LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Friday, June 08, 2007

A letter to Santa...plus your chance to add your two cents

I got an interesting e-mail recently. From a guy at MedT. He asked if I’d be willing to provide a “wish list” of things I’d like to see in the next generation pump. This is such a great opportunity I want to open the floor up to all of you. Via comments, this is your chance to tell MedT engineers what you want to see in Paradigm 2.

Here’s my wish list:

1. Alarm volume that really works. And I want it to both beep and vibrate at the same time, if I choose. I want the alarm volume to be user selectable from dainty to sooooooooooooooo loud the entire room will turn and stare. I want it to be able to wake the dead because one if its jobs is to make sure I don’t join them late some night while I am sleeping. I also want each alarm to have it’s own distinct personality. The original Guardian was great this way. The kind of noise it made told you the kind of alarm you were having. ParaPump tries to do this, but the alarms are too low in volume to be any use at all even in the summer (I can’t imagine how it will be under winter clothes. Serves me right for wearing a device made in sunny California. Note to MedT engineers lounging on the beach: in the rest of the country it can get pretty damn cold and we have to add layers.). Also, ParaPump’s alarms are so short you can barely make out the difference in sounds. Longer alarm time, please. It wouldn’t bother me to change batteries every week if I that is the price I need to pay for these features.

2. A home screen that isn’t blank. We got all this cool info, but ya’ gotta press buttons to get at it. Let us leave the pump wherever we want. Most of us will leave it on one of the CGM screens I’ll bet.

3. And speaking of the screen….what about a color one? Higher res too. We could do some fun stuff with the hypos and hypers on a color screen. Or if you combine items 2 and 3 you can take a page from cell phones and computers and let the user import a low res image file of their kid, spouse, or pet to personalize the device. I feel you MedT folks cringing as you read this, but I’ve got news for you: this really isn’t the medical device you think it is. You know how most people virtually never leave home without their cell phones? Well, we pumpers literally never leave home without our pumps. I spend more time with my pump than I do with my wife and child combined. Why not make it fun? For kids could we put some games on the pump? I’m old enough to still love my PDA but my phone doesn’t even know what time it is. If it were a VCR it would be flashing “12:00” all day long. Why can’t a pump do more? I carry the PDA for a carb data base. It’s also got a few key phone numbers like Lotta Burger in Santa Fe and my PCP’s FAX number. I use the calculator to figure out tips at restaurants. Did I tell you all the story of trying to buy a new PDA at BestBuy? The pimple-faced 12-year-old sales clerk tells me they don’t stock PDAs anymore. Seems they are passé with the advent of “smart phones.” But I like my dumb phone, I told the kid. That was pretty much the end of the conversation. Anyway, you can still get PDAs from the Palm Store on-line. Sorry, I digress. But it seems to me like this kind of simple minded stuff could be in a pump. I want to be clear, however, I do not want my pump/CGM to be one and the same as my cell phone. Some lines should just not be crossed. That’s like mating with monkeys in my book. Besides which, it seems cell phones are always running out of juice. You could actually talk your way into DKA if your phone and pump were one in the same, right? But aside from that, why shouldn’t a pump be the ultimate consumer electronic device for the diabetes population?

4. On the more practical side I want an Active Insulin (a.k.a. IOB or BOB) status screen. And I want to choose how to set it. For those of you who don’t know there are two approaches it active insulin. Whether or not to count just correction insulin or to count correction and insulin assigned to carbs. I like the more comprehensive approach myself. MedT does it the other way, with some good justification that is too complicated to cover right here and now. I just think we should be able to choose. But at a minimum, give us the results without having to enter a fake bolus in the wizard and then scrolling foooooooooooooooorever.

5. I nearly short-circuited my laptop by drooling on the keyboard when I was reading about the new version of the Guardian. It has slope and predictive alarms. I want those on my ParaPump, please.

6. And speaking of alarms and the like, let us set different alarm thresholds for day and night.

7. I think you should make the transmitter flesh colored. Anyone’s flesh. Chinese flesh color will be just fine. I’ll still look better against my Caucasian skin than this yucky cream color. Or go the other way and make it look like jewelry. Make it shiny silver with a medic alert symbol on it.

8. Let the remote power the bolus wiz.

9. Rethink the menu system altogether. You shouldn’t have to press that many buttons to do routine things, like eat. You know, we are pretty smart people. We can handle more than four buttons on our devices if that’s what it takes. I’m sure that some of the engineers worry about the fact that a large number of pumps are worn by kids. No firm wants to try to get both a juvie pump and an adult pump through FDA. But trust me, kids nowadays are way more tech-savvy than us oldsters. They can handle it.

10. Let us choose how many hours of CGM data to display.

11. Let us set different basal rates for different days of the week so we don’t have to manually change patterns for the weekend.

