You grab a pack of gum at the checkout counter. It’s an impulse purchase and you don’t think about it. It’s a snap decision, made right then and there.
Choosing an insulin pump is anything but a snap decision. You research all of your options, talk with other people who wear pumps, weigh the pros and cons of each pump, and of course, find out if insurance will cover your pump and supplies.
In my case, my insulin pump choice was a snap decision. With a capital S.
After my warranty expired on my previous pump (Of course, it was pining for the fjords five weeks later.) and an opportunity to try the next generation of that company’s pump, I recognized that I needed to do further investigating. I’d only worn two brands of insulin pumps in the over 15 years of pumping. I am still happy with the choices I made back then, but back then, I didn’t have a lot of choices.
I cheer the fact that we have more choices now when it comes to insulin pumps and continuous glucose monitoring devices. Each pump and CGM has its strengths and weaknesses, which of course, means that some people will choose them based on their own needs, wants, and desires.
Here’s why I chose the Asante Snap Insulin Pump.
I Am Ricardo Montalbán
You can’t “test drive” a piece of gum. You buy it and if that new flavor isn’t what you wanted, you throw it away or foist it off onto someone else. It’s gum, right? Costs a buck? Pshh. Get outta here.
But it’s rare (or in some cases, impossible) to test out an insulin pump. This device is going to be a part of your life for a hopefully good, happy, healthy long time. And it’s not cheap. You choose a pump based on what you think it will do for you, go through the hoops (and oh, are there big, flaming hoops!) to get approval from everyone involved, only to find that… you hate it. I know some individuals who have returned their insulin pumps before the “trial” period is over, but it’s a big, ugly hassle and insulin pump companies don’t make it easy.
Asante gets that you should be able to take a pump for a test drive. Feel the rich Corinthian leather seats. Determine if what you want is what you actually get. They offer everyone who is interested in trying the Asante Snap pump a four-week free trial, including supplies, training, and support. I got to sit in the driver’s seat and go for a long drive. I wish all pump companies would do the same.
No More Rebel Yell Time In Range!
The four-week free trial is one thing. It’s another thing entirely when you discover that by not changing a single basal rate or bolus factor, that your time in range with your blood sugar skyrockets. (And when I say skyrockets, I mean supersonic space age shiny skyrockets.) Having the luxury of a Dexcom CGM allows me to see how my blood sugars play nicely (or not nicely) during the day. I was doing a lot of Billy Idol hair spikes. Without changing my eating habits or dosing timing, I saw spikes turn into smoother lines and when I downloaded my Dexcom (Finally able to do it on my Mac!), I was shocked. 80% time in range (for me, range is 70 - 180, but I’m already tightening the higher end).
Less lows. Less highs. All of a sudden, I wasn’t exhausted at the end of the day, chasing the blood sugar dragon. My head was clearer. I had energy. I thought it was a fluke, but after almost 8 weeks on this pump, I’ve come to realize it’s two things: the Asante Snap pump algorithm and the pre filled glass cartridges making this happen. I can’t take any credit for better blood glucose levels.
Heart of Glass
The pre-filled glass cartridges not only help the insulin not degrade and lose potency as quickly as the plastic cartridges I once had to fill; it also cuts down on the time I used to fiddle around with pump set-up. Doesn’t seem like a big deal, right? It’s a big deal. You get that I’m a two-minute sort of woman when it comes to diabetes.
Instead of the elaborate ritual of drawing up the insulin into a plastic cartridge, checking for bubbles, filling the tubing, checking for bubbles, priming the pump, checking for bubbles, I drop the cartridge into the pump body and it auto primes. In two minutes, I can complete an insulin pump set up, including a new insertion set. All that extra time I have now? I can rock out.
(And I don’t have to hunt for a battery in the bottom of my purse. The battery for this pump is built into the pump body. You replace the pump body with the changing of the cartridge. Easy.)
