Cozmo Pumper Has to Switch ... Doing Research, My Cozmo is up for renewal, but Deltec no longer makes Pumps Options

[TarHeel Dave]

I have been using the Cozmo Pump for 4 years. I was about to renew it when Deltec decided to stop making pumps which has caused me to get back into research mode again. Here is what I love about the Cozmo and hope Animas users can tell me how or if the Ping system provides the same features - and THANKS!
1. On Cozmo, I can set a Infusion Site Change Reminder ... I currently have the reminder light up every 3rd day at 6:30AM - with everything else going on in my life, this reminder is a God Send - something I can set and forget.
2. On Cozmo, there is a Therapy ScoreCard function which over the set # of days (whatever I set) it will show, avg. BS, and associated Std. Deviation; Avg. # of daily samples; Avg. Bolus, Avg Daily TDD, etc.
3. I have a Temp basal rate set to 0 - effectively shutting down insulin delivery for whatever time interval I set (currently 1.5 hours) - which comes in handy every once in a while.
4. I have Temp basal rates for 110% and 120% of Normal Basal Rate and also one for 70% - I use them during long travel or exercise, etc.

Since Animas has linked with DexCom, I am into CGM sometime soon (as soon as I land a new job!). I think the remote feature would be nice (allowing me to stash my pump and not have to retrieve it for BS or Bolus events) - am I right in this? Are the above items programmable in Ping or the Remote element?? All the literature is not clear.
Also, can someone help me understand what you must do to change cartridges? Something about re-cycing the pump and it appears some settings have to be re-entered (??) On Cozmo, this was a very simple and straightforward task to do .. no hassles.....
I sincerely appreciate any insight you all can provide me in my quest of discernment.
Thanks.

[Linda B]

1. On Cozmo, I can set a Infusion Site Change Reminder ... I currently have the reminder light up every 3rd day at 6:30AM - with everything else going on in my life, this reminder is a God Send - something I can set and forget.
2. On Cozmo, there is a Therapy ScoreCard function which over the set # of days (whatever I set) it will show, avg. BS, and associated Std. Deviation; Avg. # of daily samples; Avg. Bolus, Avg Daily TDD, etc.
3. I have a Temp basal rate set to 0 - effectively shutting down insulin delivery for whatever time interval I set (currently 1.5 hours) - which comes in handy every once in a while.
4. I have Temp basal rates for 110% and 120% of Normal Basal Rate and also one for 70% - I use them during long travel or exercise, etc.

Since Animas has linked with DexCom, I am into CGM sometime soon (as soon as I land a new job!).

Dave,
I know you are asking about Animas, but I thought it would be useful if I answered your questions with regard to Medtronic Minimed.
The reminders and 'named' basal rates are unique to Cozmo. But you can acheive similar results with different techniques.
You can set an alarm on MM each time you change your set, so that it will remind you when the next set change it due.

There is a 'daily total' screen on MM. You can view the statistics you listed AND CGMS statistics but not standard deviation, for any number of days from 1 - 31.

It is simple to set a Temp basal rate whenever you need it (6 keystrokes). (act;basal;set temp basal; enter duration; enter percent; act).

MM Paradigm system includes a pump integrated with a CGMS since 2006.

Hope this helps,
Linda

[carrie]

Hi Dave -- isn't it a BUMMER about Cozmo?? At first I was really upset (dumped by the pump!!), but now I am really looking forward to trying something new. A new color, maybe even the omnipod, if it can work out with insurance. I'm getting excited now....

But you're right, nothing will be exactly the same. It is a big life change, and I wish you the best. And keep me posted please!!! I have until mid July before I really need to find another supplier, or find a new pump.

(I am really looking at the Ping too!)

