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SallyW

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don1942

My endocrinologist has high hopes that the work being done by Dr. Douglas Melton at the Harvard Stem Cell Institute will eventually lead to a cure for diabetes. Apparently, he and his team have successfully produced not only beta cells but also alpha and delta cells from stem cells. All are present in the healthy pancreatic process of controlling blood sugar. 

 

The research is currently limited to lab mice, but the conversion to humans is promising.

 

https://diatribe.org/updates-harvard-diabetes-stem-cell-research-ada-2015

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GrammaBear

I, too, am waiting for the 'promised' cure but I am not holding my breathe.

 

Sally - You asked for my input on the Tandem pump so I will try to share what information I've learned.  I had Medtronics for 5+ years prior to making the decision to switch to Tandem.  I was interested in Tandem because of the touch screen and because it has a colored screen which is easier for me to see.  My vision is definitely not perfect, so visibility of the screen is important to me.  I also grew very tired of 'button' pushing with Medtronic pump, and the idea of a touch screen (like a smart phone) was intriguing.  My insulin use is a little bit less than with the Medtronic pump but that is also a variable depending on the person.  I am not even a little bit sorry I switched to Tandem pump and would not return to Medtronic unless I was forced to do so, and even then I would consider a return to MDI.

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SallyW

Thank you GmaBear. Do you have the CGM? It's the touch, very clear, color, screen and size that has my interest. I'll ask again tomorrow, but i could have swore the rep told me that the Tslim + dexcom work just like the Medtronics system, only it's blue tooth. The Medtronics rep said that they're working on blue tooth but they're not there yet.

I'm not sure where I'll land yet but I'm learning during the waiting/approval period.

 

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notme

So far Sally, Medtronic is the only approved closed loop system.  It is true that Medtronic was caught with a very quick approval for this system and got behind.  However, this is the only game in town and the response for consumers has been off the charts high.  Between that and the hurricane, the roll out of this pump was less than ideal.  That being said, they are getting the systems out to people much faster than they first thought.  

 

The help and 24 hour service for the Medtronic pump has been exemplary.  They have a dedicated helpline for 670g pump users.  I know some people have had a bad time with service, I have not.   The service and help line has been very very good and I wouldn’t think about moving away from Medtronic.  They still are in the forefront in diabetes care.  It would be nice if there were more competition and choices out there but for now, Medtronic is the best game in town for the time being.  

 

The 670g has two modes.  You can use it in manual mode.  You can use any meter in manual mode but it will not read directly to the pump.  You will enter in your blood glucose manually.  Not the end of the planet because you still have the suspend before low option.  In manual mode the pump will stop giving you a basal rate when the sensor reads you are low and turn it back on when you are in a safe range again.   You also enter your own preset basal rates in manual mode.  

 

In auto mode, you must use the bayer contour meter.   The pump does not use your preset basal rate.  Instead the pump uses your sensor glucose readings and gives you micro boluses as needed.  The pump is constantly reading your sensor and giving you tiny amounts of insulin.  You don’t have a basal rate anymore.  It will suspend the micro bolusing when you start to go low and it will increase it when your blood glucose goes up.  It is all automatic.  You only bolus for the carbs you eat.  If you don’t calibrate or your sensor dies, you are kicked out of auto mode and your preset basal kicks back in and you are in a safe mode until you put in a new sensor or calibrate.  There are a lot of safety measures in place.  Auto mode takes time and effort to get right.   When it is finally set, it can be the closest thing you will get next to a functioning pancreas.  It is only uphill from here. 

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NoraWI

Notme, would you recommend that a total newbie, someone who has never used any pump nor a CGM, nor been on MDI for any length of time, jump into a 670g?

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notme

I don’t know NoraWI.  Maybe......  they don’t have any preconceived ideas.  However, I think it would be good if they were educated on active insulin time and IC ratio.  

 

I think it it really would depend on the person and how open they were to a big learning curve.  Heck, I have had diabetes for somewhere in the vicinity of 30+years and I wasn’t ready for the learning curve.  

 

Definitely, they would need a good trainer and an up to date endo.  