12. Keep the clips. I love them, especially the “holster” style belt clip.

13. Last item (for now!). Keep CareLink online. It’s great for visiting the Doc. But I still want to see smart software. I want CareLink to analyze my data, not just display it in pretty graphs. I want it to look at my basals and give me tips about changing my settings. Of course it will have to have five million liability waivers and consult your doctor statements, but still, let’s do it. Think of it as one of the first steps in the journey to a closed-loop pump system.

OK, diabetes blogosphere. That’s my wish-list. Now it is your turn. Tell MedT what you want to see!

47 Comments:

Blogger Wingman said...

I just went through a trial of a few pumps and setteled on the Paradigm 522. But the one thing I really wanted out of all the pumps was to be able to control it remotely. It doesn't need to be wireless like the Omnipod but put some blue tooth technology in the thing, have it beam to my palm pilot and give me an option to use a handheld device or my computer to program and activate the thing. If they could get the rates and boluses to go right into excel via blue tooth or radio frequencey that would be AWESOME.

12:46 PM  
Blogger Val said...

I'm not sure if they fixed this since version 1.0 or not, but it would be handy to have a status for "Sensor start 12:46pm, Tues July 9. Next calibration 10:14 am Wed July 10" - especially when you're in the 2-hour startup mode and can't remember if you pressed "new sensor" yet.

1:36 PM  
Blogger Diabetic Runnergirl said...

I would love to have a basal profile that starts whenever I tell it to, rather than at a specific time of day. That probably doesn't entirely make sense, so let me give an example of how I would use this. I run several times a week, but not at the same time every day. I know that my bloodsugar usually drops 10-12 hours after my run. I want a basal profile to start when I finish running so that I can have it set at a lower rate starting around 9 hours after my run. As it is now, I have to remember to either have a snack close by 10-12 hours after my run or remember to set a temp basal rate at that time.

1:47 PM  
Blogger Lili said...

My wishlist
1. IOB on the status screen.
2. Louder alarms.
3. When you're in the bolus wizard "select bg reminder time" screen, you only have about 1 second to hit "escape" to go back to type of bolus. Otherwise, hitting "escape" makes it go straight to delivery with no bg reminder. Not the behavior I expect!
4. Longer tubing available with the Sure-Ts. (ok, I know, but it's a huge one)
5. Profiles that allow you to change insulin-to-carb ratio, not just basal.
6. Being able to name profiles.
7. Temp basal option where you can have, say, 70% for an hour, 50% for the next hour, etc.
8. Site change reminder.
9. PDA remote would be great!
10. Being able to choose whether or not to use a bg value to calibrate the sensor.

2:18 PM  
Anonymous Anonymous said...

Just saw a link to this post at S.U.M. and thought I would add my two cents:

First let me preface my comments by saying that I am using an older pump (512 with V1.4C software) and I'm not using a CGM. So maybe some of my gripes have already been solved with the newer models.

1. A different set of carb ratios for each basal profile. Or does this already exist and I just can't find it?

2. The ability to program my pump on a bigger screen (perhaps on the computer and then upload it to the pump).

3. There are too many steps for doing simple, common things like taking a bolus when using the bouls wizard, or setting a temp bolus. I agree, more buttons would be okay with me.

4. The CGM sensor and the catheter should be one item. I am not using the CGM mostly because I can't stand the idea of having two holes in my skin. I have enough problems with scar tissue, etc. as it is.

5. I like the idea of being able to set my basal profiles ahead of time, perhaps tied to the day of the week. For example, I sometimes forget to change my profile on Friday nights and wake up low on Saturday morning. Also, I would like to be able to change to my other profile at midnight (i.e.; when I'm sleeping). I would like to program it early to switch to the other profiel at a certain time.

6. I want to be able to load all of my pump data into the computer where I can analyze it for trends. I think you can already do this with newer models. And maybe you can do it with my model, but you have to buy the software. I shouldn't have to pay for this software. I pay ENOUGH for the pump and the supplies.

7. Software upgrades (for the pump) should be free. Period.

8. Work on the infusion set. I have more and more problems with insertion, irritation, and scar tissue at the site.

9. The possibility to have more than one dual wave bolus running at once. Sometimes I eat a piece of pizza, so I use a really long time frame on the square part of the bolus. Then an hour later I decide I want another fatty food. I want to be able to use a dual wave for this two ... like my pancreas would if it still worked :)

10. I like that the BD monitor communicates my BG to the pump. But the memory on that thing is really short (something like 30 tests ... that's less than three days of data). And it is easy to get an error. And when you take the battery out, you have to reset everything. Could you work on the meter a little?

Well, I hope I've been good, because this is quite a wish list. I hope you can make some of them a reality.

2:33 PM  
Blogger Megan said...

1. Naming basal profiles.
2. The weekly scheduling thing Cozmo has, but it would be cool if all the pumps picked this up.
3. More reminders to do things
4. Customize text on screen
5. Set IOB in half hour increments
6. More basal patters
7. Ability to remember custom boluses and temp rates like the cozmo.
8. Non-proprietary sets
9. Free upgrades
10. I've heard that if you don't do the fixed prime, the basal stops running until you do give it, without alarming, leaving some people high for hours. This needs to be fixed.
11. I love the complex temp rate idea like diabetic running and Liliac suggested.
12. They need a food database. Every other pump has one.

