For two weeks during the holidays, I test-drove the new Animas Vibe combo device (Animas insulin pump plus Dexcom continuous glucose monitor) approved by FDA just over a month ago.

We appreciate this opportunity for a trial-run of this exciting new device before it officially hits the market in the coming weeks.

This is only the second combined insulin pump-CGM product ever made available in the U.S. (after Medtronic’s system), and the first to include the popular Dexcom G4, and it’s been a loooong time coming; Dexcom and Animas first announced their joint-development agreement back in January 2008, and this integrated system was launched overseas in mid-2011. There’s been a lot of buildup here in the States, before and after Animas filed with regulators in April 2013, so I had high hopes going into this two-week trial.

{Disclosure: JnJ supplied me with the full system and supplies to last circa 16 days. As always, this was under the agreement that they would have no influence over what we say or write.}

In the words of my awesome Animas educator during my training in late December: You can think of this system in terms of a dwelling — the two components used to be separate housing units, but now they co-exist under the same roof and are more like different rooms within one big home. Now anyone using it gets all the benefits of that combined home’s plumbing, heating, air conditioning, and so on.

I found that there are good and not-so-good things about the Vibe, and as with everything, opinions will vary. Sadly, nothing wowed me personally about the Vibe, and even the built-in CGM isn’t enough to convince me it was worth the wait, or convince me to purchase this system for myself.

Keep in mind: I’m coming at this from more than a decade of happy Medtronic pumping, and I’ve only tried the Ping for one month to get a feel for it a year or so ago. I wasn’t impressed then, but definitely wondered if this slightly-modified version complete with built-in CGM might be enough to turn me into an Animas pumper — but that wasn’t the case.

Here are my observations from my two weeks of trial-testing:

G4 Integration: The Vibe’s biggest claim to fame is obviously the CGM combination, i.e. the obviously appealing need to look at only one device for my D-data, with no need to carry a second receiver around. Note that you can still get a

G4 receiver and pair it up if you want to, though it’s not included in the Vibe box. If desired, you’ll have to contact Dexcom and likely buy it on top of the costs of the new Vibe. Since I already own a Dexcom G4, I tuned my receiver and the Vibe into the same transmitter, and they both worked fine (see notes on the new algorithm below).

On the Vibe, you have all the same hourly trend screens (1, 3, 6, 12, 24) to scroll through as are shown on the G4 reciever, but one new additional screen shows your current blood sugar reading in big numbers, plus the trend arrow, time, and any Insulin On Board (IOB) right there at the bottom! I was impressed that the system remembers the last CGM screen you viewed, allowing you to more quickly get back to where you were in case the screen times out and you have to wake it up again.

Dual-Suspension: When you suspend your insulin delivery, the CGM data stream is also put on pause. No, it doesn’t actually restart the sensor, but it means you can’t see current CGM data until you un-suspend. My trainer dropped this bombshell on me during setup, but I forgot about it until a day or so later when… a low blood sugar dropped me down to 54 mg/dL, and I needed to cut off insulin for a bit. After I treated, I looked at the Vibe’s CGM screen and realized I had no clue where my blood sugar was heading or whether I needed further treatment. Luckily, I had my pre-existing G4 receiver by my side so I could see that I was rebounding, even though I still felt pretty low. This setting is not a flaw, Animas says, because of the house-room analogy: if Dexcom and Animas are two rooms, and you step outside the house and lock the front door, you lose access to both rooms until you go back inside.

Hmm… well, we also called Med-T to ask if their pump-CGM combos (either Revel or 530G) do this, and were told they don’t have a dual-suspend like this Animas Vibe does.

CGM Algorithm: As Animas filed this system with FDA in Spring 2013, and Dexcom just received approval on its latest advanced algorithm last month, the Vibe naturally doesn’t have that updated software built-in. Luckily, this didn’t have much of a negative impact for me. I found that most of my readings were within 15 points of my updated Dexcom receiver, and the trend graphs were similar. It was fun to compare the two, especially whenNightscout/CGM in the Cloud was connected for some additional displays.

Screen and Colors: I really liked how brightly the screen lights up, every time you push any button. Unlike Med-T, the Vibe screen light doesn’t time out and stay off as you move through the screen views. And the nifty “CGM Shortcut” button on the top of the pump also serves as a backlight and dimming/brightening switch, which is nice. And yes, I really liked the contrast of white text on black screen, and how the trend line is highlighted in yellow. Much easier on the eyes compared to Med-T, which has black text on grey and a black highlighter. The colors on the Vibe CGM screen are nice, too — especially the red and blue lines signaling high and low thresholds (although it would be nice to see the number change color too, like the numbers on the G4 receiver screen do).