I’m not the only one who thinks this is a good thing. I join Scott Johnson of Scott’s Diabetes, Melissa Lee of Sweetly Voiced and others who have switched from other pumps to Asante. Here’s what some people had to say about how easy it is…
The Little Things Add Up to Awesome
It’s the little things. A customizable color screen. A built in flashlight on the pump for those early morning BG checks. A missed bolus calculation if you stop your pump for a shower. (I never realized how much insulin I had missed even disconnecting for 20 minutes.) The ability to set alarms to NOT go off at 3am to wake you up to remind you to change your cartridge.
Some people prefer an integrated CGM and insulin pump. I tried it. I’ve come to realize that I’m a Dexcom chick, tried and true. The other pump company with an integrated system has not yet updated its algorithm for increased accuracy. Plus… here’s the thing: The Dexcom G5 screen will be accessible to view on my iPhone I won’t even need to look at my pump to see my CGM graph.
When I was at AADE last summer and saw a glimpse of the future with Asante Snap (I sat next to Wil and we got to ooh and ahh at the demonstration, they announced not only would they be partnering with Dexcom for future upgrades, but they were the first company hooked up with Tidepool. (And you know how much I love them!). And then they blew everyone’s socks off my demonstrating bolusing the Asante Snap from an iPhone. I’ve never had a remote bolus device. I am totally ready for this. And when it does happen, it won’t cost me an arm and a leg (or a pancreas) to upgrade, because upgrades are $99. Straight. No chaser.
I got to design my Snap. (Well, I got to have input. The Kid actually decided on the colors.)
No Pump is Perfect
No insulin pump is 100% perfect. (If it was, it would be called a pancreas and this blog wouldn’t exist.) I do miss the vibrating alarm option I had on my previous pump. I am a little jealous of other pumps that do have remote bolusing devices. I am a lot jealous of the current integrated pumps and CGM systems that work well. And I can’t upload my data at home; Asante currently uses the clinic version of Diasend.
I’ve talked with the management team at Asante. I’ve asked questions about their future models. They listen (and they even have a patient advisory board so they can get feedback). I see the Asante Snap becoming more perfect soon.
Oh… that time in range. That blissful time in range that makes me feel more rested, less stressed, and looking forward to getting my A1C done. That makes it all worth while.
My new time in range makes my diabetes management easier and less about diabetes and more about me.
Best Snap decision I’ve ever made.
I talked to Asante so much and gushed about how much this pump has improved my life that I’ve agreed to enter into a consulting agreement with Asante Solutions to write about my experiences pumping on their website. Please check the updated About page for disclosures. Remember: My thoughts are my own. No one can make me write what I don’t feel or believe in on this blog. In fact, I get zero compensation for this - or any - blog posts on this blog. This is MY blog. MY words. MY thoughts. You get to read the uncensored version - always.
Accu-Chek has a new program that gives a fantastic discount on blood glucose monitoring strips and a little something extra to feed the soul.
It’s called Accu-Chek To: and I’ve signed up this week because I believe that they’re doing something right. (A great price. A great idea. A great program.)
It’s a monthly subscription program and they describe it like this:
Every month you’ll receive a box filled with the ACCU-CHEK® essentials you need, plus amazing items for you to discover – all delivered right to your door.
You’re given two options: Accu-Chek Essentials or Accu-Check Essentials + Discovery. It’s a five dollar difference between the two and here’s the reason why: with the Discovery add on, they surprise you each month with samples that help to nourish your body and soul (and aren’t necessarily diabetes-centric).
When you to to the website, you are given the option to view a quick video (but here it is, because you know…)
and then as you scroll down, you’re presented with two choices to start:
Do you have an Accu-Check blood glucose meter?
(If you don’t, you have the option to choose a meter. While I do have a Nano, they’ve now come out with a designer version and it’s.so.cool… Ahem.) You can choose a Nano or Aviva Plus…
Then you choose your monthly subscription option… and here’s the cool part.
50 strips = $20.00
100 strips = $40.00
(If you want the goody surprise box, it’s $25.00 and $45.00.)
You are getting the strips for almost 50% off what you would pay at a store.
