Meet the New Insulin Pump, Same as the Old Insulin Pump


Medtronic Minimed Insulin Pump 522It came! My pump arrived, pretty in pink, and, yes, it was like Christmas. I transferred all my settings over, and I am now plugged in and running with the new Medtronic Minimed 522 Insulin Pump.

As expected, the biggest difference between this pump and my old 515 is the color. The user interface, shape, buttons, and operations are all almost identical. This is strange when considered from the perspective of the rapid release, continually updating technology world that so many consumer goods operate in; compare, for example, the iPhone, which allows constant outside development and additionally makes small interface adjustments through regular software updates. There are significant benefits to this approach, insofar as development of new, innovative technology is easy and fast. Just imagine what a few clever diabetics could make possible if we had a framework to build and distribute iPump Apps!

On the other hand, the inertia of the Minimed interface is completely understandable given the regulations and responsibilities familiar to medical device manufacturers. If a user can’t immediately find his doodle-drawing application after it’s renamed in the iPhone App Store, no big deal– he’ll figure it out. But if a pump wearer doesn’t recognize the “No Delivery” alarm because its melody has changed, or boluses an extra hundred units because the Bolus Wizard configuration is computed differently, people get hurt and Minimed gets sued.

In other words, in the case of medical devices or pharmaceuticals, I can tolerate what in other industries would seem like too much regulation and resistance to change. I was reminded of this quite unexpectedly when I woke up very sticky and unhappy with a blood glucose of 38 at midnight on my first night of wearing the new pump. Sitting on the floor, after enough carbohydrates and time to have recovered to a more sentient 65, my first thought was, “Why did I get so low? Could I have configured the basal rate incorrectly?”

As it turns out, I had not, and the low was likely a result of my overbolusing for dinner hours before, and subsequently choosing to assume that I would be okay with a pre-bed blood sugar of 78 (“Hmm.. lower than I’d like, but I already brushed my teeth… it’ll be fine!”). Nonetheless, the episode made me appreciate the fact that, given FDA regulations and acceptable error rates for medical devices, there was an extremely low chance that the pump was configured correctly, but actually pumping the incorrect amount of insulin into my body. Can you imagine how damaging it would be to have a pump that claimed it was injecting 0.3 units of insulin, and instead injected 3.0 units? Or, worse yet, a pump that sometimes– but not always– was slightly off in its measurements– just enough that you couldn’t be sure something was wrong, and yet your blood glucose would vary unpredictably. Please excuse the colloquialism, but that would suck.

Luckily, my pump suffers from no such shortcomings, and, based on the last few days of observation, seems to be performing capitally– which is to say, just like the old one.

Oh, and there is one other notable change between the 522 and the 515: there is an extra menu option now for “Sensor,” which I would use if I had a Minimed continuous glucose monitoring sensor. I don’t have much use for that option, since I don’t have a sensor.

But, here’s the other exciting news from this week: that sentence, rewritten with full disclosure, should read: I don’t have much use for that option, since I don’t have a sensor, yet!

But more on that later.

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12 years ago

I’m waiting for the sensor for you!

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