Mike Hoskins

I'm the proud owner of a new insulin pump, the sixth one in my 13-year lineage of being an insulin pumper.

For those curious, here's the list: a Minimed 508, followed by upgrades to the 512 and 715, a switch to the Deltec Cozmo, and return to the Minimed Paradigm 722. Now, this new Minimed Revel 723 (that list doesn't factor in all the models I've tried out, or the pump replacements needed through the years).

You may remember that I've spent most of the past year preparing for a new insulin pump purchase and deciding what diabetes devices would be the best fit for me.

As a longtime Medtronic Minimed insulin pumper since my final year of college in 2001, I've had nothing but good luck with those devices through the years. The last pump I had was the Minimed Paradigm 722, which is no longer made and ran of out warranty more than a year ago, so that's what I was looking to replace.

New Revel in Box

You might think the latest and greatest Medtronic Minimed 530G would be my choice. But here's the thing: I am a Dexcom G4 (continuous glucose monitor) user, so the 530G with Enlite sensor isn't what I want.

With the 530G getting approved in late September, the company made the bold policy decision to no longer sell stand-alone insulin pumps to most adult PWDs with commercial insurance. You'd be forced to buy the newest CGM-integrated pump, even if you didn't want to use that CGM. That turned me off of MedT almost completely, especially since I'd just bought a Dexcom a couple months before and wasn't about to return it. And it didn't help that people were saying the accuracy and real-world experiences weren't great with the integrated Medtronic device...

So that left me looking beyond Medtronic.

Back in December, I shared my decision about choosing the Tandem t:slim insulin pump despite having some lingering concerns. Remember, I'd trial-tested that pump for a few months and found a number of things that I didn't care for. But after reviewing other insulin pumps on the market and looking at the likely future of D-devices in the next few years, it seemed that Tandem was the best choice for me.

But apparently I'm a "flip-flopper," because I changed my mind again and decided to fight for what I actually wanted.

{Editor's Note: In a world in which far too many people don't have adequate access to even basic medical supplies, this pump-choice banter may very well be a "First World problem," as our D-Advocate friend Anna McCollister-Slipp likes to say. But we still feel it's important to share our experiences as PWDs in the thick of the latest technologies.}

Weighing the Options

In January, news of the Tandem t:slim cartridge recall went public. That made me a little nervous. And I realized that the t:slim glimmer and gloss (read: pretty touchscreen and usability) distracted me from my long-held "rule" of not jumping on the bandwagon with first-generation D-devices, based on the logic that they're just too new to market and haven't been used in real life enough to know if there are any kinks or concerns that need addressing.

Never having experienced problems with the MedT pumps themselves, I wished it was possible to get a stand-alone pump. Being a curious D-cat, I wanted to see if I could, even if it meant putting up a fight.

But isn't that weird, I thought: If I wanted a MedT pump, I would have to fight the company to get them to sell me their product!

Indeed, the MedT salesforce tried to up-sell me, urging me to get a 530G and even saying that the company wasn't selling stand-alone pumps anymore. But with a doctor's Medical Necessity letter and my insurance company's OK, mixed in with my own persistence, I was able to get what I wanted.

Of course, I worried about insurance cutting off my supply of Dexcom CGM sensors if they saw my use of both the Dexcom G4 and a MedT pump as "double-dipping" into the CGM waters. Naturally, they'd assume I'm using the "latest and greatest" 530G or even the fully-CGM integrated Revel, and therefore wouldn't be on board with paying for two sets of CGM supplies.

To avoid the mess of my insurance company potentially misinterpreting how I use these two devices, I had my   endo write out the Rx to specifically state: "Medtronic Minimed Revel 723, without CGM." Hopefully that makes it clear to any insurance processors reviewing my file or anyone who might later claim I am using the CGM part of the pump that Medtronic is so heavily promoting.

Standing My Ground

The MedT sales people filed a new order form that actually said "New 530G order" on the top, and over the coNew D-Device Love Triangleurse of a few phone calls I did have to continually remind the rep that I was not getting a 530G, but simply a Revel 723. It was a bit of a painful customer service experience, but it eventually worked out.  My new clear-colored Medtronic pump arrived on my doorstep in mid-February and I've been using it ever since.

Right along with my trusty Dexcom G4, which I'm happy to say now works well with my Windows 8 laptop after the Dexcom Studio upgrade announced on March 11 (sadly for Mac users, there's no compatibility yet for you, and we're still waiting to see when that FDA approval might happen...).

Of course, I'm still anxiously awaiting anything that can help me get all my MedT pump data and Dexcom G4 data into a unified place. That's coming down the pike with Tidepool's much-anticipated Blip concept, which is about to start up clinical studies. But to date, my endo and I are forced to basically look at two different programs to see trends that may be visible from both data sets. Darn it! Viva la #WeAreNotWaiting campaign!

And at least I won the battle in that Medtronic now admits that even though the company's preference is to sell the pump-CGM combo product, people who want a stand-alone pump are still able to get one.

"We're selling the MiniMed 530G with Enlite as a system because we strongly believe this provides the greatest clinical benefit to people with diabetes," Medtronic spokeswoman Karrie Hawbaker said. "Typically, we only sell Paradigm Revel to people in special circumstances when insurance coverage or product labeling prevent them from having access to the MiniMed 530G system. However, the needs of our customers are always our top priority and if a physician feels strongly that a stand-alone pump is best for his/her patient, then we will act upon the physician's prescription and fulfill the order. We find this practice to be uncommon, as most customers are very excited about the improvements in sensor comfort and accuracy with Enlite and the value of Threshold Suspend. Regarding Revel, of course no product stays on the market forever. However, we don't have plans to discontinue Revel anytime in the near future."

So there you have it.

I'm excited to have a new pump, my first-ever clear-colored variety and not my usual charcoal gray. Of course, the plastic swivel holster that I love so much is only available at this time in charcoal so I'm sporting a mis-matched pump and accessory combo for the time being. That charcoaNew Revel 723l color was the original one for both the clips and holster, and just a few months ago Medtronic started making the clips in clear. I'm also told by MedT that there's a plan to expand the line of holsters, given the high customer demand -- so I'll be watching closely for a clear holster at some point! In the meantime, I'll have to investigate possible pumps skins to liven up my new pump (one obvious compromise in bypassing the t:slim, which is far more fashion-conscious for those who prioritize that).

So, my message: You can still get a stand-alone insulin pump from Medtronic if you truly want one and are willing to fight for it.

Or rather, more importantly:

Everyone should be able to get what they want in D-devices, especially when there's never going to be the "perfect device" (just like there aren't "perfect" blood sugars). Certain CGMs may work for some, but not for everyone. These devices should be modular, so that no one's forced to buy something they don't want just because it's what the company sees as the best bang for a buck in overall sales.

Give us a choice and the chance to do what's best for our lives!

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.