Continuous Glucose Monitor + Insulin Pump, or Just a CGM?
Yesterday afternoon I received a phone call from Carlo, a rep for Medtronic, makers of the Guardian REAL-Time Continuous Glucose Monitoring System and the MiniMed Paradigm REAL-Time Revel System that functions as a CGM/Insulin Pump. He seemed eager to offer all the information that he could, and he told me that he would be at my doctor’s appointment on Monday to demo the two devices. He talked up the benefits of the Revel, which is the unit that has a continuous glucose monitor and insulin pump combined into one device.
Ad for Medtronic Revel Continuous Glucose Monitor showing the CGM transmitter (left), the insulin infusion set (right), and the insulin pump/CGM device (waist).
I am beginning to consider the unit with the insulin pump, especially if it can give me better control over my insulin delivery. The downside is that I would have two things stuck in my abdomen, the continuous glucose monitor transmitter and the insulin pump infusion set. Plus, I would have to learn to master insulin delivery with the pump, which seems a bit intimidating at the moment. What if it malfunctions and injects me with too much insulin? Can that happen? Has it ever happened? Or does it have a fail-safe like an elevator, which prevents it from sending its passengers plummeting to the ground? All are questions for Carlo and I will be asking them on Monday.
The following is a Medtronic demo video for their MiniMed Paradigm REAL-Time Revel Insulin Pump, pictured above. **NOTE: The posting of this video is solely meant to show how the device works. It is in no way an endorsement for the product. Your own decision regarding such devices, including which device and brand is best for you, should be made by you and your doctor. It is also possible that certain information contained in this video may be outdated after February 6, 2011, the date the video was posted. 
My name is Kevin Lang and I am a Type 1 Diabetic who was diagnosed in May of 2004 at the age of 27. My last A1C was 6.0 in May 2015. I used to use daily shots of Lantus and Novolog to control my blood sugar until I switched to the MiniMed Paradigm Revel Insulin Pump in February 2011. To learn more about me, follow the about link in the menu bar.
I recently had a malfunction of my Medtronic insulin pump on July 22, 2012. While at the Albany airport, the pump emptied my reservoir (about 50 units of insulin) into my body. I was unaware of this event until landed in Chicago, 2.5 hours later and became unresponsive. My wife feed me about 600 grams of orange joice, sugar, glucose tabs, and one sandwich before I was fully aware. This was over an two hour period. Question, how can this malfunction be avoided? I would have died without my wife protecting me. The malfunction I’d estimated to have happened at least one yor after going through security based on when I became unresponsive. Is there a safe guard to override a dosage of more than 6 units max at any one time? When all was normal, I noticed that my pump still showed 60 units remaing even though my pup was empty. How can this happen?
Robert, I’m glad you’re okay. That is one of my worst fears. It was one of my initial concerns when I started using the pump; can I trust technology that much. Definitely contact Medtronic directly and also let your doctor know what happened if you haven’t done so already. Do you think the airport scanner could be to blame? There is a “Max Bolus” setting on the pump that allows a range of 0-25 units. I imagine that it is set on yours. You can check it in the “Bolus Setup” area. The only other explanation I can think of would be if you had changed your insulin before getting on the plane and forgot to rewind your pump. However, when locking the infusion set into the pump you likely would have noticed that it wasn’t rewound, and for that to happen you would have had to have connected yourself to the infusion set before locking the vial into the pump.
Another possibility would be that the buttons were accidentally pressed somehow, perhaps how you were sitting, depending on where you wear your pump. But that doesn’t exactly explain 50 units. However, you can lock your pump to avoid potential accidental issues with the buttons.
What do you think happened? Do you think the scanners could be to blame? My advice would be to opt for the pat-down regardless. I do it to protect my CGM, pump, spare insulin, etc.
I forgot to add that you should definitely look into a Glucagon shot if you don’t have a kit already. Basically, it’s a life saving way to raise your blood sugar quickly if you are too unresponsive to eat or drink anything. Talk to your doctor about it.
Hi Kev, Thank you for your advice. Regarding my accidental dose of 50 units, Medtronics said that the pump motor was damaged from the airport scanner. I estimated that the event occurred about one hour after going through the scanner. They said that it occurred during a basal injection where the motor failed to stop after the required dose of 0.6 units. Solution is to avoid all scanners. I am also going to put the pump in a aluminum pouch while in the airport and airplanes which will totally protect it from magnetic fields. I will have to make my own pouch. None are available. Perhaps it is a possibIe business opportunity. I also plan to have a glucose injection pen available. These pens only carry a dose of about 50 grams of carbs which is far too little for this situation. Avoid scanners!!!
Robert;
I also have a medtronic Revel unit with CGM. I’ve not been thrilled with the unit. I am on my 3rd one. Reliability is poor, service is pretty good, but i’ve had so many failures on parts and user-unfriendly stuff that even though the integrated unit is great, I want to change manufacturers.
I am an electrical engineer and used to wear a Disetronic Spirit pump. This was the toughest unit I’ve ever seen with phenomenal support. This thing handled HUGE radio frequency fields (was worried at first if it would even run in the presence of an open 20 kW RF generator, but no problems). Disetronic contacted me and recalled anything before I ever even discovered it myself, unlike Medtronic. They also gave you a 30 day backup pump with the unit so if your pump fails (it never did) you had a way to stay healthy. I’ve used it a couple of times when the Medtronic unit toasted itself (water exposure, stuck piston, etc.)
Medtronic seems to have a real weakness in their design and test process.
That being said, the Disetronic didn’t have the bolus calculator (big plus) and doesn’t have integrated CGM. The Dexcom CGM is significantly more accurate (i’ve used both) than Medtronic’s, but it is another thing to haul around.
Good luck.