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!).

Saturday, April 04, 2009

Bonus post—Vultures

The single set of tracks stretched for miles across the arid desert, stopping abruptly at the collapsed figure. He lay in the scorching sands, not dead yet, but not truly alive either. With no water, and no energy to go on, it was only a matter of time before the end.

High above came a screeeeeeech and the rustle of hot wind through feathers. A vulture arrived, circling, waiting. Then another vulture arrived, and then a third.

Strangely, all three vultures were different types. The first on the scene was the most common vulture in the world: the Cathartes Medteeas. They are large and slow, but tough. The second vulture was a Cathartes Animaisis, who for reasons scientists can’t explain have been experiencing a population boom. Baby birds of this type have the unusual ability to change the direction of their mother’s flight by calling out. Last on the scene was the small, nimble, and fast-flying Cathartes Ominpodus.

Yep, my fellow Cozmo pumpers, the other three want you to join their families. I got an email from Med-T on Friday explaining how they want to help out the poor abandoned Cozmo pumpers. Quoting from their Media Advisory: “In an effort to lend a helping hand to individuals affected by this decision, Medtronic Diabetes has launched the Medtronic Cares Program.”

How noble and selfless. OK, seriously, here’s the deal; and for some pumpers it is actually a very smart move. For others, not so much. Read on.

For a limited time, send in an in-warranty Cozmo pump and two box tops and they will give you a Med-T pump at no cost what-so-ever. It won’t be brand-spanking new, but will be a refurib with a two-year warranty. They will also throw in the first month’s supplies.

The only catch is you have to fill out four customer surveys over the first year. Small price to pay for an insulin pump.

I’m guessing that the first thing that jumps out at folks is that this offer is for a refurbished pump. You know, this doesn’t bother me at all, as most Cozmo users are walking around with refurb pumps in the first place. Anyone who had bought a model 1700 had the opportunity to trade it in for free on a model 1800 refurib. It didn’t re-set your warranty clock. It wasn’t a new pump, but it had all the new features. As the 1700s flowed in they were rebuilt as 1800s and sent back out into the field.

So who do I think should seriously consider switching to Med-T? Anyone more than half-way through their warranty that’s who. If your pump is only a year or two old and you love it, don’t worry. The big bad Federal Government is our friend for once. Smith’s has to keep the clinical support people there for you until the very last warranty runs out. Of course the support folks will be out on their asses the very next morning, so as time goes by morale might suffer. Smith’s also has to continue to replace in-warranty pumps as needed for that time too. The Cozmo has a much lower failure rate than the other folks, but all man-made devices can and will fail at some point. In the last year I’ve seen a couple of cases of Cozmo pump shells developing serious cracks. I’m betting some kind of problem in the molding process; but each time I called about a patient a new pump arrived next day by FedEx.

The bottom line with Smiths pulling out of the pump biz is that even if your pump craps out at three years, 364 days after you bought is; you’ll still get a replacement. That said, when your warranty is up, be it in a month, six-months, a year…then it is all over. You’ll have to chose a new pump to love. Med-T is offering you a chance to make a smooth transition right now.

As a Cozmo user will you be happy with a Med-T pump? No. Probably not. But duct-tape will only take you so far. Four years from April 26th you will be hard pressed to find insulin cartridges for your beloved pump. Sure, you could use them twice and hold out for a while. You could watch eBay like a hawk to scoop up every last cartridge you can find. But ultimately you will have to choose a new pump. It will be traumatic, like a divorce you didn’t want. But ultimately you’ll find a new mate and fall in love again.

Med-T is asking you out on a first date. They even brought flowers.

The most cynical amongst us will say Med-T, losing new Rx market share to OmniPod and Animas are desperate to get all the Cozmo users on board. I can’t recall where the hell I read it, but I saw a statistic recently that estimated that Med-T is only pulling in 3 out of 10 new pump scripts. That’s not enough to feed an 800 pound gorilla.

But today, tomorrow, or next year, your choice is going to come down to Med-T, Animas, or OmniPod.

