Dee, the “unproven” factors as I mention here are what I find in my comparison of pump replacement choices that I have discovered in my research - my personal gathering of public disclosures.
I’m looking at the four iAIDs readily available in the USA and the four components involved in each system:
Sensor - t-Slim, iLet, OmniPod5 all use the Dexcom G6 FDA Approved for insulin dosing April 2017; updated software for the first two has a toggle to select the G6, G7, or Libre3, the only three devices FDA Approved. The MiniMed 780G uses a Guardian 4 sensor that has not yet received FDA Approval.
Algorithm - The Tandem CIQ has undergone intensive FDA independent 3rd party testing procedures before approval and has been in use since January 2020. The iLet and 780G automatic dosing software were “fast-tract” and received FDA 510(k) Clearance, but not yet Approved. I like the theory Bolus as frequently as every 5 minutes, but for me this is too risky - my t-Slim automatic bolus of 0.117 today was too much, and this correction was dosed at 60% of calculated dose. Good results reported about the Omni 5.
Infusion Sets - all, except OmniPod, are manufactured by the same outfit.
I hope this helps. I’m still looking and trying to find more information, such as how good the Medtronic guardian actually is in real-life; it is brand new and I’m hoping it is significantly improved compared to the three prior editions. I really like the iLet using the prefilled cartridges as this will be a big improvement over the t-Slim.
@Dennis,
I appreciate the breakdown. I thought the latest from Medtronic had been approved. I’ll be reading more on it. I have been pouring over everything I can find. Most is very good and I’ve decided to go with the 780 G upgrade, unless something drastic changes my mind. I’ve even read a lot on diabetes sites in England, where it has been available for over a year. I am wary of any new products for sure, but I feel pretty good about Medtronic. I’ll post more later on and I’ll keep looking here for more info.
Dee @HighHopes, from what I recall you saying, the 780G may be a very good choice for you; I still hope to meet soon with a Medtronic Rep to see if it could be a good fit for me. Given the history of previous versions of Guardian I’ve been advised to be cautious. The algorithm used in the 780G appears to be “Rocket”, code name at UVA where it was being developed by the same team which built CIQ which was sold to Tandem. I like the work done there.
There are significant differences between “FDA Cleared” and “FDA Approved”; the FDA has long descriptions of differences with reasons.
Quick update on this thread. If anyone wants to talk to someone who is on the iLet pump then feel free to reach out to me. I’m been using it and testing its capabilities in varying scenarios. Have also done many tests with the glass cartridges - they offer lots of great flexibility.
@Cherylh09, Am more than happy to answer any questions about iLet pump. I’ve been using it since October and continue to be impressed with it. Feel free to DM me and can find a time to speak with you and your son regarding this pump. Am sure you/your son will have follow up topic questions and a call will allow for a quick exchange of thoughts.
Will that work for you?
And thanks Joe for tagging me on this thread. I’m not always on the message board and I received an email from the tag!
Exciting news! I got a VM from an iLet rep that my insurance has contracted with Edgepark to cover the ilet pump! They have sent the request to Edgepark and expect processing to finish sometime next week !
Dorie: Now that insurance (Medicare?) is paying for the iLet you should call your normal DME company to check if they are selling the iLet pump. No reason to change if you don’t have to.
What about the iLet pump made you choose it over a Insulet, Medtronic and Tandem or pump?
@wadawabbit, Awesome news! I’m enjoying the iLet pump. It’s very freeing to not have to worry about managing BGs. All I have to do is feed it insulin, change insets and announce meals - ok the last one I often forget to do and frankly don’t worry about it. The pump manages the rest.
I upgraded the pump software last week as they now support G7! Took them only two months to announce support after getting G7 integration tools and samples from Dexcom.
Trust me, I will be reaching out😊! And why not start now?
How do you handle exercise? Can you pause insulin if necessary? And - when I started on Omnipod it took about a week (a couple of pods) for the system to “learn” my body. What’s the process like with iLet and how long did it take for you?
