MINIMED
Minimed (Medtronic) has been making insulin pumps for years and years. I have actually been a loyal medtronic customer and supporter since the 1990’s. My first insulin pump was a a medtronic 507. They sure have come a long way over the years. I have not only used the various medtronic pumps over the years, but have also been one of their certified pump trainers for over 20 years. Medtronic’s newest addition is the 670g pump, the first hybrid closed loop system available. What does “Hybrid” mean? Well this means that it will do automatic microbolus corrections of high and low sugars. It is not completely automatic, patients still need to enter sugars and carbs for accurate insulin delivery. Their system will use the Medtronic guardian CGM reading to do automatic micro-boluses, this will help patients who either over or undershoot their boluses by a unit or 2. It will not be able to bolus enough to compensate for an entirely missed meal-time bolus. This new system has been a ground-breaking invention and had a lot of hype surrounding it’s release. The reviews have been mixed. Sadly, I have been unable to get one to try myself. Medtronic had none available for patients to try and despite my many attempts to appeal the insurance to get the pump ahead of my warranty expiration, I was unable to get a hold of this pump. The pros for this pump are that patients have been shown increase their time in range. It has also been shown to decrease the risk of hypoglycemic episodes almost to zero. The cons are that the sensor has been known to have many issues with needing frequent blood sugar checks. Many times this happens in the middle of the night and wakes patients up. Another con is that it corrects to 120mg/dl. For patients who are, or would like to become pregnant, auto-mode can not be used because most doctors prefer them to stay under 120 all of the time. The 670g is waterproof, however the CGM will not read in the water, therefore you will be kicked out of auto-mode when in the pool for a long period of time.
OMNIPOD
Omnipod is the only tubeless pump on the market. It comes with a controller that is separate from the pump to bolus through (called the PDM for personal diabetes manager). This pump is often used with the DEXCOM sensor but does not have an interfacing where the CGM is displayed on the PDM, so most patients use the phone ap for DEXCOM along with this pump. Patients who are active and concerned with tubing issues love this pump. This is also preferred by a lot of parents who have a child on a pump. The pump is waterproof but the PDM is not, so basal delivery an continue in the water however, bolus can not. Omipod has been popular among athletic patients. I have had the opportunity to use this pump and do enjoy being able to wear it on my arm (an area that had little use until Omnipod) for delivery. I found it at first a little annoying to remember the PDM, but once I got used to it, I rarely forgot it when I was out and about. It was nice at bedtime to not have a pump to tuck into my pjs. Definitely a great pump for those who do not like tubing. There are also rumors of new technology on the horizon, hopefully coming out soon.
TANDEM
The newest Tandem pump is called the T:slim X2 insulin pump which now has basal IQ technology. The T-slim uses the DEXCOM CGM to monitor blood sugar readings. The T-slim pump technology uses the DEXCOM reading to suspend the pump when a low is predicted in the next 20 mins. The pump will remain suspended only until the sugar starts to rise. This allows patients to get their glucose up without causing a rebound high. It is predicted that their hybrid closed loop technology will be available in the early summer months and patients will be able to do an online course to receive the code to upgrade to the new system. This pump uses the DEXCOM CGM which does not require any calibrations. Pros are no finger sticks, and decreased time in hypoglycemia. In addition data suggests that overall time in range increases, patients appear to be more willing to bolus aggressively knowing their chance of lows will be decreased. Cons are that the new technology is not yet available, so patients will have to wait a few more months and their will be a charge, which has not yet been revealed. I was able to trial this and I loved it. It was amazing to me to see the number of times it suspended to keep me from going long, without me even know it. My best night I rode a straight line at 75-80, with 6 suspends while I slept. I had no beeps and slept through the whole night.