Carrie

[TarHeel Dave]

Linda, Carrie - thanks for your input.
Right now, the Animas Ping (with all its deficiencies) is top on my list and here's why (I hope you might be able to comment): My research has led me to believe that the MM system has problems with some of its algorithms used for Insulin Duration, Insulin amount derived from carb input, old motor technology, etc. also the proprietary infusion set setup limits one to MM infusion sets (I found yesterday that there is a vendor that has a method for the MM so that it can use a leur lock - which is great as the Cozmo Cleo infusion sets are just incredible). I have also read that the MM CGMS sensor is not as accurate as Dex. Thoughts? Have these things been a hinderance? Mind you that the Ping has issues as well not sure if this one applies to the MM, but with Ping, when a cartridge is changed, you are forced to fill the infusion set tubing (even if the tubing is not being changed out) - this is totally unnecessary and just raises the hassle level (for me at least). Every pumper I have talked with loves their pump (me too!!) ... this exercise I am in now is interesting as I am forced (based on experience) to ID what is really important feature wise to do a fair comparison - outside of the marketing hype. My credo for all these years of using all kinds of diabetic tools has been this: "If the tool reduces the hassle level for me, it is good". Thus this quest for insight. Thanks.

[Arlene S.]

Linda, Carrie - thanks for your input.
Right now, the Animas Ping (with all its deficiencies) is top on my list and here's why (I hope you might be able to comment): My research has led me to believe that the MM system has problems with some of its algorithms used for Insulin Duration, Insulin amount derived from carb input, old motor technology, etc. also the proprietary infusion set setup limits one to MM infusion sets (I found yesterday that there is a vendor that has a method for the MM so that it can use a leur lock - which is great as the Cozmo Cleo infusion sets are just incredible). I have also read that the MM CGMS sensor is not as accurate as Dex. Thoughts? Have these things been a hinderance? Mind you that the Ping has issues as well not sure if this one applies to the MM, but with Ping, when a cartridge is changed, you are forced to fill the infusion set tubing (even if the tubing is not being changed out) - this is totally unnecessary and just raises the hassle level (for me at least). Every pumper I have talked with loves their pump (me too!!) ... this exercise I am in now is interesting as I am forced (based on experience) to ID what is really important feature wise to do a fair comparison - outside of the marketing hype. My credo for all these years of using all kinds of diabetic tools has been this: "If the tool reduces the hassle level for me, it is good". Thus this quest for insight. Thanks.

I have been pumping with MM going on 16 years and I've been using the CGMS since July of 2006. I've had no problems with the IOB function. One is able to set the time but it is possible to override the wizard. As far as accuracy is concerned, my CGMS has been very accurate: there is rarely more than a 10 mg/dl difference between my SG and BG readings. I calibrate 2 to 4 times a day. As for the pump and infusion sets, I used luer lock sets on my older pumps and I don't see any advantage there. It's true that MM uses proprietary infusion sets but there is such a wide choice that it doesn't matter to me. As for the need to fill the tubing if you are reusing it, I believe that if there is insulin in the tubing you probably just need to prime it enough to push it through.

I suggest that you call the pump companies and ask to try their pumps. Also you might want to go to the websites and take a look at the manuals.

Hope this helps.

[JohnG]

Linda, Carrie - thanks for your input.
Right now, the Animas Ping (with all its deficiencies) is top on my list and here's why (I hope you might be able to comment): My research has led me to believe that the MM system has problems with some of its algorithms used for Insulin Duration, Insulin amount derived from carb input, old motor technology, etc. also the proprietary infusion set setup limits one to MM infusion sets (I found yesterday that there is a vendor that has a method for the MM so that it can use a leur lock - which is great as the Cozmo Cleo infusion sets are just incredible). I have also read that the MM CGMS sensor is not as accurate as Dex. Thoughts? Have these things been a hinderance? Mind you that the Ping has issues as well not sure if this one applies to the MM, but with Ping, when a cartridge is changed, you are forced to fill the infusion set tubing (even if the tubing is not being changed out) - this is totally unnecessary and just raises the hassle level (for me at least). Every pumper I have talked with loves their pump (me too!!) ... this exercise I am in now is interesting as I am forced (based on experience) to ID what is really important feature wise to do a fair comparison - outside of the marketing hype. My credo for all these years of using all kinds of diabetic tools has been this: "If the tool reduces the hassle level for me, it is good". Thus this quest for insight. Thanks.

Hi
Just a couple of comments.

My Medtronic RT system is very accurate, Last two weeks BG average (Finger stick 113)-(CGM 110)
Based on 107 Finger sticks and 3770 CGM readings. If you would like to see my printouts I can share them with you.
CGM is not for every one there are physiological reasons that my keep you from using this technology. And
one more thing to remember is the sensor reading does not coincide with meter readings during the same time
period except for when BG is very stable and this lag in time will very by individual.

