Considering Pumping

[Cluck]

I haven't posted in a while. Life kind of caught up with me and I was dealing with poor healing of abcsesses caused by Lantus insulin.

Anyway, I am now going down the road of finding a pump that might suit me, in an effort to make by BGs more stable and avoid those highs and lows.

We have a branch of the Joslin locally and I went for an appointment for some education into pumps. I was pleasantly surprised, in that the nurse practitioneer and the pump educators seemed to know their stuff. This was refreshing!

Unfortunately, they seemed to be limited in the pumps they will recommend. They have the latest Medtronic, Animas and the Omnipod.

I rejected the Omnipod immediately due to it's size (I'm not very overweight and it would show anywhere I would put it), and the problems I've heard about it not sticking well enough. The pump educator recommended the Medtronic because of the local rep. who is great to deal with.

I kind of liked the look of the quicksets, although I could not manage to insert one myself, and the silhouettes freaked me out with the long needle and angled insertion. So I started the paperwork.

I was called the next day by Medtronic (pretty good insurance I suppose) and they told me that they are no longer making the quicksets, only the silhouettes and that because supplies will be limited, each customer will only get 10 sets/month.

This really pissed me off. The rep wouldn't tell me why they had withdrawn the quicksets. My educators have said that I will probably need to change sets more frequently than every 3 days due to high activity levels and sweating during the summer. I asked whether it would be possible to have more than 10 sets a month and the rep pretty much said no! I could not believe it and simply will not be under the thumb of a company like that. I determine how I take care of my diabetes and that is NOT going to change.

I guess that I am looking for some advice, encouragement, words of wisdom, information. All or any would be VERY much appreciated.

[Subby]

First I've heard about the quicksets stopping production. I couldn't find reference on the web. It would certainly be weird for a rep to say something so very very major if it was not true, but I guess something "on the drawing board" if you want to consider MM further, would be to validate this claim!

There was recently a recall of a great deal of quicksets due to a dud production line. I wonder if wires have been crossed somehow with that...

The limited range you mention is about all you've got to look at anyway. There are only a few players in the pump industry. Those are the major ones, I believe. Sooil is the only other one I can think of right now. There might be one or two other smaller ones.

The sils come in a much shorter needle as well. These work great for me. You can (should be able to) also get some other set types: sure-ts, polyfins, here's the list.
Infusion Sets (http://www.minimed.com/products/infusionsets/index.html)

The limit of sets per month sounds bizarre. Is it the rep or something to do with your insurance? I wonder if it isn't worth just starting again with some other person, if you haven't been put completely off minimed.

Now, all that said, why not talk to Animas? YOu could just give them a call. It is of course important to feel you make the right choice for yourself. I wouldn't be swayed purely by the reps abilities to sell, though. There are concrete reasons you might like one pump over another. For example, the 300u reservoir option of minimed. Or the remote and tester component of the Animas. And there are other reasons.

Keep talking, keep digging, keep thinking! Strange things like those set number limitations aside, I'd say either an mm or animas should stand you in good stead.

[butterflykisses]

The quicksets were recalled a few months ago and Minimed obviously is still trying to meet the demands of their customers. Although they offer other 90 degree sets, I'm sure they're having a hard time replacing all the sets out there. This is why they're limiting the amount, so that they can spread them out over all those who need them. This is also the problem with their proprietary system and one of the reasons I didn't go with them again. :(

[sarahspins]

This is also the problem with their proprietary system and one of the reasons I didn't go with them again. :(

Agreed... luer sets are much more readily available... plus you aren't limited to just what MiniMed offers in terms of styles.

I just started pumping again with an animas ping, and I used Sils before with my Paradigm pump and had no trouble inserting them by hand (they only look intimidating - it's not any worse than putting in any other set) but I have to admit I really like the built in insertion device that comes with the Inset 30's.

MiniMed seems to have a number of issues.. that's part of the problem I suppose with being the "market leader" - their demand exceeds their supply at the moment.