3:13 PM  
Blogger Bernard said...

All great ideas. Especially LOUDER ALARMS, and Lili's numbers 3 and 5 suggestions.

I'd like to add the ability to set a bolus (normal, square wave, or dual wave) and a time (15, 30, 45, 60 minutes) in the future to give it. This would help on those days where I'm a little low before eating and I don't want to bolus immediately, but I don't want to forget.

More buttons would introduce a lot more capabilities. How about just adding one more?

Home screen should show date, time, insulin on board, and time of last bolus.

Let us see the real data from the software on the PC (I'm assuming there's no data export right now).

Non-proprietary sets.

Better upgrade options. The price is too high at present.

Ability to retrieve data without the BD meter (don't know if this already works on the 522/722).

3:19 PM  
Anonymous Anonymous said...

Favorite food database like on the deltec and animas, call me lazy but that would be great!

3:23 PM  
Blogger Allison said...

Everything everyone has said, plus:

Pre-set temp basal rates! I would love to be able to tell my pump to start my temp basal rate at 4 in the morning, and have it last until 7 in the morning. This is mostly because I have issues with my blood sugar after drinking alcohol. If I set the temp basal too quickly, I go high, but if I don't set it at all and just go to bed, I wake up low. Messing with a basal profile takes a lot of time because it changes each time I drink (how much to change the basal and also the duration). It would be easier to incorporate this into the temp basal, because that's what I'm doing - temporarily changing it, not changing it for a extended period.

3:32 PM  
Blogger Kate said...

1) I would love it if I could periodically download a new alarm (like the cell phone ring tones) to my pump. I NEVER hear them when they actually go off, and if I were to invest in getting the CGMS to go with my 522, it would be pointless at night. Annoyingly loud music, however, might wake me out of a very sound sleep. (think something heavy metal that would be screaching,etc and no one would want to ignore-I've slept thru thunder storms so it has to be pretty jarring to get my attention at night-not the current wimpy "beep-BEEP-beep"). Our brains adapt to noises we hear all the time, so if we could periodically switch out the alarm for something different when we start to tune it out, maybe it'd be worth the battery it uses.
2) I would also be fine with one more button if it saved some time.
3) I like the idea of having key info like IOB and last pump/sensor change on the mainscreen at all times.
If I think of any thing else, I'll add it. My main annoyance has been the alarm thing, and I'm not the only one, so I really hope they can do something to vary that.

3:44 PM  
Anonymous Anonymous said...

I know the Paradigm has a remote you can use to bolus, but how bout adding an easy bolus button somewhere on the pump that you can tap similar to what the Cozmo has. Might be really cool. :)

3:49 PM  
Anonymous Jana said...

Okay, here's my two cents. (By the way, are the Medtronic people looking directly at this or are you compiling a report for them, Will?)

1. More basal patterns, at least 7.

2. Basal patterns tied to days of the week (hence why at least 7).

3. Insulin-to-carb ratio "patterns" and the ability to tie a basal pattern to an insulin-to-carb ratio pattern. This seems like a no-brainer to me, since when you're insulin needs drop dramatically (like when you're exercising regularly, if you're me) your insulin-to-carb ratios also change. Right now, it's a pain in the @$$ to have to reprogram the bolus wiz from scratch when changing the basal rate is as easy as selecting another pattern.

4. Copying this from Lili's number 3: "When you're in the bolus wizard "select bg reminder time" screen, you only have about 1 second to hit "escape" to go back to type of bolus. Otherwise, hitting "escape" makes it go straight to delivery with no bg reminder. Not the behavior I expect!" DITTO! This has resulted in my having to suspend a bolus on numerous occasions!

6. Have the BOB/IOB on the status screen, and make it optional whether it includes all boluses or just correction boluses, since people have different preferences on this issue.

7. Delayed temp basal rates--i.e., set a temp basal to start in 2 hours time and run for the next six hours or whatever.

8. Remote connected to the bolus wiz instead of the manual bolus--some of us have forgotten how to do the math in our heads now that we have the bolus wiz. ;)

9. Being able to have more than one funky bolus (i.e., dual/square) running at the same time.

10. This one is completely frivolous, but, um...colored tubing? Kids would like it. And I would like it too! Just imagine: electric blue, purple, neon pink...what fun!

11. I don't think the pump needs a food database. Too hard to navigate. But maybe design a new optional (read: device we would have to cash out dough for, like the current remote) PDA-style gadget that serves as a remote and as a food database?

4:15 PM  
Anonymous KellyDH said...

Most of these ideas sound really great, but one really important upgrade for me would be: waterproof the pump!!

I am really into water sports (especially kayaking), so am actually considering switching away from the Paradigm in favor of a waterproof pump. However, I would love to stick with MiniMed if I could just take the pump on the boat without living in fear of the slightest moisture.

