Medtronic clearly sees a lot of revenue potential in future devices. According to Reuters, they are planning to spend 35% more this year on their next generation of diabetes devices. According to the article they want to make these
simpler to use and more effective in managing the disease
I do hope they also consider other design aspects like the fun factor and how they look. Ease of use is definitely important, but I'd also like a device package that doesn't necessarily look like another mobile phone. I'd also like to move away from the Henry Ford-like approach to diabetes devices. "You can have that in any color as long as it's black or blue".
As a long-time Minimed pump user, I moved to a Cozmo last year because I just didn't see any innovation in what Minimed were doing. The design of the sensor for their CGMS is just plain ugly and way too large.
Do you want proof? See klil's picture from the Diabetes 365 project. How did they manage to make something this big? Have they checked out what Dexcom managed to do?
Despite my cynicism, I think this commitment from Minimed is a good thing. They're the big dog of diabetes devices and if their additional spending produces innovative designs, it's a sure thing that competitors and start-up companies will take up the challenge.
While I'm talking about device design, I hope you've had a chance to see Amy's post about the recent DiabetesMine design contest.
I've mentioned the super bolus before on this blog. This is a technique that only works for people who are using an insulin pump.
According to John Walsh's original note about the super bolus:
A Super Bolus is created when some of the basal insulin delivery is stopped or partially reduced, and delivered instead as additional bolus insulin on top of a normal carb or correction bolus. This shift of basal to bolus insulin creates a larger bolus that can have more impact in situations where more insulin is needed quickly. These situations may include but are not limited to covering high glycemic index foods, larger intakes of carbohydrate, and speeding the return of an elevated blood sugar to normal.
The super bolus boosts the effectiveness of a regular bolus by taking some of your basal insulin and delivering it early. For example, if your basal rate is 0.7 units per hour, you can temporarily turn off the basal delivery for one hour and then take the 0.7 units immediately. The trick is how you take that insulin. If you took it as a bolus then it would affect your insulin on board totals, so instead you take it by using the prime features that you'd normally use to fill the cannula after inserting a new infusion set.
I shot three short videos that show how to do a super bolus on different insulin pumps. This gives you a chance to compare these pumps in action and see how to use this useful technique which helps correct high blood sugars a little faster.
Here's how to take a super bolus with a Minimed 512 insulin pump.
Here's how to do it with an Animas 2020 insulin pump.
And here's how to do it on a Cozmo 1800 insulin pump.
According to a Medtronic press release, Medtronic and Bayer will work together to distribute a new blood glucose meter for Medtronic patients outside the US. Originally I missed the fact that within the US, Medtronic has made a similar agreement with LifeScan. Thanks Kevin and Amy for pointing this out.
The new meter for those in Canada and Europe will be based on the Bayer Contour and will transmit results to Minimed insulin pumps and the Guardian REAL-time CGMS.
The new US meter will be based on the OneTouch platform. I wonder whether they'll use a version of the more stylish OneTouch UltraMini, the Ultra2 or something completely new because of the need to include the circuitry for wireless transmission.
And once again, I hope that one or more of these three companies (Medtronic, Bayer, or LifeScan) will finally decide to work towards a standard format for representing diabetes data.
Sometimes I'm a bit of a perfectionist. I demand a lot of myself and expect it from others. I'm telling you this because maybe I just have unrealistic expectations.
In September my current insulin pump (Minimed 512) will be 4 years old. At that stage it will be out of warranty and I can get a new pump and expect that insurance will cover most of it.
Insulin pumps are truly a marvel of technology. This is a small pager-sized device that I will wear 24 hours a day, 365 days a year. It helps me to keep my blood glucose levels close to normal and it's something that I'll probably actually use and interact with at least eight times a day, every day.
So why are pump companies making it so hard to try one out for a short while? Yes, I can read the instruction manual and get some feeling for how the pump will behave and feel. But that's not the same as wearing the thing and using it for a week or so.
My original plan was to contact a few pump makers and ask them for a one or two week loaner. I'd fill it with a saline solution and wear it together with my old pump for that period. That way I could gauge its accuracy and usability and see if it was right for me.
So far I've contacted three different companies. One (Cozmo) has told me they don't have a loaner program. And the other two claim to be working on it, but I'm not holding my breath.
Pump companies (Minimed, Animas, Cozmo, and others) - WAKE UP. These are complex devices that are essentially extension of our bodies and our brains. There is no way I'm going to purchase a new one without trying it out first.
I don't want a 30-day money-back guarantee. I want to be able to try out the pump, with its software for a week or two. I want to know how it will work for me.
Will I be able to use it when I'm exercising? What are the insulin on board calculations like? How easy is it to bolus? What do I need to do to set a temporary basal? Can I easily calculate meal requirements? What kind of extended bolus options are there, and can I use them?
Maybe I'm crazy. Maybe I should just look at the glossy brochures with pictures of happy people and just pick one at random?