Treat-to-Target, Not Range: I’m a fan of how Animas gives you a target number for blood sugars, and uses that to figure out how much insulin you might need for corrections. The notion behind that is aiming for specific targets, rather than just keeping you within some range defined as not-too-high and not-too-low.

Math Class Redux: One of the key differences in how Animas pumps calculate insulin doses is by showing you all the math and calculations as you scroll through the menus and numbers — rather than just “magically” producing a result like many other systems do. Veteran Animas users may be used to this, and even like it… but I found it frustrating. It reminded me of how math teachers in school made us show our work rather than just writing down a result. In this case, seeing the “work” didn’t provide any value to me, and the screen just seemed cluttered with too many numbers anytime I added in a BG value, corrected or dosed for food.

No Remote / Canceled Boluses: One big change with the Vibe is that it doesn’t come with a meter remote like its Animas Ping predecessor. Now, the remote itself isn’t a big deal for me, as I’m not one who wants to hide my pump in a pocket or underneath clothing and use a remote control for discreet programming. But the very nature of the Vibe calls for a remote, IMHO — because while dosing insulin, you can’t touch any button at all, or it will cancel your bolus. I lost count how many times I dosed insulin, and then when sliding the pump back into the holster on my belt or clipping it back into my pocket, the bolus was cancelled because a button got nudged! Yes, you do get a bit of a warning on the screen… for me, it vibrated four times, compared to the single vibration that indicates a bolus is completed. But coming from my long-familiar Med-T pump that vibrates three times after each completed bolus, I got mixed up by the difference in these alerts and didn’t realize what had happened. This is beyond infuriating to me. And potentially dangerous as well.

Less-Than-Ideal Scrolling: Top-to-bottom scrolling is also how most Vibe menus operate, though the status screens allow you to actually scroll down to the bottom arrows and navigate and back and forth. But the lag time is very noticeable, and it doesn’t stop scrolling on the number when you let go of the button. This is another big frustration for me, compared to the slick, user-friendly designs I’ve seen on the other pumps out there. This clunky functionality really makes the Vibe feel a pager in a smartphone world, or a Palm Pilot PDA in a touchscreen iPhone/Android universe. I’ve even been (not-so) fondly referring to the Vibe during this trial-run as my DOS-Prompt pump, thanks to the old-school scrolling and look of the menus.

Another issue I ran into was that while scrolling through the menus to process a dose, if a CGM alert happens to interrupt, the system takes you back to the home screen to confirm. As a result, you’re forced to start the whole insulin dosing process over again from the start. Ugh!

Here’s a quick demo (without any sound) of correcting a high blood sugar with the Vibe:

Wait For It: Seconds upon seconds are wasted with this pump. You suspend insulin delivery or CGM, or begin an insulin dose, and the Vibe immediately gives you a quick beep or vibration letting you know it’s on Pause. But when you click on Resume, there’s nothing… for a whole 18 seconds, the pump just sits there without changing, locking you onto that highlighted Resume line while you wonder if you’ve actually restarted your insulin dosing and CGM or not. This drove me absolutely nuts.

Jump to Value: On the bright side, the Vibe does have a “Jump to Value” feature that lets you avoid the need to scroll up from 0.0 every time you want to calculate an insulin dose (as you must with the Ping). With the Vibe, if you hit the up arrow once, it automatically jumps to the last number used, and then you can scroll up or down to change it. This reduces some of the scrolling time, so I give Animas props on that change.

Feel the Burn: This is surprising, but also something I’ve heard others mention — there were several times when the insulin seemed to burn when going into me. Animas delivers a lot quicker than Med-T, so even with the delivery speed set on “Slow” instead of “Normal,” the sensation made me flinch a few times. That coupled with trying out the Inset all-in-one angled infusion setsfor the very first time, I had four of my infusion sites start hurting after a day or so and one even had an insulin-bubble under the skin where the cannula went in. Maybe it’s all operator-error and learning curve here, but combining that burn factor with how it only gives you about 180 units after priming, the insulin aspects of the Vibe made me less enthused about the whole system.