Sorry if you answered some of this above or elsewhere, and I imagine once my insurance approves it () I’ll get some answers from the training materials too but thanks for getting me started.
@wadawabbit, Hi Dorie - Sorry this is late, been traveling on vacation. For intense exercise I disconnect and carb up (as needed) then I typically reconnect when I’m done. If the activity is less intense and my BGs are already a bit higher then I typically keep it connected and as my BGs fall the pump stops with autocorrects doses and instead does the smaller .05 to .07 of a unit in basil every 5min. Another person at Stanford hospital (he’s a diabetic nutritionist) got the iLet before me and he does long bike rides. For those he said he disconnects the pump, carbs up then reconnects the pump when he’s halfway into his ride. As I play racquet sports I prefer to have the pump disconnected so it doesn’t get hit or fall out of my pocket during a point, so I wait till I’m done playing before reconnecting. Beta Bionics is working on an exercise selection but not sure when it will be available.
Training the pump is pretty painless. It takes 7 days to train and all you have to do is eat your usual carb meals for breakfast, lunch and dinner. Once the pump is trained your “less” meal option is roughly 50% of your usual carb meal and “more” meal is 50% more. Autocorrect doses will manage the rest to give you a soft landing on your target setting. Fell free to keep the questions coming!
However, I’ll jump ahead and answer one on prefilling cartridges! I’m able to fill 5 cartridges from a single vial and will do all five at one time with one syringe. Can keep the remaining insulin in the vial for later use when you have a few vials with enough insulin to fill a cartridge. I pre-chill my empty cartridges (keep them in their sterile packaging) and fill them while in sterile packages, by only making one needle size hole in packaging from the syringe, then put them back in the fridge until they are needed. I fill them until the bottom stopper sticks out a bit beyond the glass cartridge. And after priming the tubing I’ll end up with a bit more than 160 units. This lasts me about 6 days on a single cartridge.
Thanks @gmershon and no apologies necessary. I appreciate the info. I like being able to pre-fill - just between us () I did that with my Tandem cartridges although it was not recommended. It will be nice to carry a cartridge with me on change day, rather than a viral of insulin as I do with Omnipod.
Some insulins work best when you bolus in advance, and doing so iis especially necessary with a smart pump or loop. Do you have to bolus in advance, with the iLet or can you wait until you’re ready to eat? That’s been a challenge for me lately.
I’m hoping to hear good news this week, which means tomorrow or Friday, so I hope I’ll be joining you soon! Did you do any online training to prepare, or just train with a rep?
@wadawabbit, I don’t bolus in advance. I do it when or after I eat. Sometimes I forget completely and then the autocorrect kicks in. I also don’t bolus for snacks unless it’s more than 15g carbs. No pre-training is needed. Just with your trainer is all you’ll need. Note that you can also call the beta bionics support for an extra charger. They shipped me one for free. Also, can ask your trainer (before training) if they can bring a handful of steel insets to try later. Oh, and their tech support is amazing and super friendly.
Here are some interesting BG results from a weekend of business meetings and on iLet pump. Had pizza late on Saturday night and ate way more than my “more” meal announcement. Ate a “usual” breakfast and a “more” Thai curry for lunch on Sun (with no potatoes and had about 1 cup of rice).
My “usual” dinner is around 35-45g carbs and my “usual” lunch is around 40-50g carbs. “More” meal announcements are 50% more than usual, so clearly I ate way more carbs for those two meals than my “more” can cover. The pumps autocorrects did all the heavy work as I continued my work meeting. Clearly those meals were loaded with carbs and best of all… I didn’t care! It’s Spot’s job (the name of my pump) to manage my BGs. Fun to see this after it happened.
!
) I’ll get some answers from the training materials too but thanks for getting me started.
) I did that with my Tandem cartridges although it was not recommended. It will be nice to carry a cartridge with me on change day, rather than a viral of insulin as I do with Omnipod.