I've been wearing both Dexcom CGM systems for about 24 hours now. It amazes me how closely they track one another, though yesterday the old one was always about 10 points below the new one. Today I'm seeing about the same difference. You can also see there are some gaps in readings for the Dexcom 7. I think the receiver is a bit fussier about rejecting possibly bogus readings. I wonder how that will look when I'm more than seven days into the Dexcom 7 sensor.
I came across a 19-page HSBC Global Research report(PDF) comparing Minimed and Dexcom based on the ADA conference and a survey that HSBC took. The report estimates there will be about 140,000 CGMS users by the end of 2009 versus about 15,000 today (and 6,000 at the end of 2006). That's a huge growth rate, and you know it will impact insurance coverage. I think it will also drive the demand for software to help healthcare teams interpret the huge amount of numbers they'll see in place of log books.
I hope this quote will come about
We would view any such collaboration between DexCom and any of the leading insulin pump manufacturers – Johnson & Johnson (Animas), Roche (Disetronic), Smiths Group (Deltec), or Insulet – as a positive for both parties, as both companies would better com
Personally, I think that CGM will become the standard for testing for anyone with Type 1 diabetes. Read the report, I think you'll find it interesting.
I'll post some pictures from the Dexcom 7 software later in the week. I did try the new software with my old data values and it worked just fine. So I've much more interesting statistical views of my readings available back to March.
Note: I currently own some shares in Dexcom, I work not to let this influence what I say about the company or its products.
Finally here's a picture from last weekend of some of the lovely flowers in my sister-in-law's place in Rhode Island. What a lovely weekend we had there.
Yesterday I met with the Dexcom representative and actually bought the unit.
The 'system' (receiver, transmitter, charger, cables, software) was $375, and the first 5 sensors cost $175. Total cost $550.
Officially the 5 sensors will give me values for 15 days. However I'm currently wearing a sensor that I first started on Monday and it's still working fine. So if I get an average of 7 days per sensor I have enough for about 5 weeks.
Now there are definitely aspects of this device that I don't like. But when it works it gives me great results. For example, if I'm about to drive I can look at the value and if it's stable and between 120-160 then I feel comfortable getting into the car without testing.
Next week I'll start the paperwork with Aetna and see how much of this I can get covered. I'll post on that as the process unwinds.
I agree with the Dexcom representative that Dexcom is committed to CGM devices, that's all they do right now. Whereas Minimed is really all about pumps, and they use the CGM device more as an accessory for the pump. I know this is over simplifying things, but the pricing models are very different.
I'll post more about this decision later. I'm rushing off to an all day Code Camp at Microsoft.
I found a very useful slideshow that compares the Dexcom and Minimed devices. It's written by John Walsh and Ruth Roberts authors of the excellent book Pumping Insulin. You can find the slideshow on the Diabetes Mall forums.
I need to point out that I also decided to buy some shares in Dexcom. Despite my interest in seeing the company do well, I'll continue to be upfront about the pros and cons of the system.
Yesterday I met with the Dexcom representative and actually bought the unit.
The 'system' (receiver, transmitter, charger, cables, software) was $375, and the first 5 sensors cost $175. Total cost $550.
Officially the 5 sensors will give me values for 15 days. However I'm currently wearing a sensor that I first started on Monday and it's still working fine. So if I get an average of 7 days per sensor I have enough for about 5 weeks.
Now there are definitely aspects of this device that I don't like. But when it works it gives me great results. For example, if I'm about to drive I can look at the value and if it's stable and between 120-160 then I feel comfortable getting into the car without testing.
I agree with the Dexcom representative that Dexcom is committed to CGM devices, that's all they do right now. Whereas Minimed is really all about pumps, and they use the CGM device more as an accessory for the pump. I know this is over simplifying things, but the pricing models are very different.
I'll post more about this decision later. I'm rushing off to an all day Code Camp at Microsoft.
I found a very useful slideshow that compares the Dexcom and Minimed devices. It's written by John Walsh and Ruth Roberts authors of the excellent book Pumping Insulin. You can find the slideshow on the Diabetes Mall forums.
I need to point out that I also decided to buy some shares in Dexcom. Despite my interest in seeing the company do well, I'll continue to be upfront about the pros and cons of the system.
Update: I had posted the wrong location for the comparison slideshow. You can find the presentation here. Sorry.
The Diabetes Technology Blog is focused on using technology to life better with diabetes. I review: blood glucose monitors; continuous glucose monitor; blood sugar meters; diabetes software and living with diabetes.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 35 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN CGM to track my blood glucose levels. I also take Symlin to help control my post-meal blood sugars.
I'm blessed by God, and every day brings the possibility of a cure.
Do you want proof? See klil's picture from the Diabetes 365 project. How did they manage to make something this big? Have they checked out what Dexcom managed to do?
