An FDA approval of a new diabetes device is always an exciting thing, especially for a company that's been in the holding pen for a while, waiting to get a device to market. That was the case this summer when Roche learned it had finally secured the regulatory agency's OK for its Accu-Chek-Combo system.
Of course, we immediately started wondering how this new pump-with-glucose-meter-connectivity stacks up to already-available Animas OneTouch Ping? Has Roche one-upped the competition?
Today our correspondent Mike Lawson reports on the similarities and differences of these "next-gen" systems.
For obvious reasons, I've always wished my coffee pot would talk with my toaster. Admit it. Wouldn't it be great if a warm, golden-brown piece of toast would pop up every morning just as your morning pot of coffee completed the brew cycle?
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The coffee pot/toaster technology doesn't exist yet.
But in the diabetes world, we're lucky that some smart people have figured out how to make blood glucose monitors that can communicate with insulin pumps.
This technology may not produce coffee-time toast, but it does allow us carb-counting People with Diabetes (PWDs) to navigate just how we manage our blood sugars when having that toast and coffee. And it does so in a discreet way. This technology is often called "discreet pump therapy" because it allows the user to employ his or her glucose meter like a remote control to communicate with her insulin pump -- so one doesn't have to be pulling the pump out all the time to push its buttons.
The U.S. pump-glucometer market is ever-changing and we're always on the alert for new device approvals. At this time, however, there are just two major "discreet pump therapy" options on the market.
Other pump-glucometers out there may have wireless communication and interaction, like the Medtronic Revel (that allows users to view CGM data on the pump) and the Omnipod system (which controls a stand-alone insulin reservoir from the PDM), but those systems aren't exactly using the same kind of two-way technology these pumps are to connect a traditional BG meter and pump.
The Animas Ping has been on the market since 2008 and has dominated this space since. The new kid on the block is Roche Diabetes Accu-Chek Spirit Combo system that got FDA approval in July and is just now ready for shipping this month.
Both systems allow the user to administer insulin from their meter using remote technology. They both offer on-meter tools to help with carb and bolus calculations.
Unfortunately I wasn't able to get my hands on both systems simultaneously to use and contrast them in real time, so to make a head-to-head comparison, I'm going off mostly what's online in the marketing materials and what company representatives have told us.
Go the Distance
An important difference between the two systems from a user perspective is the distance that the glucose meter and the pump can be apart from one another to administer insulin.
The Animas Ping will allow users to administer insulin if the remote is within a 10-foot radius of the pump. The Accu-Chek Combo only has a radius of 6.5 feet. This might appear to be a small difference to a traditional user dosing insulin for him or herself.
But the 4-foot difference is undoubtedly more important to parents who administer their children's insulin. After telling the pump to deliver insulin with the remote, the child has to stay "in range" of the pump until it has received the order to administer insulin. After that, the kid can take off... but you've gotta keep 'em close till the order comes through. And who wants more reasons to be chasing a kid around with a glucose meter?
If Looks Could... Bolus
You will also notice that the two systems look a little different. The meter remote for the Animas OneTouch Ping is fairly standard when it comes to blood glucose meters — monochromatic display and no graphics. It's everything you've come to visually expect from a glucose meter.
The Accu-Check Combo, which was released more recently, has a much more visually exciting display on the meter (the pump has a boring gray-on-gray) that includes full-color and allows for color-coded graphs and bolus data.
This new trend in visually appealing displays has sure been catching on! The new VerioIQ meter from OneTouch and the brand new DexCom G4 Continuous Glucose Monitor both have full-color, bright displays that rival the display of the newest smartphones and are getting people with diabetes excited about their devices again. At the same time, others are wishing companies like Roche and Animas would focus on better accuracy of their meters instead of better on-screen graphics.
Dueling Definitions of 'Waterproof'
One of the most glaring differences, the 'waterproofness' of the two pumps, is actually not a difference at all. Caroline Pavis, director of global communications for Animas, tells us the "OneTouch Ping is proven waterproof at a depth of 12 feet for up to 24 hours."
But Nancy Dean, the marketing director for Roche's insulin delivery systems, says the two systems have identical IPX ratings.
IPX? Wasn't that an '80s band?
IPX actually stands for "Ingress Protection Rating" which classifies and rates the degrees of protection provided against the intrusion of outside elements (fingers, dust, water, etc.) in electrical enclosures.
The rating for both the Accu-Chek Combo and the Animas Ping is IPX8. So why is one of these pumps marked "waterproof" and the other not?
Dean said that Roche made a decision to label the Accu-Chek Combo system as "water resistant" rather than "waterproof" because it's impossible to "eliminate the potential for cracking and water penetration with total assurance." So they're erring on the side of caution.
Now, this may not be a deciding factor for some. Not everyone is a white water rafter or swimmer, but it's something many users keep in mind for the simple fact that pumps and meters are sometimes known for taking plunges in sinks, toilets, showers and decorative fountains at the shopping mall.
So, that's the water issue...
Does Size Matter?
And last not least, there are differences between the two systems in the insulin cartridge size. The Accu-Chek Combo features the largest available cartridge size on the market holding up to 315 units of insulin. By contrast, the Ping has a cartridge that holds just 200 units of insulin.
According to Dean, the larger cartridge size is a big plus, because "this maximizes convenience for those requiring larger amounts of insulin," she said. The infusion sets for the Accu-Chek Combo, however, have the same lifespan as those for the Animas Ping. So for those who won't dose all that extra insulin right away, what do they do with those extra 115 units of insulin in their reservoirs? Maybe for some, the boasted benefit of a larger cartridge is not much of a benefit at all.
Without a doubt, both the Accu-Chek Combo and the Animas Ping systems are improvements over older, traditional insulin pump and glucose monitor systems.
If you're like me and wooed by the display and graphics of new technology, the Accu-Chek Combo successfully hypnotizes and allows you to see your data in a colorful new way. But most of the frills of the Combo are just embellishments that make the system prettier, while not necessarily more useful to the wearer.
More insurance companies are currently covering the Animas Ping system at this time, but that is a small problem for the Combo that new products must always overcome when first entering the market. Soon, most insured PWD will see very little price difference between the two systems. So you'll have choices, at least in terms of different brands with different aesthetics.
Now, if we could only do something about getting the coffee pot to talk to the toaster.