I went to a big name store (rhymes with Ball-Mart) a few days ago just to see what the shelf price of strips were. Even the cheap-o strips don’t meet that price when you use the Accu-Chek To: program. And you get a meter for free. And you don’t have to go to the store. And the strips are accurate. (After all the work that’s been done with StripSafely, I know which strips I feel I can trust. My personal opinion.)
I’ll get strips sent to me every month and a box of goodies. This month’s samples could include lip balm, body butter, tasty treats… and I’m all about that. If you like what you get for samples, you can purchase more at the site. (And you can also purchase more diabetes testing supplies. I’m going to check that out, too…)
The boxes are sent out on the third Wednesday of every month. Tick-tock. Get yours for this month.
So, if you are looking to supplement your existing strips every month (which I am doing, as my insurance won’t pay for the number of strips I blow through each month) or you are trying to figure out a way to keep costs down and take care of yourself, this is the program we’ve all been waiting for.
The Fine Print
Here’s the deal: you cannot use this program and get the cost reimbursed through Medicaid or Medicare. It’s for individuals who either do not have health insurance or you have health insurance but will not seek to get reimbursed from your insurance using this program. It’s only available for U.S. residents right now.
For individuals like me on a high deductible insurance program and strips are part of that high deductible, while I can’t get the strips I receive through the monthly subscription program as part of my deductible, every bit helps.
I am not an employee of Roche. I am not compensated for this post. My opinions are my own. I just think this is an amazing program that does two things: saves me money on things that are expensive for my diabetes and gives me a little lift with the samples they send.
Q: How do you fit millions of people with diabetes into a room that seats 120?
A: Send 10 Patient Voices winners to the Diabetes Mine Innovation Summit.
On November 15th, an eclectic group of people converged on the Stanford School of Medicine for what has proved to be one of the most monumental days in my diabetes career. (OK, so it’s not a vocation that I would have picked for myself, but I treat it like a career, except there’s no time off and no 401K and the medical benefits are tepid at best.) Medical investors, the FDA, representatives from pharma and device manufacturers, non-profit icons, big names in diabetes, physicians, and for the first time ever, payers from a few large insurance companies all talked - sometimes with each other, sometimes at each other, and even at one point, yelling at each other about diabetes.
There was laughter, there was anger, and there was wonderment over the promise of technology and the frustration over the same technology. There were surreal moments and for the first time in what seemed like forever, a moment where I was left speechless, jaw gaping and heart pounding. Intrigued? Thought so.
Amy Tenderich, the woman behind Diabetes Mine and the Innovation Summit, welcomed everyone with a brief overview and the Patient Voices video, which I have already provided for you in a previous post. This summit was to share ideas surrounding the topic: “delivering on the promise of diabetes technology”. I’m going to give you a spoiler early in the post: the diabetes world is not even close to delivering on that promise.
Strip Safely and the FDA
Dr. Courtney Lias, the FDA representative of the In-Vitro Diagnostics division (overseeing pumps, strips, etc.) was first-up on the podium, giving an overview of the role that the FDA plays in the technology innovation machine. She stressed the importance of an open dialog between manufacturers and the FDA well before the tech is submitted for FDA approval. Requests for more data slow everything down, but if the FDA and the device manufacturer are skipping down the yellow brick road together, there are fewer surprises. (I don’t know how close a relationship the FDA and Dexcom, Tandem, and Animas have. There was a collective sigh heard around the country when the integration of Dexcom and these two pump companies were delayed for “more data”. Case in point.)
But what was a proud moment was the mention of the Strip Safely advocacy campaign held up as an example of advocacy that is working (for better or worse, I’m sure, in the FDA’s mind). As her slide titled: Patient Interaction stated: If our goals are aligned, can support our efforts. If not aligned or in sync, they can hurt policy implementation. Good communication is key. Bennet Dunlap, my partner in Strip Safely (He’s Batman. I’m Robin. I get to say “HOLY…..” a lot.) and I were tickled to see Strip Safely mentioned. We made a few waves with the FDA initially, but we also understand that they’re just as frustrated as we are. We need to work together to find a way to enforce the accuracy of the technology that is currently on the market.