Food Database: I wasn’t sure the food list was something I would care much about, but it turned out to be a feature that I liked. Turns out, Animas put this back into the Vibe after making it only accessible in the Ping from the OneTouch Ping meter, unlike their earlier 20/20 pump model that included it in the pump itself. The pre-programmed list includes all kinds of basic foods in different categories, and I used some of them without any issue. But unfortunately right now, there’s no way to customize or personalize the food list (or the alert tones with our own custom-created sounds). Vibe users overseas can do some personalization, but not us in the States (grrr). Animas says the new Vibe doesn’t work with the older ezManager Max software that would normally allow for these customizations, and as of now the third-party DiaSend web-based logging platform doesn’t support the food database either.

Data Access: Having never before tested Diasend, I found it pretty easy to setup and use. And it was so very nice seeing all my data in one place – at least, my pump and CGM data. But as it turns out, since I am usually a Med-T pumper and use the connected Bayer Contour Next USB Link fingerstick meter, my meter isn’t supported by Diasend. The non-Med-T linked version of that Bayer meter is supported, but not the linked one, thanks to competition between Animas and Med-T. I didn’t actually download data from my Vibe until the near-end of my trial, so it didn’t occur to me earlier to use a different meter for these couple of weeks. Oh, well. And I did contact both Animas and DiaSend about the food database being included, and DiaSend assures us it’s in the works. That will be a nice feature, to see all our food lists associated with the carb counts and insulin dosing.

Water-Friendly: Animas pumps are are waterproof at 12 feet for up to 24 hours. While this means absolutely nothing to me personally, my Animas trainer mentioned that it’s actually one of the most highly-mentioned pros of the Animas pumps by most users, and I’ve heard from many D-friends who say it’s very important to them. It’s something Animas can boast over competitors, since none of them can match it (even OmniPod, since the PDM controller isn’t waterproof).

So that’s my breakdown on what I call “life features” of the Animas Vibe. If you want to read more about the technical aspects, visit this recent pump comparison roundup, and or check out some other DOC reviews by Kerri, Manny, and Melissa.

In summary, I’d say the Animas Vibe does what it needs to, and has no qualms about touting its biggest draws — CGM integration, water-friendliness, and some easy-to-see color screens. You can’t argue with those, really. And how can you seriously criticize a device that’s the only Dexcom G4-pump combo on the market, that’s been promised for seven years?!

As I wrote this review, I struggled with that. I spent two days reflecting, re-reading, re-evaluating the Vibe and trying to find more good benefits that I’d maybe missed or overlooked. I didn’t want to come off as a grumpy curmudgeon who refuses to accept change simply because it’s different from what I’m comfortable with. I didn’t want to be overly critical, but of course I need to share my honest take as someone coming to this trial with 14 years of pumping experience. And I actually had high hopes I might somehow be smitten with the Vibe.

Unfortunately that didn’t happen, and my honest final verdict is this: the Vibe feels like an outdated, counter-intuitive medical device that seems like it would have been more relevant if released several years ago as promised. Today, it doesn’t feel innovative, but rather like a device that’s filling a market need for choice only because it promised that a long time ago, and it’s “better late than never.”

But hey, the Vibe has a G4 built-in… right? Shouldn’t that the one and only selling point that matters?

I guess it depends on how much a weaved-in CGM really means to you personally, whether a remote-controller option is a deal-breaker for you, and how much water activity you may have in your life.

Even though Tandem Diabetes has submitted its own t:slim pump-Dexcom G4 combo to FDA and could very well have that cleared soon, Animas snagged a six-month exclusivity agreement with Dexcom, so we are at least that long away from having another G4-integrated option. There are other partnerships planned for the coming year or two as well, and that all just makes me nervous about whether we’ll see any upgrades from Animas anytime soon — or if we’ll have to wait many more years for the next iteration.

Meanwhile, we’re happy to hear Animas say that in case someone buys the Vibe and is not happy with it for whatever reason, there is a 30-day return policy*. As with all devices, I’m a huge believer in trying these out before making such an important commitment.

*(CORRECTION: Animas reached out on 1/9/15 to inform us they are not offering free trial-tests before you buy, as we were originally told when phoning the main Animas customer service number and asking whether potential-customers could try one out before buying.)

Thanks for this review opportunity, Animas, but mostly thanks to both you and Dexcom for seeing this long process through to the end and bringing PWDs another choice.