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!).

Sunday, June 17, 2007

The Question

The question took me by surprise and I didn’t know how to answer. I found myself staring into his eager brown eyes, anticipating my answer, while the gears in my head spun. “Ummmmmmmm…..” I said to give myself more time.

It all started at our bi-annual diabetes circus. That’s what I call it. Of course that’s not its official name. I think the official name is the Diabetes Health Fair. But it is a circus. All we are missing is an elephant and clowns. And cotton candy.

The Lion’s Club has a mobile eye screening lab in a massive RV that can barley make the turn to get into the clinic parking lot. We have a volunteer eye Doc come in and do basic eye screens for the un-insured (most of my patients). One every ten minutes. All day long.

We have a specialty footwear firm come in and do foot screenings and fit custom shoes when needed. The dental side did screenings for gum disease and the like. Drug reps who want some face time with end users set up booths in the lobby. The brand new ambulance was parked out front for everyone to gawk at. We do blood sugar screenings of Type 3s and anyone who happens to drop by.

It’s a long day and I’m the Ring Master.

At lunch one of the foot guys, who happens to be a T-1 like me spied my pump.

That’s when he asked the question: “Which pump do you recommend?”

You know; I don’t know. As a pump, I really don’t think that much of the MiniMed product. I think that as a pump, the CoZmo is light years ahead of the MedT product. It does more and is more user friendly. It’s like in the really old days when you compared the early PCs to the Early Mac computers. PCs were chincy with their info……

You can do things faster (like eat) and with more info at your fingertips with the CoZmo. Medtronic prides itself on being a medical device company. The ParaPump is very much a medical device. On the other hand, I get the feeling that the CoZmo was designed and built by diabetics. It is made with the user in mind. It is friendly.

The ParaPump is built with the mission in mind, user be damned. Medtronic seems to view it as a tool that we must learn to use. Smith’s understands that we must live with these devices 24-7. FOREVER.

I’ve been using ParaPump for quite a while now. Long enough to get use to it, love it, and hate it. It requires all three.

So if I think the CoZmo is better why didn’t I just say so and why is the ParaPump still snuggly on my belt? Three letters: C-G-M.

Continuous Glucose Monitoring. I felt one hypo a while back but I’ve been in the low 50s a dozen times since with no clue save my late-to-the-party alarm system, which never the less saved my bacon each time.

Truth be told: at this point, if I could, I’d go back to wearing my CoZmo pump and my old garage-door-opener Guardian. Too bad the new elegant little MiniLink transmitter won’t talk to the old guard. But, there is no more getting the transmitter for the old system. Even though it was big, ugly, had no graphic screen, and required me to wear two boxes on my belt; it did what I required most. It woke me up when I needed to be woken up. It never failed to command my attention. It was loud enough.

So why do I still wear the ParaPump? Because I’m chicken shit. I’m afraid to be without my CGM. Life is too dangerous without it. I could set it’s basal rate to zero and use it as a stand-alone CGM and then put my CoZmo back on; but its not THAT bad of a pump. Why have two boxes for no real reason? Although I may do that for a while when I run out of my supply of MedT infusion sets. I’ve got four months of CoZmo sets in boxes that I hate to let go to waste….

So maybe this guy doesn’t need CGM. Or maybe he couldn’t afford it if he did (a common problem). But in the back of my mind I was feeling that it was on the cusp of malpractice to recommend anything but the pump that had integrated CGM capability.

Sure the guy could wear a CoZmo and then get the by-all-reports excellent new Guardian with it’s sexy slope alarms. I assume it suffers from being equally shy volume wise, however. Or he could wear a DexCom, although its users don’t seem to stick with it. Or he could wait for the missing-in-action Abbott Navigator. If Navigator ever gets out of the FDA, and If it works, and If Smith’s mates it with a CoZmo then Medtronic will be in trouble. But that’s a lot of “ifs.” It may not happen. Not soon anyway. MedT may have the integrated pump/CGM market to themselves for many years.

But it is too bad to have such a lovely CGM married to such a poor pump.


Anonymous Anonymous said...

I am on a minimed model 722...and I have to say that I feel the same way you do. I loved it at first, but as I see all of the advantages that the cozmo has to offer, I really would like to switch. my insurance won't cover the cgm, so I dont know about that, but I really do think that I made the wrong choice in pump selection, and I have three more years before my insurance will pay for a new one. I guess I am lucky to have one, so until then, I will just haveto deal.

8:20 PM  
Blogger Bernard said...


Does the Minimed device still use the BD meter to download data to the PC? That was also a weak link for me with my current 512.

9:17 AM  
Blogger Megan said...

I'm seriously looking into getting a CGM in the near future. I have a Cozmo, and I love my Cozmo. It's an awesome pump. Looking at the colorful Medtronic literature, it's a decent pump. It's not bad, but it's not my Cozmo. So, the same question has been on my mind. There's a decent chance my insurance will pay for a new pump for me. So I'm at a point where I think I would get a 522, get the Minilink, and use it once in awhile- when I'm more active than usual, when I'm settling basal patterns, and when I'm sick. Then I would use my Cozmo the rest of the time. That's what I think so far... Unfortunately, the Minilink upgrade to the 522 is cheaper than the Guardian on it's own.

10:35 PM  
Blogger Wingman said...

For me the Cozmo had a bit too many bells and whistles and I wasn't a fan of the design. I like the straight forward medicalness of the Minimed and would rather have the food database in my palm pilot than on my pump (easier to navigate). I felt that while the Cozmo offered a ton of extras they didn't outweight the CGM or the "B" button on the minimed.

2:47 PM  

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