The pump does not need to be internal. You can have an external pump, which resolves the issue with battery life and insulin replacement. Have an external pump, but have it connected to an internal port, similar to a port-a-cath
I did something similar, using some medical components. It was functional, a proof-of-concept. There are a few problems, but on the other hand, I am not working in a research facility, I was just making it in my basement.
The biggest challenge is a blood-based CGM. I am totally stumped on that one.
Actually, that isn’t really a big problem. Medtronic had one on the market briefly. It was implanted in your superior vena cava and lasted about a year.
However, it is a signficant pain to implant something like that as opposed to using the subcutaneous approach where the patient can do it since the infection risk is unimportant in a subcutaneous usage.
I agree that this is a big impediment to full implantation or even partial implantation like Eric shows in his picture. I have a friend whose daughter has had two cochlear implants. One of them was infected and needed a surgery to remove it so they could try again, but it took a lot of time and antibiotic courses before they reached that conclusion.
And now in these days of increasing numbers of antibiotic resistant bacteria, I would be very hesitant to go for this approach - and it needs to be re-done periodically?. I will admit that I wince when I see pictures of IV insulin injection. IV catheters just plain scare me unless you have no other choice: 80000 infections per year in US I did try IM injections for a while, but even for those I didn’t see enough upside vs. downside to continue.
They didn’t sell enough to make a viable product. It was aimed at people already getting an implant for something else. It wasn’t a stand alone, but rather an add-on.
We selected the Omnipod above all the others really for one reason. Tubeless. I didn’t want Liam running around worrying about getting things snagged or ripped out. Being a toddler anything is possible. This was the primary reason. The second reason were the small doses that were possible with is. We hope the closed-loop system will be thoroughly tested and approved within the next 5 years, then we’ll go to that. We won’t do first generation…we don’t trust it for a toddler. We’ll wait until 2nd or 3rd generation to be sure they’ve been tested thoroughly enough on the @Eric’s (guinea pigs) of the world!
Oh, I remember now! I also picked the Omnipod because of the built in BG meter with the Freestyle Lite (very small blood drop requirements)
Interesting… looks something like the port I had surgically placed for my chemo treatments. I had the port removed, but thinking now maybe I should have kept it in and re-purposed it !
I know that if I had kept it, I would have been required to go in regularly to have it flushed, and didn’t want to bother.
Right. Those are often placed near the heart and implanted. I was thinking something peripheral. Anything to get it into the bloodstream faster than a normal subcu injection would be great, I think.
No planning, no extended highs, just instant insulin. It wouldn’t really be needed for basal, just bolus.
When I chose my first pump Tandem was new on the market, I was intrigued by it but not yet sure I wanted to try the new kid on the block. Its been almost five years, this time I’m confident enough to give Tandem a try
@SLEE - You are currently on a Medtronic 723 - yes? What is the reason you did not switch to the Medtronic 670g. That would seem to have been the easiest switch for you. Also do you use a CGM?
And good luck with the Tandem. We also just switched recently onto the Tandem t:slim X2 from an Animas Ping. Switched around the beginning of the year or so. So far so good…
The current 523/723 that medtronic sells cannot be used with OpenAPS. You need older out of warranty versions. Not sure if they totally prevent the newer versions to be hacked, or just a matter of time before someone does.
Yes, it would mean buying a used older pump (do they even still sell the 523?). These do show up on the used market (Craigslist, etc) occasionally, so it is possible to find one with a bit of concerted effort. Apparently the critical determinant is the firmware rev they are running. Unfortunately, OpenAPS has not yet been able to crack any pump that wasn’t already completely open. The older 522/523 (and prior) did not have any protection at all, and those are still the only ones that are usable, AFAIK.
If you have an older 523, you can check the firmware rev to be sure that it would work.
Between increased infection risk and need to have a port “flushed”, would it really be worth the approximate 30 minute reduction in insulin reaction time? I suspect this is why there hasn’t been more movement towards such an approach.
Yes, MM523/723, are still sold as of last year I got one.
If you are not using MM cgms, many insurance companies, including mine, will only approve the older (cheaper) models. That was fine with me, as I am used to all the menu paths, saved money, and don’t like the menus on the newer models anyway.
I have an older 523 that is too recent to work with aps. And yes, I am aware older pumps can be found on Craig’s list and other places.
@Thomas I don’t believe the 670 is available to T2s and I have never really wanted a CGM, without a CGM a 670 would be no more useful that a 723. I chose the Tandem T-Flex because of its ability to do larger boluses. I am quite insulin resistant and can throw back some bolus’ that would make your average T1 cringe. I do at times bolus more than the 25 unit limit of any Medtronic
@SLEE - I just re-read. I had missed that you switched to the Tandem t:flex. We recently switched to the Tandem t:slim X2. Now that I look at the specs of the t:flex, I totally see where you are coming from.
The documentation on OpenAps shows the specific model and versions that work.
My current and previous 523 have version that is too recent. But I do have an old 522 version that should work. Hope to try an openAPS set up one of these days… maybe when I retire. I do pretty good without it.
Also, I don’t think medtronic has them advertised on their website as being currently available. I got my 523 in March 2016, and it may be they no longer sell them. But even in 2016, they were not on website, other than to get user guide.
It’s not just 30 minutes, it’s an almost immediate response to the insulin. It really is unlike any normal injection. If I have a big spike, I can make that thing free-fall in about 5 minutes. It isn’t just a gradual BG coming back down, it is an almost instant turn and drop. There is risk there, you have to be careful with it.
The other tremendous thing about it is that it’s gone very quickly. You don’t have a 3-5 hour insulin duration.
Certainly there is an infection risk. But there is no comparison with what it’s like taking a subcu or IM injection.
since i began correcting with IM shots, i feel like if i could get the accuracy of a pump delivery system without using a syringe, i would do it in a heartbeat. so, why don’t they make and 8mm+ delivery system just for boluses (and i mean one that is MUCH easier to read and much more accurate) than the options that we are limited to now? i would to ally be on board (no pun intended) for that.
