# New pump - advice please



## Annette (Oct 14, 2015)

I have an appointment next week with my (new) DSN to go and discuss finally getting a replacement pump. After all, my Combo is now 5.5 years old...
So my choices are to get a new Combo, or to go with the Insight. My DSN has said that they have some concerns with the Insight, that there are some glitches, and that she would advise going with the combo, but she will give me the choice.
I've heard both good and bad about the insight on here, but really, I want to know, what should I look for when I see the insight? What questions should I ask?  Are the glitches so bad that I should remain on the combo, or do the good points outweigh them?
Any advice?


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## Redkite (Oct 14, 2015)

There are loads of complaints and concerns about the Insight on parent Facebook groups (my son is not a Roche pump user himself), and I know of one parent who has given back the Insight and actually switched to Animas Vibe.  Another is getting a Combo - however I understand that any Combos given out are "old stock", ie manufactured a while back, even if "new and unused".  I would be very cautious if I were you.


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## Annette (Oct 14, 2015)

Redkite said:


> I understand that any Combos given out are "old stock", ie manufactured a while back, even if "new and unused".  I would be very cautious if I were you.


Thanks, Redkite,  good to know. I will query this.


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## Sally71 (Oct 14, 2015)

I would have another Combo in a second!  
But the main problems with the Insight that I've read about are that the handset is too slow (egg timer stays on screen for ages, although apparently it's doing more than the Combo one so you have to try to balance that out), the handset takes ages to charge and can't be used whilst it's charging (I suppose you could unplug it temporarily though?), and I met a woman at our clinic who said her daughter was on her third handset already because they are really flimsy and keep breaking. 
I think I would find it a bit annoying that the cartridges are smaller and therefore would need changing more frequently - I like to control how much goes in and make them last 6 days.  But people are saying that the prefilled cartridges are so easy to use because you just bung them in and don't have to faff about priming and de-bubbling, so maybe the good outweighs the bad on that one!


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## trophywench (Oct 14, 2015)

The cartridges last me 5 days as they are - a 3ml reservoir used to last me 10 days! - but as you don't have to change the tubing unless you want to it really doesn't matter. 

The handset needs only charging every 6 days or so - it doesn't take ages at all!  I suppose if for some reason you leave it turned on all the while, instead of switching it on and off - well it might need charging more often.  But I've never left a meter turned on all the while, so why would you ever need to with a pump one? 

In some ways the Insight is far too detailed for its own good.  For instance, the time units on the Basal programing, are in 15 minute slots - WHY?  Boluses are measured in 100ths of a unit - WHY?

Perhaps that's why it's slower, I dunno.  I don't know that it does anything different though?   Does drive me a bit dotty - but I have timed it and to be honest, if you sit down, open the case, test your blood, tell it it's before a meal, tell it how many carbs, tell it to calculate the bolus, agree what it says, then confirm it and wait for it to start ticking out the delivery thereof - it's less than a minute! 

Personally I'd prefer a hybrid - ie just a smaller version of the Combo - but they don't make them!  I have heard it mentioned somewhere or another that the Insight has the capability to incorporate stuff that can be integrated with a CGM in the future.  I've no idea if that's true, but I suppose they do need to try to keep up with other manufacturers.


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## Sally71 (Oct 14, 2015)

Wow Trophywench, your insulin requirements are small!  I've just had to whack daughter's basal up by 30% all at once, just because she's been growing so much, am now almost filling the Combo cartridge and only just getting 6 days out of it! 

You are right about the CGM though, I was talking to a Roche tech person the other day and pumps up to now could only Bluetooth with one other thing at a time, i.e. handset OR CGM.  But they've made the Insight capable of linking with 5 things at once, so you could have handset, CGM, phone app and goodness knows what else all talking to your pump at the same time!  It's probably a bit in the future before they get it working though...

PS now I know what you look like!


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## Redkite (Oct 14, 2015)

Annette, lots of users have reported battery depletion problems, and the following was issued:

https://www.gov.uk/drug-device-aler...ump-battery-depletion-or-unexpected-shut-down

Also (can't find the link), Roche apparently issued a safety notice re if you bend or knock against something, two buttons can be pressed and, if held for more than 3 secs, pump will deliver insulin. There is no fix for this.


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## trophywench (Oct 14, 2015)

I was typing away - and lost it.  Anyway - I'm not saying you couldn't press both buttons at the same time but if you ask me, you'd either have to do it very carefully (in other words deliberately!) or be the most unlucky person to have a pump.

Yes, if you use poor quality batteries in your pump - it takes one AAA battery - this can apparently happen!

Why on earth would you use poor quality ones when Roche supply you with TOP quality ones, free of charge? - same as they do for the Combo.

I don't know how bomb- proof they would be for kids - but they are smaller than a Combo.

Well why would changing a cartridge when it runs out bother you?  It isn't like you have to fill them and get rid of bubbles and all that crap.  You do have to wait while the piston rewinds, and you do have to push another button to fill the tubing if you changed that (it's an automatic amount) but then you just connect it up to the same cannula!


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## Redkite (Oct 14, 2015)

Just reporting what I've seen on parent forums TW, we don't have the Insight ourselves.  But the battery problem seems not to be confined to people using cheap batteries - many are saying that they've been having battery-depletion issues even with the batteries provided by Roche, and having to recharge handset/meter on a daily basis.  Roche is dealing with each individual family by telling them theirs is an isolated issue, whereas it seems to be much more widespread.  Some have had their pumps replaced, others have had a new chip sent out.  Customer service is reported to be poor!

Obviously, people tend to be more vocal with grumbles than praise, so maybe there are just as many folk who are happy with the Insight.  But from what I've read I wouldn't even have it on my shortlist for my son's next pump.