Second, I wish I could transfer my downloaded data from the meter and the pump into Excel or some similar database software. That would make combining all my data into one useful notebook sooo much easier!

5:16 PM  
Blogger Marina said...

Make the CGMS sensors thinner and shorter. How in the heck can I deliver insulin via a 6mm thin cannula but can't take my blood sugar (or, okay, interstitial fluid sugar) without a 13mm thumbtack?

On a related note, my CGMS insertion device requires way too much pressure (and therefore, a stiff drink) to get it in. I'd love an insertion device where you just hit a normal button and "1..2..3" poof it goes in.

6:26 PM  
Blogger Scott said...

I'd like to see the ability to set a bolus for a future point in time. For example, when I eat pizza, I know it will rise hours later, or when I eat extra protein for dinner (Thanksgiving, for example), I know I will need a bolus before waking, and the only alternative now is to increase the basal rates to like 400%. The companies claim its a safety issue, but its my body and I don't need to be protected from myself!

7:03 PM  
Anonymous Rachel said...

Many great ideas. As a parent with a 3 year old with a 522 and minilink, I have a list:

1) a light button that only does the light so you can turn it on and off, regardless where you are in the other screens/ pumping.

2) CGM data displayed as the home screen (or being able to select that as an option). I look at it countless times in a day.

3) A remote parent monitor so I can be across the room or across the playground and can see the readings.

4) a child lock out system - but just for insulin delivery. I don't want to have to lock and unlock for every time I peak at the cgm number.

5) smaller increments for basal dosing

6) LOUDER ALARMS (or do #3 above)

Thank you for compiling this and to your MM person for asking for input. This technology is life changing. We are having sensor/tape issues today and I feel such a loss at not having the data I usually do .

7:32 PM  
Anonymous Kathleen Weaver said...

I would like a better form factor. The reason I went with Animas, is that the package of the pump itself is flat, rather than round. It fits closer to the body.

8:32 PM  
Anonymous Anonymous said...

1)I would like it to navigate more similar to the cozmo
2)A new infusion set(I have been having more and more problems with the quick-sets becoming bent, and angled sets dont work for me)
3)More presise bolusing and basal rates, like the .025 the animas pump has
4)maybe something like the cozmonitor, but not adding too much thickness to the pump itself
5)Site change reminders
6)Color screen would be cool, but not a top priority
7) Maybe something like the cozmo's hypomanager feature

10:38 PM  
Blogger nicole said...

All of the above but my top 4 wish lists as a parent of a child with T1 is:
1. Louder alarms
2. Louder alarms
3. Louder alarms
4. A remote unit that I can set at my bedside and hear the LOUDER ALARMS.

You *may* see a pattern here LOL. We are new to pumping and so far are loving the MM722 with CGMS! I am so glad that we went with it I just wish that they had tweeked these things before we started. I wonder if when they go to do this we will have to get a new pump ;)

11:23 PM  
Anonymous payam7777777 said...

make the whole thing remote, like omnipod; a controller(not an optional parental unit but a mandatory controller as the only thing by which we can operate the pump, because otherwise you cant make the pods small and you cant omit the god damn tubing) and an [as small as possible] pod; remove the tubing. in other words, let the remote do EVERYTHING. do it! even if it means buying/merging with omnipod, it's worth it. omnipod is such a great idea. you know it and you gotta accept the need for change.

1:14 AM  
Blogger Drea said...

Many of us have been keeping wish lists on our blogs or the Insupin Pumpers Forum, so I am really excited to see your post ... and glad to hear Minimed will see the list you compile! I agree with all of your points, and here are a few I can add!!

-Stand alone software that does not require internet. I am a MAC user and there is NO software from Minimed supported for MAC OSX. I also find the upload time to carelink slow and often taken multiple attempts due to the poor cord to meter connection. I would like to see software that is stand alone on my computer (a PC and MAC version preferred) that has the option to upload into the carelink system for Dr visits.

-Site change reminder

-IOB screen (already mentioned, but this is a biggie!!)

-Better resolution screen to see sensor data. Bigger screen face, color, better resolution

-Backlighting that stays on. I use the vibrate mode, and when the pump is vibrating, the back light turns off. ANNOYING!! I would like to see a "light" button that can turn on off at any time

-colored infusion sets

-recharable battery

-tube length around the 30 inch length

-Free upgrades - and more often software upgrades

-carb databse like cozmo

7:39 AM  
Blogger manny hernandez said...

My wishlist:
1) Carb database: I feel like an outcast when I compare the Minimed against the Animas or the Kozmo.
2) A more solid solution to carry the pump than the clip. I've broken 3-4 of them so far (by accidentally sitting down and sliding the pump by the edge of the seat).
3) I will also subscribe to Bernard's comment on data. We NEED to have access to our data beyond what we have nowadays.

Nice to have:
1) Color display.
2) Touch screen.