OmniPod is awesome and creative, but not right for everyone. If you like traditional pumping you’ll realistically have to choose between Med-T and Animas.

I’ve not used the Animas pump, so I’m hard pressed to say how it compares. They keep promising to loan me one to test-drive, but it has yet to materialize. All of these remaining pumps calculate insulin on board in a way that will be traumatic for Cozmo users to adjust to, but beyond that there are things to love about all the systems.

Med-T: a pump that can receive signals from a CGM (although only the most basic of alarms, not the full Guardian-style system); and a free-standing meter that transfers your BGL to the pump. They also have a damn fine infusion set.

Animas: with the Ping you have the option of controlling insulin delivery from the freestanding meter. Pretty cool idea. I mean, ya gotta get the meter out anyway; so why not just leave the pump on your belt, in your bra, or wherever.

OmniPod: tubeless pumping and a controller with a built in meter.

Animas is being a little lower key (so far) about scooping up Cozmo users, but on their home page there is a picture of a Cosmo pump with the bold headline “A special message for Deltec Cozmo pumpers.” You click on the link and the first thing they tell you is that their infusion sets are compatible (true, but all non-Med-T sets are luer lock and interchangeable). The insulin cartridges, or future lack thereof, will be the dagger in the heart of the last die-hard Cozmo pumper. Animas also assures us that “we are here to support you during this time of transition.” No upgrade offer at this time.

I’m told that OmniPod is scrambling to come up with a very low or no-cost switch over plan like Med-Ts, but the details are pending.

So the Cozmo ship is sinking. We’ve hit the berg. We are going down. Nothing can stop that. But it could be worse. There are plenty of lifeboats and three rescue ships just waiting. It is the end of a era, but hardly the end of the world.

On Monday: back to Navigator Adventures


Anonymous Carol said...

Thanks Wil for posting this based on experience and with humor :)). Cozmo pumper here...just off the phone w/ MM before I read your post. Personally thinking this is a good excuse to get a MM CGM (have 80/20 coverage for unit & supplies) and take the MM plunge. I believe I have either 2 yrs warranty left or possibly 2.5 on my cozmo (time to start pulling receipts for more than just the taxes). Anyone know what happens if the MM 2 yr. warranty is up, the MM pump breaks, and the ins. co says "sorry...we won't get you another one for 6 mos?" MM rep says he feels sure that won't be a problem, but I'll want to dig a little deeper on that and make sure.

12:46 PM  
Anonymous Anonymous said...

Thanks Wil.

Our family found Medtronic's choice of the word "Cares" blatantly disingenuous. For 14 years we've not been interested in this company's pump, and will continue to stay away. We have 3.5 years left on the Cozmo warranty and will hold out until we are forced to make a decision, or something new and fabulous hits the market.

Any thoughts at this time about whether Abbott will ever release the Aviator (although the remote is not attractive to use either) or if now would be a terrible time to introduce a new pump to market? We have found the Navigator to be accurate and look forward to the next generation. Unfortunately, it looks like it'll be quite a while until the Aviator may be integrated with the Navigator - if ever.

So glad to have you blogging again!

8:11 AM  
Blogger Jonah said...

Are the Accu Chek Spirit and other out of the way pumps really such a non-option?

I wish all of the Cozmo users good luck.

5:04 PM  
Blogger Jill said...

Thanks so much for this post! I just ran across your blog :)

My daughter is 9yrs old and we've only had our Cozmo for 3 weeks and had the option to send it back and choose a different pump since we were still in the 30 day-return-policy window. After much thought and lots of tears, we declined and we decided to keep the Cozmo! We love it :) We're keeping our fingers crossed and hoping something new shows its face on the market in 4 years!

8:52 AM  
Anonymous Anonymous said...

You totally forgot to mention that Disetronic is still alive... sold under the brand name Roche as the Spirit pump.

You also forget that Abbot, the makers of the freestyle meter (and the test strips that the cosmonitor uses) is entering the field with the Aviator pump.

My cozmo had 8 months warranty left on it... I jumped on the Medtronic offer.


4:20 PM  

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