Yes the Animas pumps use different algorithms than the MM pumps but I can assure you My Bolus Wizard works great.
My Average standard deviation is between 20 and 30 from month to month and I only use the Bolus Wizard if
it had problems I could not achieve this kind of control.

The only pump using different motor technology is the OmniPod (stepper motor) the rest of the pumps use DC motors (same technology).
But I think there will be more pumps in the future using stepper motors their much smaller. But I'm not
concerned with what kind of motor my pump has unless they go to remote control and eliminate the screen
on the pump completely and make the pump much smaller.

Every one has there own preference when it comes to Infusion sets and there are plenty to chose from.

My pump selection was made exclusively on the integration built into the Medtronic RT System.
If I was not interested in CGM, it would have been hard for me to pick between Medtronic and Animas in todays market.

Good luck choosing a pump

JohnG

[Phetonb]

I too am facing the dilemma of needing to change pumps since Smiths Medical will not produce the Deltec any more.

My warranty is up, and so long as my faithful companion keeps on going, I am fine. But to be pro-active, I am investigating the options now, so I won’t be pump less for long when my pump dies.

CGM is not my primary concern, as my insurance will not cover that for me at this time. I do want that technology when it is covered for me, in the near future, I hope.

I am leaning toward the Animas Ping so far. I love my Cozmo, and would like something similar. A friend of mine has a MM and she hates it. I can learn any system, but one similar to the Cozmo will be less of a change for me.


Cliff

This post has been edited by Phetonb: Apr 1 2009, 06:13 PM

[TarHeel Dave]

Hey Folks. Thanks for the information. Your real world experiences with these systems and willingness to share them with me is great. I have read the manuals from the vendors, I also have talked with some (not all) of the vendors technical support teams. I have read all the vendor's web site content as well. Four years ago, I selected Cozmo after talking with a local Pumpers User Group Members my endo. and CDE - and it has served me well with absolutely no regrets. I have gotten used to its features - like an old pair of jeans, it just feels right ... Now I need to buy a new pair and there is (as it was 4 years ago) a lot to think about - especially with the addition of my Cozmo experiences!
The MM info I have read and shared in this forum I thought was not on the mark but needed your non-sales/corporate experiences -- Thank you. I would love to lead the pump program development team of these companies (I had done new product design/development some time ago for IBM)!
So my plan at this point is to take your collective input, go back and take another hard look at MM and Animas - the two vendors I have narrowed to in my final selection. CGMS is important as well, MM is already there with an integrated system, Animas is not far behind (as they have paired up with Dex) ...
Thanks again.

[frank]

Hey Dave,

I just wanted to let you know that I do not change my cartridge with every site change and I do not do a full prime when I don't change the cartridge. I use the same tubing for two sets. I have not noticed any air in the tubing when I reuse it. Oh yeah, I am using the Animas. Good luck!

[meeaow]

Hey Dave,

I just wanted to let you know that I do not change my cartridge with every site change and I do not do a full prime when I don't change the cartridge. I use the same tubing for two sets. I have not noticed any air in the tubing when I reuse it. Oh yeah, I am using the Animas. Good luck!

If I refill my cartridge, when I disconnect it from the tubing I notice that I do get air in the start of the tubing, therefore I do need to prime this out!

Also, I was under the impression that when you refilled/changed the cartridge with the Animas you had to reprime every time in order to set the occulsion sensitivity properly?

[Liz]

If I refill my cartridge, when I disconnect it from the tubing I notice that I do get air in the start of the tubing, therefore I do need to prime this out!

Also, I was under the impression that when you refilled/changed the cartridge with the Animas you had to reprime every time in order to set the occulsion sensitivity properly?

I have Minimed, not Animas, but there have been times when I needed to remove the tubing from the reservoir (cartridge) and I ended up with a tube full of insulin, but a big air bubble at the connection to the reservoir. Now I just use the plunger to draw all of the insulin from the tubing back into the reservoir, tap out as much air as possible and then prime it all again to fill the tubing and push out any remaining air that might be at the top of the reservoir.