Hope Medtronic can make all these great suggestions a reality!

I want to take the chance to invite all of you to join www.tudiabetes.com, a Social Network for Diabetics. Allison, Bernard and Scott (who have posted before me) are also members and can attest to how useful of a community it is for diabetics to share their stories, tips and concerns in multiple ways (discussions, posts, videos, photos and more). See you there!

7:54 AM  
Blogger Lili said...

Payam, I'm allergic to Teflon and I have to be able to move my set. So if it turned into the Omnipod, I couldn't pump anymore.

11:44 AM  
Blogger Adam said...

I'd like to see the time / profiles option built into every feature of the pump. I'd love to set different volumes / vibrate for alarms based on time of day. Also setting different high / low alarm values for the sensor based on TOD.

Louder alarms as everyone else has said.

It'd be nice if we could get pre-filled cartridges. I had these for my disetronic pump, and it saved a lot of time and cut down on the bubbles.

Alarms when your bloodsugar is changing faster / slower than a certain rate.

The clip doesn't allow you to turn the pump upside down (so the bottom of the reservoir is facing up), which helps keep bubbles out of the tube.

When entering a BG value, if you accidentally select yes on "send bg to meter", the BG is immediately sent over. Even if you hit ESC and change it to no, the BG has already been sent. It'd be nice if this screen defaulted to 'no', because I can't think of anytime you'd want to send your BG over twice.

12:12 PM  
Anonymous Anonymous said...

1) Site change reminder
2) food database
3) sets in which the inserter is part of the package (think Animas)
4) IOB features corrected
5) better upgrade packages
6) color screens (think Animas new pump)
7) smaller pump
8) temp basals you can set ahead of time. For example, its 7pm now you set it to start at 3am
9) basals based on days/name them for activites

2:03 PM  
Anonymous Anonymous said...

She does not, as yet, use your pump, as the Animas suits her needs very well. EXCEPT, we have had our eye on your continous blood glucose feature and if you can ever get to the point where you use a smaller insertion needle for the sensors and a truly comfortable insertion device (I'll bet at least half your customers are children), we would switch over pronto. Because of puberty and growth spurts, children need the continous monitors even more than adults do. But it is difficult to ask a child to put up with the discomfort associated with the continuous monitors. Bear in mind a lot of these kids are lean and have very little fat, so it is more painful for them to wear the devices than adults. Please work on this!

5:37 PM  
Anonymous Anonymous said...

Just a new pump would be GREAT!! I still have an old minimed 507 (without the c)...so anything would be life giving!!

2:46 AM  
Blogger Anne said...

-make it waterproof. This is the #1 reason why I would not choose Minimed again. (I used to have one back in the day.) Sorry, I don't want to be afraid of melting when I get wet!

I did have the opportunity to try out a Guardian RT last year, so you've probably made improvements since then. Still, here are my suggestions:

-Have different-sounding alarms for rate of change of glucose and also be able to set alarms that go off when the glucose values change into different ranges.
I used the guardian during both a marathon and a triathlon and it would have been very convenient if I didn't have to keep looking at it. It is important to me to know where my glucose is, even if it's doing okay. It is annoying to keep having to pull it out and look at it when I'm racing. If I could have an alarm or some sort of beep that would go off every 10 min (or some adjustable time window) that conveyed both concentration and slope, that would be sooo helpful!

-don't know if you do this yet, but make the data available. It boils my blood when companies treat diabetics like idiots.

Thanks!
Anne

7:18 AM  
Anonymous Caro said...

I've not been able to read every comment posted so far, so I may be duplicating, but here goes with my list:

I totally agree with louder alarms, IOB on the status screen and also items 5,6, 10 and 11 on your list.

In addition:
- I'd like the ability to set different correction/sensitivity factors according to the blood glucose value, not just the time of day. It takes me much more insulin to come down from a 20mmol/l (360mg/dL) than it does from a 10mmol/l (180mg/dL)

- I'd like different bolus ratios tied to different basal patterns. I need different basal amounts on weekdays and at the weekend. I also need different bolus ratios. I resent having to reset all the information in the bolus wizard every Friday night (and frequently forget)

- On similar lines, I'd like the ability to easily change the correction factor or carb ratio for a single bolus, without changing all the settings. If I've been exercising, or drinking alcohol, I may want to reign in my doses just for a single dose. Currently I do the math mentally in these situations, but I'd rather not - the pump s more accurate. Animas already has this feature.

- I'm not sure that I'm in agreement with more buttons, because what I'd really like is a larger screen. All the scrolling does my head in! Plus the CGM graphs would be clearer on a deeper screen. Currently each line point on the graph covers a range of nearly 1mmol, which can lull me into a false sense of being steady!

- Faster bolus delivery. I'll admit, Animas is probably a little too fast, but I've lost count of the number of times I've accidentally disconnected my pump for a shower only to remember later that the huge breakfast bolus I'd programed two minutes earlier wasn't done delivering!