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## Sally71 (Oct 15, 2015)

Hmmm, we are having a bit of an issue with batteries in the Combo handset at the moment, and I think the issue is with the battery contacts rather than the batteries. I am having more trouble using their lithium batteries than with bog standard alkaline ones (which apparently are a tiny fraction longer and therefore sit on the contacts better!). Roche techy chap told me something to do which might fix it but if not he'll send me a replacement handset.  Wonder if the Insight problem is also to do with contacts?

I've read all the bad stuff about the Insight, but there are clearly people who are happy with it too.  We've had faultless performance for 3 years from the Combo, the current issue will get sorted one way or another and is manageable in the meantime, and we've always had good customer service from Roche so I've got mixed feelings about the Insight.  We are due for pump renewal next July, ultimately the final decision will be my daughter's because she's the one who's got to wear the thing and be able to cope with it at school.  I think she'll want to stay with a Roche one, because she likes being able to hide the pump completely under her clothes (thereby avoiding embarrassing questions about what it is) and do everything with the handset.


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## Northerner (Oct 15, 2015)

I'm not a pump user, but some of this is reminiscent of the Accuchek Nano meter from Roche - that was also notorious for battery problems, and probably related to the contacts rather than the batteries. I had a problem with the meter telling me the batteries needed replacing when they shouldn't have, and calling customer service led to them telling me to try something, messing around taking them out and putting them back in again. Didn't solve it so got a replacement, but didn't trust it after that so stopped using it - can you imagine fiddling around like that when you think you are having a hypo? Now much happier with my Contour Next! Roche also acted as though it was an isolated problem, whereas it was well reported on t'interweb.


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## Pumper_Sue (Oct 15, 2015)

There are def more than a few issues with the insight pump, battery problems handset problems just to name two consistent complaints. I have seen more than one post where people have returned the pump and said they don't want it.

So basically you have to read all you can and make the choice. Just remember though if you go for the combo which I have heard will be available for the next 2 years what do you do if that develops a fault and has to be replaced by the insight?


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## Annette (Oct 21, 2015)

Well, the decision has been taken out of my hands. Just had a call from the DSN saying that they had a major electronic failure of a new pump, 2 days after it was started, and on the back of that they have decided not to put anyone on the insight until it has been sorted out. So I am getting a new Combo as soon as it arrives.


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## trophywench (Oct 21, 2015)

I know someone had a Medtronic go bananas somewhere in the Scottish islands on hols and had to be helicoptered to wherever, mega stega hypo from the overdose it delivered, a few years back.  It never affected any other Medtronic user.  I've known a Novopen to cease to function - affects no-one else, just one of those things.

However if that's what your hospital have decided whether it's right or wrong you are stuck with it.  Mind you - St Cross didn't stop letting people have Combos after I sent mine back when the meter packed up soon after I had it, or when the pump piston winding mechanism failed some time later!  - so why do it with the Insight?


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## Annette (Oct 21, 2015)

I think, having spoken to Kim, they have had so much trouble with the insight that Dr S has decreed that St Cross are giving out no more.


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## Redkite (Oct 21, 2015)

Sounds like a prudent decision!  One lady on one of the parents groups says they're on their fifth pump (Insight) in just six months - unlucky? coincidence?  Something's not as robust as it should be with that pump!


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## trophywench (Oct 21, 2015)

Do you know Annette, whilst yes I am of course glad to have a pump whatever brand it is etc - I'm seriously concerned about them limiting everyone to a SINGLE pump from a SINGLE manufacturer.  After all - Roche are sposed to be stopping the Combo, aren't they?  I mean - people are saying how good the newer Medtronic is, aren't they?

It's weird isn't it?  I mean I know it's comparatively early days with me, but.  And I'm certainly not the gentlest, most patient person when it comes to pressing buttons or remembering it's in my trainer pocket, with the tubing caught round whatever when I'm caught short and tear my bottom half clothing down in a rush, so there have been a number of pump/porcelain interfaces, as it swings freely on the tubing!


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## HOBIE (Oct 21, 2015)

Hello Annette. Really good luck in what you choose. I have e-mail address, mob phone no & office no for my Medtronic rep.  They are a nice bunch of caring people who I can talk to etc.   Once again good luck    Pumps are good !


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## trophywench (Oct 21, 2015)

Annette - like me ! - doesn't get a choice, Hobie !  Our hospital trust only do Roche !  It is true they can't stop you asking for something different - but who knows whether they'd agree to fund it, when it gets to whoever controls the purse? You couldn't get any help with it, from the hospital cos they don't know about anything else except Roche.

When they were considering starting to offer people pumps, they interviewed all the manufacturers and went with the one they trusted most - that's what I was told anyway. 

(But I rather think it's meant to make one implicitly believe that Roche must be the best, rather than make one feel resentful at times, as I do!)


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## HOBIE (Oct 21, 2015)

You are better sticking to what your NHS staff know about. If you have a problem, hopefully a phone call & push a few buttons. Done  In the first couple of weeks of pump I had downloaded my results on my computer at home, I was ridding alone in my van that morning on way to work & Bluetooth phone went off. I answered & my Dsn told me to adjust pump.   Done in minutes  Happy bunny  (that's more than 7yrs ago)


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## heasandford (Oct 26, 2015)

Sally71 said:


> she likes being able to hide the pump completely under her clothes and do everything with the handset.


this is my continual request - none of the others, except the Omnipod of course, work like this from the meter. Why doesn't everyone want this too?

Although I also agree with Trophywench that it would be nice to be given a choice - I also can only have a Roche pump. Have I really only had it for 2 years?? - I would never want to give it back!


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