Enlite! Oh... wait.

Ever since I heard about Medtronics new CGM Enlite sensor I was excited to get it. It's reportedly tiny, painless, more accurate, with an intended 7 day use. Despite the Dexcom being the favorite choice for long-wear and comfort, I've been waiting for a sensor that has all that, but continues to integrate with my pump. The FDA had been SUPER slow in getting it approved. So, finally a couple weeks ago we got the news that it is approved and immediately available! I called them to get it sent to me, but found out that you have to also have the latest pump with low threshold suspend. So, I have to wait until my warranty period is over (May 2014), before I can get the newest pump and the Enlite sensors. I guess patience is all part of the game. But, I have to say... this timeline is nothing compared to what my sister has experienced in the UK with national healthcare. She was told a couple years ago that she was on a waiting list for a pump, and then hasn't heard a peep since.

In the meantime, I'm using expired sensors because I get much more wear on one than is recommended. I get 7-10 days on a 3 day sensor. They are working just fine. I had to ask M-tronic to stop shipping me sensors (and a bunch of other stuff) till I could get caught up. I probably won't have to get anymore before the Enlites come. The good news is, I'm on a winning streak with the Sofsensors no bleeding or bruising, just moderately painful harpooning. I can live with it till at least May.

New meter, again.

I use pretty much whichever meter is integrated with my Medtronic insulin pump. It keeps things simple. First they gave me a B-D Link Meter, then about two years later they switched to One-Touch Ultra Link, and now they are paired up with Bayer. A few months ago they shipped me a Contour USB Next Link. Yep, next is right.

The Next Link is supposed to be more accurate, and it has a USB connector right on it, and works to upload your pump data. So, you don't need another device to upload your stats to the Medtronic CareLink reports website. It's pretty small too.

All that said, I'm not totally flipped over it. There are definitely some things I like about it, but unfortunately the things I don't like about it pop up every time I use it.

Operation:
My old Linked meters used to just send the test results directly to the pump and initiate a conversation about a correction, if needed. This one asks me every time if I want the results to be sent to the pump. Every time... I have to decide. It also asks me upon each test whether this is a before meal test or an after meal test, I always push "no mark" because... I really don't care... (my pump already has all the meal times programmed so I can look at that data later). So, before I can see my darn numbers I have to answer questions, and then I have to tell it to send the results to my pump. I'd love to skip the questions and just get on with it. This is a major weakness with this meter, for me... I've thought that maybe it can be programmed to skip this stuff, but I haven't investigated. (I just did and found that you can either "never send results", or "ask me".)

Okay, other factors... 

• Despite the meter being small, the case is just as big as other meters have been. This is okay for me, because I always try to keep my Symlin pen with my meter, and it barely fits in the case. 
• The elastic strap that holds the meter in place is flimsy and cuts right across the middle of the screen. This is weird. 
• The zipper on the case opens in an unintuitive way so that whenever I unzip it, my meter is upside down. It's like you have to forget all you've ever known about books, left to right, and top to bottom.

Some good things...

• I like the color screen.
• The results are quick, once you answer the requisite questions and finish getting annoyed. 
• The test strip container is big enough for you to get your finger into the container and drag a strip out. I've had a few meters where you had to shake them out.
• The meter has a rechargeable battery that you can recharge less than once a month by attaching the USB connector to your computer. My other meters only needed batteries about once a year, so this isn't necessarily an upgrade.
• Accuracy? I tested this meter against my One Touch Ultra Link a few times and didn't find  much of a discrepancy. I think it may just be a reason to get users on board with the change, but in the end it probably isn't that significant, considering that the accuracy standards for meters are rather soft (+/- 10%). The change probably had more to do with business relationships and money than accuracy. Maybe I'm just jaded?

That's what I have on this. I'd be interested in hearing from anyone who has thoughts on this change. And if you know how to make it more convenient to operate, let me know...

Update: After messing around with the settings a bit, I was able to turn off the "before meal/ aftermeal" questions. Now I just have to test and send reading to my pump. It's not as annoying, but still kind of unnecesary.

I'll take a flashy new pump with a Dexcom on the side.

After hearing that the tSlim pump would soon be available in the US market, I decided to go to their site and see what they had going on. I knew that they had updated their technology to a level that compares with other devices that we use, like iPhones, and the like. After looking over everything they had, I was pretty interested in their pump. The main things that I liked were the full-color screen, the type of info that is displayed on the home screen, and being rechargeable. But, the thing that most caught my attention was that they are working with Dexcom for sensor integration. I hope that they mean that the pump will act as a Dexcom receiver. That would be excellent.

I requested info from Tandem about their pump and also asked how soon the CGMS integration might be available. I received a reply (from a human being, no less...) and they told me that the work was, indeed, underway, and that it would be available as soon as possible. I know in FDA years that's probably still a while.

If Medtronic doesn't update too much during that time, I'll probably be jumping over to a more colorful display, well thought out design, and sensors that last longer and hurt less.

Meanwhile Medtronic is also working on patch pumps, and they already have a new sensor (also longer lasting, and less painful) going through FDA approval. If you like patch pumps, Omnipod is pretty well received and they are also rumored to be working on CGMS integration with Dexcom. I might like patch pumps, but my favorite infusion sites are places (buttocks!) where I can't discreetly wear a pod.

Anyway, I think it will be a pretty interesting year for some developments in the technology and I hope that the transition to new stuff goes smoothly for insurance, etc. You can only hope.