Swept Away by Tidepool
This, my dear readers, was the reason I believe in the power of our community. Tidepool is a California Public Non-Profit that is putting into action my dream… or to be more accurate, it went beyond my dreams and straight into my fantasy. (No, not that one. Shhh…)
Tidepool is providing an open-source platform for real-time data from all devices I wear to the cloud, securely, sharing the data in real-time with anyone who should see it. Text messages to parents if their children go hypoglycemic while at school? Yep. Text message to physicians if a certain parameter is hit? Yep. It hit every one of my requests and some that I hadn’t imagined, including a little app called nutshell, which Brandon Arbiter created. You input a meal (in the example, it was Huevos Rancheros) and the carb count and how much insulin you take to cover it. The next time you eat that, you can look back and see if you went outside your acceptable range - and you can adjust accordingly.
I could type for hours about how much I admire what they are doing - and if they have a fan club, I want to be their President. (Heck, I’d make T-shirts and do spirit hands while cheering in their office. Too much? Probably.) They are a non-profit and as such, need a little financial help. Take a look at what they do and if you like what you see, you can donate to them. Out of all that I saw in relation to technology at the summit, this is the one thing that I am most excited over. That data would help a lot of us make good decisions in real-time. We need to support projects like this that will help us use the technology that we pay dearly to use.
Third Verse, Same As The First (Hat Tip to The Violent Femmes*)
Anna McCollister-Slipp, co-founder of Galileo Analytics and a T1 to boot, was blunt. Since the last DM Innovation Summit, nothing has really changed. We are still stymied by proprietary technology, frustration of the complexity and the cost, and the stall on the innovation disruption needed to make our lives with diabetes easier and more manageable. She was an excellent speaker, but left me feeling deflated and a little depressed. It’s not as if I didn’t know this already, but sometimes I want it
sugar-coated Splenda-coated just a bit.
Passion With Payers
And now begins the heated, passionate part of the summit. As I mentioned earlier, my jaw dropped during the summit - and it happened more than once during the panel presentation of five different payers. It began rather sedately and I’m sure that those sitting up at the front of the room, including the moderator (who was incredibly patient), expected this to muddle along smoothly.
They obviously haven’t met the lot of us in the wild.
Insurance companies are not altruistic. They are a cross of risk-management gamblers, firefighters, and paper pushers looking to keep as much money in their pockets as they can. Despite my description, this isn’t a bad thing all the time. Capitalism is what it is.
Like Anna’s earlier discussion, they were blunt, but unlike Anna, they didn’t understand their audience. We are patients and doctors and manufacturers who were stunned to hear them talk, quite frankly, too openly about how they try to avoid new technology and paying out more than they have to, and that patients are not their customers.
My jaw was already unhinged, but another Patient Voices winner, Corinna, sent it crashing to the floor when she stood up and confronted the panel, interrupting the moderator, shouting:
“I don’t give a shit about your spreadsheets!”
If I had a pin, I could have dropped it and heard it jingle jangle on the floor.
The silence was complete.
She wasn’t done. She told them what she thought and the floodgates opened, with other Patient Voices, advocates, clinicians and manufacturers representatives letting the panel understand what they thought of their policies and ideas.
The insurance company representatives became understandably defensive, with one stating that he felt personally attacked. In my opinion, if you’re in the insurance business and are sitting in a room of people who are denied over and over again for the items that keep them and their patients alive and healthy, please don’t expect to have roses laid at your feet or people thanking you for your cost-cutting limits and restrictions on strips and insulin.
Will they be back next year? Time will tell. I’m sure that some of them will wear thicker skin if they do attend.
Diabetes Mine surveyed a large group of people with diabetes about technology and the results were presented by Kyle and… Oh, look. Me.
We’ve got concerns. And complaints. And wishes. And if you want to see the survey results, the data is all right here.
Once again, I was struck with the feeling that none of this data is surprising to people with diabetes, but it may be to those who design the technology for us (and even a greater surprise to those insurance companies who often prohibit us from using the technology that does work).
