woman from Minimed who attended the meeting was wearing the sensor and pump. She said that she normally just lets the transmitter dangle. The transmitter is fully waterproof. So if you removed your pump to go swimming, you could leave the sensor/transmitter in place.

In that case it continues to collect data for the first 45 minutes after it's not 'connected' to the pump, and will upload that data to the pump once reconnected. It seems very likely that the sensor size will be reduced as Minimed refines it.

It appears that it takes about 21 days to get used to the new information available and learn how to take best advantage of it. There may still be a significant benefit in just using the sensor from time to time (wear it for a month and then not for a month) - which would certainly save money for people who don't have insurance coverage.

It also seems that it provides much tighter control because it allows you to see a high coming and take earlier action to reduce it. Ditto with a low.

Other things that I learnt:
Minimed has a program where they will lend you a pump if you're going overseas on vacation and want to have a backup with you. There may be a minimal cost (? $50) associated with this. Some students who go overseas for an entire semester take advantage of this.

The next version of the pump will provide predictions about where your blood sugar will be in 30 minutes. It's not clear when that would come out. My guess is not before the fall of 2007.

The version after the next one will probably be a closed loop system. This really helps with your basals. You'll still have to work boluses and dealing with illness/exercise separately. Since I see this as a much more significant change in the overall system, my bet would be that we don't see it before early 2009. It would be interesting to attend the FDA approval hearings about that one!

I can't vouch for the accuracy of any of this info, it's a mental set of notes that I sent to some diabetic friends the next day. I hope it's useful to someone out there.

posted by Bernard @ 3:11 PM