- Escape should always mean escape. I hate that if you have the BG reminder function on, once you get to that screen you can't go backward. You either have to let the bolus start then hit suspend to cancel it and start over, or wait for the pump to time out.

- Ditch the annoying open circle on the home screen. It stands for so many things it no longer means anything at all. It appears when basal patterns are active, a dual wave is running, a temp bolus is running, the reservoir is low or the battery is low. It is quite feasible for all those things to occur at once! A colour screen and larger screen could alleviate this. For example for low reservoir the reservoir indicator could appear in red, or even flash, and more room on the scree would allow for more icons - just think of how many the typical cell phone can show!

- I'd like a customisable "time-out" time for the screen

- The ability to set more than one dual wave at a time. I hate fiddling around with a dual wave plus a temp basal to get the desired effect.

- The ability to set IOB duration in half-hourly increments, not just hourly

- If they're not going to allow us to choose how we want IOB calculated, at least make sure the value shows on the bolus wizard screen every time. Presently if no BG reading is entered, no value appears. Animas pumps calculate IOB like Medtronic pumps, but they at least have the advantage of always showing IOB, making a manual subtraction of the value easier if even when the pump doesn't deem it necessary to do automatically.

- A version of Carelink for Mac users please! Or rather, for any browser other than IE.

- A controversial one: ditch the proprietary connector. I know Medtronic want me to have to use their sets. The truth is there are plenty of Medtronic users currently who use the Thinset reservoir and what ever set they choose. If Medtronic ditched the connector, I know that I would at least always use their reservoirs.

- Don't even think about getting rid of the clip that attaches directly to the pump. So many pump companies seem to deal with clips as an afterthought.

- Consider reinstating waterproof status. Waterproof is a customer service issue. Here's the deal: I had an original 511 (and before that a 508 and a 507) My 511 is clearly marked as waterproof and there is nothing different about the casing on that pump to the casing on my 522. Waterproof status was withdrawn because cracks in the case caused by everyday wear and tear render the pump liable to leak. Other pump companies deal with this by accepting a failure rate related to water exposure and they replace pumps accordingly. My first Animas IR1200 died for this reason and was replaced within 24 hours, no further questions asked.

- Last but not least, the Paradigm series should be fully software upgradeable. Many of these suggestions are fixes to the software. It should be possible to apply future upgrades such as these to the next generation of pumps pumps by means of a CD or even download.

Hmmm... that is quite a list. I don't want anyone thinking I don't love my pump as it is - I do! Oh, and I've referred to Animas quite a bit here similarly because that s the only other pump with which I am intimately familiar.

12:34 PM  
Anonymous Anonymous said...

Ditto on everything everyone else has mentioned. Plus:

Overtreating lows seems to be a problem for many. (obvious reasons, I know, but still a problem) so I want a "correction carb value",with suggestions on how many carbs I need to correct lows. I want it set up in the same way as the insulin correction mode to correct highs. I want to load my own sensitivity values, I know I need more grams of carbs to treat a 41 than a 65.

4:26 PM  
Blogger Amanda said...

I agree with the louder alarms! And the making it our choice to have the sound alarm AND have it vibrate!

I, too, would love to be able to have a different basal rate just for the weekend. Should be fairly easy to set up, right?

This last one is incredibly simple...it doesn't even require new technology. I would LOVE 33 inch tubing. The 23 isn't quite long enough (especially when I wear a skirt or dress) and the 43 is just a little too long sometimes. I can't quite plan out my outfits for 3 days at a time and have it match the tubing I'll use. I guess I'm picky...but I'd like something in the middle, please!

:)

7:49 PM  
Anonymous Anonymous said...

For parents an option to buy some type of portable alarm as an add on that can at least get a range of a few feet from pump, but make loud enough noise to be heard through the baby monitor, and thus not be silenced by a mound of blankets, or because the person has rolled over and is sleeping on it. Don't know if it is possible, but that is my wish, and I'd be willing to pay a little extra to have it as an add on.

9:01 PM  
Anonymous Aaron S said...

I think most of whatI wish for has been covered already, but I will mention a couple of the ones that I really would like to see.

1. Get rid of the open circle and replace it with something more useful. Separate alarms from information. Along with this, I would like the ability to name the basal patterns and then be able to display the name rather than just seeing the circle.

2. Patterns for carbohydrate / insulin ratio.

3. The weak signal alarm should clear itself if the problem has been resolved and there is no data loss.

4. A useful remote. I like the suggestion of a PDA like device others have mentioned.

5. The ability to delay a bolus. Along with this, I would also like to either be able to have a square wave delivered more in the pattern of a bell curve (or at least be able to step the wave so that it isn't necessarily square).

6. Make it waterproof.

The rest of the things I would like to see are related to carelink rather than to the pump itself.

1. The ability to enter a comment that isn't tied to any specific event.

2. The ability to enter information about insulin injected from a syringe.

3. Have a Senor change event as well as the infusion set change event.

7:38 AM  
Blogger Clemma said...