That’s Not All
I haven’t even gotten to share the afternoon’s interactive creativity session and the closing presentation that rocked my world by Dr. Joe Smith of Westhealth. (Promise you I’ll give you that later. It’s worthy of a post entirely on the topic he covered.) I walked out of that room, my heart filled with the hopes and dreams of millions of us… and the desire to fight for the technology innovation that we need.
You want to hear some other perspectives? You should!
Scott Strange - I’m Sure All Patient Concerns Are Absurd
Amy Tenderich - Exploring Disconnects & Black Boxes
Wil DuBois - A Skeptic’s View of Our Summit: Anger and Hope in Palo Alto
My thanks to Amy Tenderich and the sponsors of the Diabetes Mine Innovation Summit. As a scholarship recipient, I was reimbursed for my flight, lodging, and some meals while attending. I also received a free registration for the summit and a bag that included a Misfit Shine from Target.
*Prove My Love by The Violent Femmes is one of those songs that makes me think of my youth…and laugh.
Accessorizing with diabetes is a bitch.
In the Diabetes Dark Ages, I carried a backpack to keep me alive. Heavy meter, opened rolls of Butterscotch and Five Flavor LifeSavers©, insulin, syringes… I envied the girls who slid lipgloss into their back pocket and sauntered off. Backpacks are not sexy, but at least I could wear things without wondering where to put my pump.
In my twenties and thirties, I carried a very large purse, a.k.a. the “war bag”. My meter was smaller, glucose tabs replaced the Butterscotch LifeSavers© (yum…), but extra pump supplies took up the space where vials of insulin and syringes used to be. I got creative with pump placement when I wore dresses and skirts. My bra was a popular hangout (pun intended, but as you know, it was a pretty empty place) and I used a Thigh Thing on special occasions.
I haven’t been able to step outside my door with a tiny clutch purse and slinky skintight dress
in years ever. I’m over it for the most part, and these days, it’s rare that I have a reason to get dolled up. I live in jeans and T-shirts with no desire to hide my diabetes or the accessories that come with it.
A few months ago, I purchased a few Dexcom G4 cases from Tallygear.com, because the case that came from the company was..nerdy. (Like, why didn’t it have a pocket protector and glasses with tape in the box with the G4?)
All of a sudden, accessorizing became cool. Donna, the CEO of Tallygear, understands the need to be cool, as her daughter is also a Type 1. Colors, patterns, and ways to wear your gear without looking like rejected extras in Revenge of The Nerds is her goal with all the options her company offers.
Donna sent me a gratis new Tummietote 2 band a few weeks back to see if I would like it. I tried it on and wore it around the house, feeling… weird. I’ve been so used to checking my Dexcom using the case that I had purchased that even though you can get the new TummieTotes have clear windows, it was a little awkward for me.
And then it was time to go to bed.
I’m a restless sleeper. On the best nights, I toss and turn, thanks to my back and my shoulder and my inability to soothe my racing thoughts or the beep of my Dexcom. My pump’s tubing wraps around me if it’s not clipped to clothing, and there have been nights that have not gone well despite my best efforts.
The Tummietote is heaven around my hips.
Slip my pump into the stretchy pockets and I don’t pull at my tubing. When I get up in the middle of the night because The Kid has decided that’s she’s slept enough (4am? Are you kidding?), the pump doesn’t crash to the floor as I roll out of bed. My set doesn’t get ripped out.
I love it.
I still keep my Dexcom next to me in the case with the carabiner for now, but it may find it’s way into one of the many pockets. I can see how sporty people (of which I am not one) would totally sport (yes, another pun - it’s two for one Tuesday!) a Tummietote with clear windows. The extra pockets could hold glucose tabs and even a phone.
With companies like Tallygear showing the world that accessorizing with diabetes is fashionable, I’m surprised that more people aren’t clamoring to get it. (A Tummietote, yo. Not diabetes. That’s an exclusive accessory. Functioning pancreas not included.)