[Subby]

Apart from what Cluck has reported about what the rep said, has any mm user actually come across problems of running out of sets or not getting access to sets? It's news to me.

[shades9323]

I am in the process with Animas. They told me a 90 day supply of infusion sets would be 5 10 set boxes.

[poodlebone]

Unfortunately, they seemed to be limited in the pumps they will recommend. They have the latest Medtronic, Animas and the Omnipod.

That's actually not limited. Right now those three pumps as well as the Accu-Chek Spirit are what's available. The Cozmo is no longer being made. A new system similar to the OmniPod is in the works and is supposed to be released next year, at least as a trial in certain areas. Still, next year is not now so that can be taken out of the choices. The Accu-Chek Spirit is more popular outside of the USA for various reasons.


I kind of liked the look of the quicksets, although I could not manage to insert one myself, and the silhouettes freaked me out with the long needle and angled insertion. So I started the paperwork.

I was called the next day by Medtronic (pretty good insurance I suppose) and they told me that they are no longer making the quicksets, only the silhouettes and that because supplies will be limited, each customer will only get 10 sets/month.

Minimed recently had a problem with a lot of Quick-Sets caused by a lubricant in the part that attaches to the reservoir. All of those sets were recalled and they don
t yet have enough stock to fully replace them, but Quick-Sets are still being made. People who returned the faulty lot are getting replacements but at the rate of one box every 3 weeks, rather than a one time replacement of everything they sent back. Since they're low on Quick-Sets people are using the other types of sets, making those a little scarce as well. I've heard this will continue through November, I think. Eventually they should have all stock replenished and full deliveries will resume as usual.

The Quick-Sets are easy to use, especially with the inserter, but many people have had problems with them that have nothing to do with the recall. Kinked cannulas (cannulae?) resulting in non-delivery of insulin is the big probelm. For some people they work great but so many others have gotten fed up with them and switched. I switched to Silhouettes which can look scary at first but really aren't. They come in a 17mm & 13mm cannula and the 13mm is far less scary looking than the 17mm. I insert manually. I also use Sure-T sets which are inserted straight in like a Quick-Set, but have a steel needle rather than a cannula. The needle is tiny (6mm and thinner than a fine gauge syringe) and you don't feel it at all. It's a breeze to insert, easier than doing an injection.

When people have been running low on sets and call Minimed, they will overnight ab ox right away. They don't want you to go without. I agree that it does suck and the recall is affecting those of us who weren't even using Quick-Sets, since everyone is trying other sets now. For a new user they should at least send 2 boxes right away. If you do go with Minimed, ask them for samples of all of the sets so you can try them all out. I suggest 13mm Silhouettes and the Sure-T. The Sof-Set is similar to the Quick-Set (90 degree soft cannula) but it requires extra tape to keep it down and takes longer to insert due to that. The disconnect is also along the tubing, not right at the set, so when you disconnect there's a 4" piece of tubing dangling from the set.

I've been using MM pumps for the past 4+ years and have been very happy with them. I'm due for my shipment of supplies very soon and have no idea what I'll get or when. I get 2 boxes of Sils and 2 of Sure-Ts every 90 days. I may only be getting one at a time like everyone else.

[lark 27]

I called Medtronic the other day to ask why they shorted me on the order. (They sent one box of quicksets instead of 4). They explained they're getting caught back up after the recall of lot 8 quicksets. They're sending me one every 4 weeks instead of 4 all at once. There was definitely no mention of discontinuation.

[Cluck]

Many thanks for the replies. I will keep researching and finding out more.

I think there have been some definite crossed wires and miscommunication so far.

The Medtronic rep really did tell me that quicksets were not available anymore. Of course it could be that they are only supplying existing customers until they manage to catch up but she would not elaborate.

I must have seen the longer SILs, perhaps I would be less scared by the 13mm ones and I would like to see what the Sure T-sets are like as well.

I have another appointment with Joslin at the end of this week and I will go armed with many more questions and will ask to see all their pump and infusion sets again.


Edited for spelling