[Phetonb]

Hey Dave,

I just wanted to let you know that I do not change my cartridge with every site change and I do not do a full prime when I don't change the cartridge. I use the same tubing for two sets. I have not noticed any air in the tubing when I reuse it. Oh yeah, I am using the Animas. Good luck!

Frank,

As an Animas user, I have a question for you. With my Cozmo, when doing a meal bolus, my pump has the option of me putting in the amount of carbs in my meal to plan my bolus. I went to the Animas site and "tried out" the programming there, and could only find bolus options for entering units of insulin.

Can I tell the Animas I am going to eat 60 carbs and it will then give me the correct bolus amount?
Or, will I have to calculate the Units of Insulin and enter that amount to do a meal bolus?

This is an important feature for me. Makes life much less complicated when you don't have to calculate units of Insulin, only have to count the carbs in a meal. My insulin requirements vary with time of day, and remembering my insulin to carb ratio is easier when my pump does that for me.

The rep I spoke to said it could be programmed to enter carbs with the meal bolus, but I could not figure it out with the online sample.

If any MM pumpers can answer this question about the MM, that would be great as well.

Thanks for your replies,


Cliff

[Linda B]

. With my Cozmo, when doing a meal bolus, my pump has the option of me putting in the amount of carbs in my meal to plan my bolus. I went to the Animas site and "tried out" the programming there, and could only find bolus options for entering units of insulin.

Can I tell the Animas I am going to eat 60 carbs and it will then give me the correct bolus amount?
Or, will I have to calculate the Units of Insulin and enter that amount to do a meal bolus?

This is an important feature for me.

Cliff,

Both Animas and MM have Bolus Wizards that calculate the bolus based on your current BG value and the number of carbs you are getting ready to eat. They also do correction boluses based on your current BG.

Linda B.

[tedm]

If any MM pumpers can answer this question about the MM, that would be great as well.

On the MM Paradigm, under Bolus, you have an option for "Bolus Wizard Setup". The first option is Wizard on or off. If the wizard is off, under Bolus, the first function is "Set Bolus". If the wizard is on, there are two functions, "Bolus Wizard" which allows entering your BG and carbs, and "Manual Bolus" where you simply enter units.

[Phetonb]

Thanks for the info.

I will re-check the website demo pump Animas showed me for the wizard.

[gigem99]

Thanks for the info.

I will re-check the website demo pump Animas showed me for the wizard.

Cliff,

Understand that "bolus wizard" is strictly a MM term - Animas has something similar, but I don't know what they call it. One of the things I do know, however, is that the Cozmo and the MM pumps both suggest a bolus, and allow you to get that bolus with a single button punch. MM patented that technology, and when Deltec came out with it, MM sued and either outright won or settled. Deltec had to pay MM a royalty for each pump it sold that used that technology.

The Animas pumps do not do this. They will recommend a bolus, then you have to manually enter that bolus in order to receive it. A few more button punches, and I would personally find that very annoying.

Maybe an experienced Animas user (hello Frank?) can chime in and be a little more specific on how the Animas calculates boluses.

Tom

[Gordo]

I would bet that MM or Ping will offer free or reduced upgrades for Cozmo users soon. It might help make some of your decisions if you're basing your choice heavily on what is covered by insurance.

[Gordo]

Speaking of which...MM has beat me to the punch.
https://www.minimed.com/cares/

[frank]

Hi All,

Sorry for not gettng back to you sooner but I have been out of town.

Yes the Animas will calculate the bolus amount. This is based on both your BG reading and the amount of carbs you are going to eat. I can't tell you the specifics on how it calculates other than it takes into accout IOB, BG and Carbs. You can also do a manual bolus, by entering the # of units you want to tak. I don't know how the MM works but from the sounds of it all there are fewer button pushes than with the Animas. Even if this is true, I don't find the "extra" pushes as an issue.

I have found it to be a very easy pump to use and get use to.

[iJabber]

The Animas pump has an EZCarb feature that calculates a suggested bolus based on either carbs entered manually or on carbs from a database of 500 foods and your BG reading.

Animas is also making a special offer to Deltec users.

Extra button pushes? A non-issue...

iJabber

This post has been edited by iJabber: Apr 11 2009, 08:44 AM