1) I have long wished for a kind of reverse bolus feature. If I have low blood sugar, I would like the pump to take IOB/BOB into consideration, and tell me how many grams of carbs to eat to treat the low without sending me too high.

2) I also am considering moving away from a pump entirely, and over to the OmniPod, because I have so much trouble in the summer figuring out where to put the pump. When I'm wearing a thin summer dress with not much underneath, the options are limited and it drives me nuts. None of the accessories I have tried have worked for me. I don't know if this is a request exactly, but I thought the MedTronic powers might want to know it.

9:04 AM  
Blogger Cara said...

Louder alarms. I can't hear the alarms & if I have it on vibrate, I can't feel it if I am asleep. This has been a problem in the past.
Also, waterproof. I would love that.
Being able to run 2 different dual wave boluses at the same time. If you decide you want something else to eat later it is hard to figure out what to do to set another dual wave.
A larger/more colorful screen. With IOB visable would be very nice.
I wouldn't mind a food database for things I eat on a regular basis (although I already know most of those carbs by heart anyway).

11:50 AM  
Blogger Daiesy said...

I want a super bolus - one that will take insulin away from your basal for the next two hours, and add it to a bolus for high-carb foods.

Oh, and #2 - when in the bolus wizard, and you enter a meter bg, the default for "BG to update sensor" should always be the same, regardless of your last choice on the menu.

12:03 PM  
Blogger Daiesy said...

Oh, and different times for low and high blood sugar alarms - I would like to know when I'm at 80 during the day, but I don't want to be woken up in the middle of the night unless I am already low.

Being able to run more than one dual wave boulus running at once would be nice.

Ability to set a temp basal without it alarming every hour - so I could use temp basals overnight without being disturbed.

On carelink, I'd love to be able to set my own longer time frames - for charts over a month or two, or even over just a day or two for all charts. I would also like to be able to have a "sensor accuracy" type chart that covered more than just one day.

12:31 PM  
Anonymous Anonymous said...

Repeating earlier requests... while there are several things that would be nice to have, the following three are showstoppers for me:

1. Superbolus
2. Multiple alarm threshold settings (night vs. day)
3. Predictive alarms

12:40 PM  
Blogger Betsy said...

Thank you for this opportunity to provide some feedback. I have a Paradigm 715 that is two years old, so please accept my apologies if any of these issues have since been resolved.

1. When I run out of insulin mid-bolus, I would like the option to have the pump, once it is reloaded, continue the bolus where it left off.

2. I would like to have the option to put my pump on a vibrate mode that is silent no matter what the alarm or how long I take to respond to it. Make it vibrate for longer or with more intensity to get my attention if you must, but the user should have the choice to keep it completely silent.

3. Please make the pump truly and consistently undetectable by metal detectors.

1:57 PM  
Blogger Hannah said...

I have had my 712 for nearly 4 years, so I'll be upgrading soon. I'd like to see the following:

1. I am one of the many unfortunate Type 1's who also has insulin resistance. Most pump manufacturers forget about people like us when designing pumps because they are working on more precise small doses for those of us who don't require a lot of insulin. I want a max bolus that goes up to 30 units. If I end up eating a carb-heavy meal when my sugars are a little on the high side, I don't want to have to bolus twice.

2. I'm all for being able to set different alarm types for different times of day. I'd want something loud for when I'm sleeping, and vibrate when I'm at work with the added convenience of NOT having to remember to change them myself.

3. Speaking of alarms, let's have some different intensities on the vibrate function. If I'm driving in the car on a bumpy road (plenty of those where I live), I don't always notice a vibrating alarm right away.

4. Waterproofing. Everybody wants it. Everybody could rest a little easier if they know their pump will be safe even if it falls in the toilet, the car wash bucket, or on the water rides at the amusement park.

5. A more solid design of your casing. As my pump is now, there are lots of seams and crevices, and after carrying my pump day after day in my pocket or in my cleavage, these little spaces get filled with dust, dirt and dead skin cells. (Gross, right?) Make a pump with fewer gaping seams, and this problem will disappear.

6. Relating to that, if you can't fix that, remember how the battery packs for the 508 used to come with the little cleaning brush for dusting the drivescrew? If you can maybe throw a few of those in with the infusion sets or something, everyone's pump can be a lot less grimy. (I realize I sound a little OCD here, but if I have to drop a couple grand on a new pump, shouldn't I be able to keep it clean?)

7. Make your pump skins cheaper. I'd buy them if they were MORE THAN ONE for ten bucks. Sheesh.

1:07 PM  
Anonymous maureen said...

Ditto on the WATERPROOFING!

4:38 PM  
Anonymous Jenny said...

For very young children, smaller increments in the basal and bolus settings would help (.025), and starting at .05. My daughter's basal is currently set at 0.10 - the lowest on the 512, and she goes lower than her target (150) too often (70). Topping her up with free Starbursts seems to defeat the goal of diabetes management via the pump.