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NoraWI

I agree. It IS a steep learning curve. But the lack of preconceived ideas IS a bonus. I have been wondering about this as it applies to me and the pump decisions I have to make in the near future. Of course, today's closed loop is not the panacea that one hoped for. I feel there are still so many *holes* in our understanding of DM. Lack of insulin as a cause is only part of the story. I'm not sure there is anyone delving into the other parts at this time, which makes me feel abandoned and quite sad.

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SallyW

I've been pondering this conversation quite a bit the past couple of days and where I fit in as far as the pump decision.

 

When they first mentioned going on a pump to me (abt 9 months ago) I was bummed, I was scared, I cried, I thot it meant "closer to the end." I'd never heard of pumps before and in my mind I was thinking a long the lines of a colostomy bag type apparatus. That's what lack of knowledge can do to you.

After researching and reading, studying and listening my opinion of a pump is the extreme opposite. I absolutely want to be on one of the two systems. As far as learning curve there isn't anything about having diabetes that hasn't had a learning curve for me. I honestly don't think there's an end to what can be learned, because once I get something figured out there's always something else that I don't understand and have to figure out the formula for. And then everything changes.

I sure wouldn't go into this without training and both companies are supposed to have excellent and dedicated training staff.

 

On another thought I've pondered...

I have qualified for both systems, Medtronics and Tandem. My deductible is paid and limits met so insurance is paying 100%.

I'm wondering... What good is it going to do to get the Medtronics pump when the CGM isn't available until March? I could get the complete Tandem and Dexcom system right now (covered under Anthem BlueCross). What if I got that system for now and when I go on Medicaid (March 1st) maybe the Guardian CGM will be available and I could move to the Medtronics system.

Can I do that?

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notme

No Sally.  Once you get a pump, you will not qualify through insurance for another one for the duration of the warranty, usually five years.  I know Medicare only lets you get a new pump every five to seven years.   I think Medicare was seven years but someone will,correct me if I am wrong.  

 

The Guardian sensors are already being shipped.  Many were told March and they are getting them now.  But, you need to do what is best for you.  The Tandem pump will not be a closed loop system but many have been happy with the pump.  So I guess now the decision is yours.  

 

I would suggest you you look at other sites and go to the Facebook page for both. The 670g users group is excellent.  I am sure tandem also has a page.  

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SallyW

Thank you.

If I have a pump for five years how do they deal with upgrades. Say they make major improvements to the Medtronics system, will they allow me to upgrade as the systems upgrades?

Edited by SallyW

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don1942

Thanks for the links, Sally. Unfortunately, I was unable to join the Facebook group because I have not gone through the required training program. My trainer does not want to begin until I receive the Guardian sensors which are on back order.

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1668880

Well sad to be the bearer of bad news but give up on a cure for Diabetes. The amount of money made from Diabetes is so much that they will keep a cure for it quite because they do not want to lose out on all the money they are making from it.

 

On the other side if your insurance only covers the Dexcom G5 sensors I am sure you can find someone whose insurance only covers the Guardian® Sensor 3 that the 670G uses and trade the sensor with them if they don't use them. If not unfortunately you are not able to sell them any more due to needing a prescription to get them. I was buying my pump supplies on ebay when I did not have insurance and was able to get them for a decent price from people who had more then they needed but that came to an end due to the rules of Ebay and the US government.   

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briargate

Been using medtronic pumps for years and am very pleased confidant with their products,  Endo keeps pushing switch from 630 tot he 670G, but the cost for the CGM and supplies is substantially higher than meter and 630

 

   Is any one on Medicare that could advise the cost of supplies for the 630 or 670G supplies? 

 

thanks,  

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don1942

Medicare does not cover CGMs and supplies for Medtronic. My supplemental insurance covers 80%. I just ordered my first 90 day supply of Guardian sensors and was told my cost would be $200. Hopefully, I will be able to recharge the transmitter and get another six days on each sensor.

 

I believe the cost of Enlite sensors for the 630 was $135 for a 90 day supply.

Edited by don1942

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notme

I have always gotten 10-14 days out of a sensor.  I know some people who have gotten more.  I just never push mine past 14. 

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don1942

My third to last Enlite sensor got flakey (read 78 but stick test read 156) four days in. Second to last got flakey after eight days. Hope my last senser (trainer will set me up with new Guardian sensors on Monday) stays accurate until then.

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