This is an unsolicited review. My opinions and ideas are all my own, but feel free to try out my idea of sleeping with a TummieTote. Donna did send me a free Tummietote 2 and an extra G4 case to see if I would like them. I do. I’m buying more accessories from Tallygear. They’re like black boots and the eight pairs of prescription glasses I own. Can’t have too many.
Hey, look! It’s Saturday! Things went a little haywire yesterday and I forgot to push a button to publish this post. Whoops. Day late,
It’s summer. It’s hot. I’ve been having issues with things that are supposed to stick to my body not sticking (and of course, the opposite.) This week, I’ll be sharing what we can wear to help our pump/CGM accessories (and all of our gear) stay where they are supposed to stay. So, instead of strutting on a runway, this is what you’ll get from me this week… Cue the music!
1. Just stay down, will ya?
Call it what you want. A flip-flap. A curl-up. A peel-away. When my Dexcom G4 sensor doesn’t want to stay on my body and the adhesive starts to come up, I’m afraid to shower because I’m afraid the sensor will stop working if it gets wet underneath. (You want me to shower. Remember, I sweat a lot for a thin girl.) I see a lot of my friends having the same problem this summer with the heat reaching record temperatures), so I look to their recommendations for what’s going to work. I used to use surgical tape, IV Prep wipes, and even Smith & Nephew IV 3000 1-Hand Transparent Dressings (which rock but I use way too many at once), but I’m off to try this stuff: Opsite Flexifix . Kerri uses it and that’s good enough for me.
2. I can’t pronounce it, but I love using it!
Carabiner. I have a thing for funny words, and for some reason, this one is giggle-inducing. (Ask me to say Oberammergau. I’ll entertain myself quietly mumbling in a corner and snorting while I let the vowels roll around in my mouth. It’s the linguist in me that gets all crazy about words.) Anyway…
The Dexcom G4 is great, except for one thing: the case that comes with it. Nothing screams “pocket protector nerd” like the stiff unfriendly case that arrives in the box with the übercool CGM. So, I was thrilled when I learned of Tally Gear and their G4 cases that scream “NOT pocket protector nerd”. The Tally Gear G4 Platinum Protective Case comes in seventy different design/color choices (yes, I bought two boring color ones, but I’m planning on buying more!) and has a belt loop and a carabiner. That little metal clip attaches to my belt, my bra strap, my underwear… yep. If you don’t know about Tally Gear, then go to their website. (They also have Tummitotes that are cool if you have extra stuff to carry…)
3. TWhen youhey’ve been around forever - and by forever, I mean since I’ve started wearing an insulin pump in 1999: Unique Accessories, Inc. (Unfortunately, their website also looks like it’s from 1999, but don’t hold that against them…)
When I got married (the first time AND the second time), I wore the Leg Thing purchased on their website. (It comes in white and in black - I have both.) I wear the Leg Thing when the dresses I put on have no place to discretely tuck my pump into a bra. (As if I need a bra anyway.) With the clip attaching to my underwear and the Leg Thing stretched around my thigh, the pump is there and not going anyplace. Yeah, you guys may not need it (unless you’re wearing a kilt or like dressing in women’s clothing), but for women, I highly recommend it.
4. Pump bling is in.
Whether you’re wearing a Medtronic, Animas, or Omnipod, there are skins/stickers to make the pump uniquely yours. My Revel pump is boring black, purchased back when I worked and wanted to keep the chatter about my pump to a minimum during board meetings and trade shows. Now that I work for a toddler, I’m looking to jazz it up a bit.
- Medtronic gives me these options for making my pump stand out.
- Pumppeelz has options for the Omnipod (and G4 and Verio IQ meter, too!)
- Animas gives you these options for blinging it up.
5. I can’t wear them anymore, but I totally support them in this color.
The Blue Heel Society.
I miss wearing heels (my mind says yes!yes!yes! - but my back says nowayinhell!). This group is all about advocacy with panache and I love them for it. Need I say more? Nope.
So, no matter who you’re wearing, wear it proud - and in many cases, sticky!