Insulin pump and CGM: how to choose and where are the catches

Do you want to install an insulin pump or continuous glucose monitoring (CGM) system? Excellent! Let’s talk about what you need to know and how to choose a technique with which you will live for at least four or five years.

What is the catch of new models of medical equipment?

Diabetes devices are becoming like smartphones – new models appear all the time. Whatever you buy, something better will come out in a year or two. New devices will collect more data, be more integrated with the technologies of other devices, and have more automated features than ever before.

Medtronic ‘s line of insulin pumps . The noise about the innovation of the hybrid closed system MiniMed 670G is still standing, but information about the imminent release of the company’s new product – Minimed 780G – appears more and more often. Various sources back in 2019 reported that an improved hybrid system could be expected by the end of 2020. Of course, the pandemic and the global crisis will make their own adjustments, but the flywheel of change cannot be slowed down for long.

While we tend to want the latest in technology, it’s worth considering where the fierce competition is driving manufacturers and what that means for us consumers. New developments are, without a doubt, great. But even if there are funds to buy innovative devices, fresh medical devices are not always good. In fact, the rush to develop more and more new models affects the future user experience.

Let’s return to the same MiniMed 670G. In theory, this is a very good technology, and it can be said that the product is very popular with users. Many users remain extremely loyal to the system, but Medtronic has run into difficulties. In November 2019, the company was forced to warn its customers about a potentially dangerous hardware malfunction, and research showed that a large percentage of 670G users eventually stopped using the auto mode feature, mainly due to technical difficulties. One of the researchers compared this device to a mobile phone from the 90s – a huge technological leap forward, but it still needs to be improved.

Despite the significant mechanisms for regulating the medical equipment market, in a competitive environment, such a situation with the latest developments is very likely, if not inevitable.

On the other hand, not all technologies reach Russia. And those companies that operate in our country represent only a small part of the market, and often launch their new developments with a large time gap. Most of the time it’s up to local regulation. There are many pros and cons here. However, it is worth noting that the technologies available are usually already proven models. Therefore, when it comes to “fresh models” in Russia, if you have a sufficient budget, you can take new items without fear.

What to look for when choosing?

We have already written about the nuances of choosing an insulin pump:

  • nuances of choosing an insulin pump (technical specifications)

About the advantages and disadvantages of CGM and FreeStyle Flash monitoring Libre :

  • what is a Continuous Glucose Monitoring System (CGMS);

Here are some of the things experts advise to look out for when choosing a CGM and an insulin pump.

What to put first CGM or insulin pump?

If for financial reasons you are in the dilemma of whether to choose a pump or a CGM, take a look at the results of the three-year COMISAIR study. We did an analysis of this work and publications on the topic in the article What is better to put the pump or CGM first? STUDY.

Please note that most Medtronic pump models presented in Russia are equipped with continuous blood glucose monitoring ( Enlite MMT-7008 monitoring sensor) . You can use both the insulin pump and the monitoring function, and if necessary, use the device only as a pump.

The price of the device and the cost of consumption per month

An important question is how much the device will cost and how much it will cost to buy consumables for a month. Discuss options with your endocrinologist. Your doctor will advise you on the possible options, as well as tell you what CHI programs are available for installing a pump (there are also options for receiving and installing a pump for free).

The store where you buy your pump or CGM will also give you detailed advice.

Consider the cost of consumables for a month in the amount recommended by the manufacturer. Those. if you have an infusion set with a Teflon cannula, then the replacement will need to be done 1 time in 3 days. This means that you will definitely need 10 sets per month. There may still be force majeure if something happens to the kit and an emergency replacement is needed. Usually this does not happen so often, but it is necessary to have a safety stock.


Systems can have alarm features for low or high glucose levels, rapid changes in glucose levels remaining in an insulin cartridge, missing calibration data, and more. For some patients, it is important to be alerted every moment, for others, too many alarms can be intrusive and even stressful. Of course, most often you can turn off alarms for a while or not use some features at all. When choosing, think about what functionality you need and what you are really willing to pay for.

Remember also that some signals can be very useful, but will be intimidating for a novice user. For example, if you purchase an insulin pump with a CGM or a continuous monitoring system with a low blood sugar alert, this feature can save your life. Nevertheless, teachers of the school of insulin pump therapy advise to get used to the notification system gradually.

This is especially important if the user of the system is a child. Parents should turn off the vibration on the device at night. It is better to check the child’s condition yourself during his/her sleep. So your child will not develop fear and rejection of the new system. And when he/she gets used to the new device, the next step is to work with alerts and psychologically adapt to the alarms.

Remote control / control applications

Almost all devices have a remote control and applications for managing and tracking indicators. Here 2 questions appear: the cost of additional equipment and whether it is official.

With original devices and applications, there are no questions. If your budget allows, buy it. For example, you can control your pump remotely so you don’t have to take it out every time you deliver a bolus of insulin. Parents can monitor the child’s condition.

We will not dare to recommend applications and devices not from official manufacturers, and even more so from the DIY series. Although there are many people who use such developments. You can gain experience on forums, in groups of social networks , at various dia-events . It is better to check the transmitted information, since there is a high probability of falling for scammers. And yet personal experience, albeit a large number of people with diabetes, is not representative enough.

The Food and Drug Administration (FDA) is constantly fighting such developments. The question is rather controversial and there are no definite answers. Many “homemade” can really make life easier for people with diabetes. And yet, since such devices do not pass the entire chain of rigorous tests, the risks are significant. For example, read more about the FDA’s war on homemade artificial pancreas systems.

What is the result?

Choosing an insulin monitoring or delivery device is not difficult, but requires preparation and study of various materials. The help of your endocrinologist will be very helpful. After all, if Internet resources give a detailed picture of the technical and financial side, then the doctor will tell you what legislation and procedures are guided in the region, the features of the provision of services and what equipment you can get advice in your locality (service centers, company representatives, consultants and medical training). .staff ).

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