8:36 PM  
Blogger Bernard said...

Wil

Has Medtronic ever considered blogging about their pump development process? I'm sure they'd get a lot of feedback about new feature suggestions from that!

Let us know if you hear back from them on any of the suggestions.

6:38 PM  
Anonymous Anonymous said...

I have a Paradigm 522. It's my 4th pump. I'm perfectly happy with the pump software-I guess I don't really tinker with the basal profiles as much as others. My two greatest wishes: SMALLER and WATERPROOF. When I'm next eligible for a new pump, I will choose the smallest one available.

8:29 AM  
Anonymous Kent Teffeteller said...

I want:

The ability to turn off wireless features in setup.
Color Screen
Luer Lock infusion sets
Food database
Freedom from static electricity wiping out pump settings
Improved pump software for PC and for Macs
Better ruggedness
Improved IOB system
Improved pump support on late nights and weekends
The ability to use your pump around FM/AM transmitter sites without problems!

3:35 PM  
Anonymous itsnotabeeper said...

I am so excited that MM has requested some input. I really hope they do see all of this and truly consider our requests. Many great ideas have been posted thus far. Although none of my wish list items are original, they truly are things I have wished were included in my current paradigm 512. I would love to see an improved minimed pump with a focus on the following:

1. My most desired feature ~ A High-Resolution Color Screen. I use my reading glasses full time due to my need to glance at my pump and press buttons so often throughout the day. I don't think I would need to wear them all day if I had a color screen as the contrast involved in a color screen tends to stand out. I would certainly be willing to pay the extra cost in batteries to have a device that needs to power such a screen (Animas - great break through! Love the black background and color letters)

2. Please discontinue the use of open-circle alerts. Creating a different icon for each type of alert is sensible to me. Having a color screen could simplify this.

3. Having the ability to download audible alerts (similar to a cell phone's ringtone) is also of special interest to me. Coworkers are always telling me that I am making that "zoom zoom zoom" sound again. Okay, it really is more of a beep BEEP beep, but they joke that it sounds like the old Mazda commercials. Point is, they hear it more often than I do.

4. How about a higher tech look? The minimed pager look is very outdated. I understand that the pump has so much technology in it and money needs to be spent in that area, but can we compromise and meet half way? I really don't expect an ipod looking device, but I would be happier with something that has a bit more asthetic appeal than the current beeper look.

5. In addition to a high-resolution color screen, I would love the screen to be larger. As much as I would hate to admit it, I would almost rather have the whole device be slightly larger if it meant I could see more on the screen at any given time.

6. I love the idea listed above about a home screen that doesn't fade to blank.

7. Food Database. Food Database. Food Database.

8. The Correction Carb Value is a great idea. I agree that I need more carbs to compensate for a low of 45 vs a low 70. Having some help from my pump during these times of not-so-clear thinking would certainly be appreciated.

9. I would love some waterproofing. I understand that all companies run the risk of damage to the pump which ultimately forces the pump into non-waterproofing mode, but I agree that this feature really needs attention. I have spent way too much money on pouches to allow me to take a dip (albeit a long 5 hr dip in the Maine white water) without fear of my pump dying. I dream of the day when I can just attach the pump and go.

On the lighter side, I feel minimed has done a great job in many areas. The CGMS innovation is great; I dream of the day that I can use one. Great work, Minimed! The clips are very much appreciated. I own the holster type and the low profile type. I love them and could not imagine wearing the pump without them.

5:37 PM  
Anonymous Martin Jensen said...

I'm using a Paradigm 715 with the B-D meter.

MT needs to understand that this is not a gizmo -- it's a body part. Would you put up with any other organ you had to take off when you get in the shower? Waterproofing is a prerequisite. I heard an MT guy say, "we just can't say it's waterproof." Bullshit. I had a fraction of a second slip at the edge of a pool and my 508 was toast. Soggy toast.

B-D link in the dark: When the meter sends a BG and I try to do a bolus wizard, the light goes off. I have to escape, then turn the light on, to see what I am doing. Also, the meter itself doesn't have a backlight. Dumb.

I eat a low carb diet, and if I am getting enough exercise, the exertion takes care of it -- no bolus necessary. Okay, so I've been sending it BG readings, and pushing all kinds of buttons on my pump, but after 24 hours it goes into Auto Off mode. Why? No bolus. I'm not unconscious, I'm just in balance. Why isn't it smart enough to know that there are other ways to interact with the pump that to shoot insulin?

In case you missed it, that comment about forgetting to do a fixed prime might leave somebody with no insulin delivery and no warning for hours? It happened to me. Pump users tend to be busy people.

How about a way to buzz my earphone with an alarm, say, when I'm at the theatre?

Bluetooth is the obvious way to get the most of features into the pump that everyone is asking for. You could also conveniently wash your hands of any pesky liability -- let us decide how to program the thing and you can put the lawyers out to pasture....

3:46 PM  

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