Watching their ads, I'd shrugged off their emphasis on how quick the pump is to change and prime in much the same way that I shrugged off Omnipod's "we've got no tubes!" angle. Big whoop. Having worn Omnipod off and on for 5 years, I find tubelessness to be a pleasant feature, but it's not life-altering. What else ya got?, I often ask the companies who tout a single major design innovation.
But Asante may actually be on to something. As I close out my first week on Snap, I am finding that my favorite thing about Snap is how little I have had to mess with it. I'm on Day 6.
- No cartridge change (I finish up my 300 units today around dinner time)
- No tubing change
- No priming
- No battery to mess with changing or charging (the controller charges its small backup battery off your disposable pump body battery)
The prefilled 3 mL pen-style cartridge? I got an Rx and a box from my local pharmacy with 5 cartridges. That's about 30 days for me. I'm still on my first one. I haven't touched it. Same pump body (what the cartridge slides into). Because the insulin is not compromised by plastic cartridge or bag chemicals as it can be in other pumps, it sits happily in its original glass vial/cartridge, tucked safely away (I can see it through the viewing window - been missing visibility since switching to tslim and Omnipod), and I don't even have to change my TUBING until the cartridge is empty. Fresh insulin is coming through the tube straight from the sterile vial. (Snap's pump body is currently specifically designed for Humalog cartridges, but Novolog is coming next, they say - it will take designing an alternate pump body due to cartridge length and diameter. So, if you're a Novolog user, you'd order the pump bodies specific to Novolog cartridges.)
Breakdown of the components (3min):
But back to how much they've cut out... I changed my site on my third day. That's it. Just the site on my skin without the tube. That's all I've done. It's still ticking away on day 6. I'll use the last of my 300(+)u cartridge today and change to a fresh pump body/cartridge/tube today.
|Snap weighs less than these, but is longer.|
Also, I have a ridiculous number of insulin pumps.
|from left to right: Omnipod UST400, Cozmo 1800, Snap, t:slim|
What I loved about the tslim is the carb calculator that totals the carbs as you enter different foods, I'd say. We've got that, said Mark.
Video of me programming a bolus (~2min) while using the carb calc feature:
I also love that the folks at Asante have developed a relatively simple occlusion detection system where the tubing meets the cartridge rather than relying on back pressure at the infusion site like a traditional pump. Anyone who has had as many occlusions as I have (again, thinking of tslim and Omnipod) can appreciate detection earlier in the delivery process. This is a huge selling point for me. I want to know that the pump detects that it can't deliver insulin - not that it may or may not have partially delivered what I asked it to before it realized something was amiss.
An interesting feature for those moving to Snap from other pumps is that Snap calculates your IOB however you and your healthcare team prefer. Do you like the Minimed/old Omnipod model for IOB where only correction insulin is considered? Done. Prefer the Animas/Cozmo/Tandem/new Omnipod way of including your mealtime insulin? Done. It's in the pump settings.
In many ways, the menus feel Medtronic-esque. As I haven't been on an MDT pump in 6 years, I find myself thinking, where would ___ be on a Paradigm? And there it is. I had been enjoying more screen since leaving Medtronic for Cozmo/Omnipod/Tslim, but Snap uses their small screen efficiently. It's clear to read, low resolution (my husband explains to me that this saves their device a ton in battery), and I can read it fine in broad daylight. Still, the low res screen is NOT sexy. And the colors of the controller (currently dark blue, black, or a light red) don't excite me either. I'm told some brighter colors are coming our way (green, magenta, etc). I've done a decade on black pumps. Give me something that will whistle back at my pink Dexcom.
|Hey girl, did your standard deviation fall from heaven or do you just have great control?|
|Graph of...monster teeth?|
I've grown accustomed in the last year to having my IOB in my face. Tslim and Omnipod both show you IOB on your startup screen as soon as you wake the pump and respond to the key sequence or confirmation screen, respectively. I'd like to see Snap's IOB more obvious. I have to wake the pump from blank screen (just like with other pumps) but then click status and then click one more screen (screen 2 pictured below) to see my IOB. If they could cut that by a button press or two, I'd be happy.
|Taking you through the status screens.|
Temp basaling is easy. No, it doesn't have presets (also no bolus or carb presets). It uses a positive percentage method for temp basal and calculates and presents what the rate is actually changed to. If I go in knowing that I want to run approximately 30% of my .95u/hr basal, I can make changes down to .05u, so it allows me to choose values like 37% (.35u) or 32% (.30u) or 26% (.25u). On my status screen, I can see time remaining. To cancel the temp basal, I go back into the basal menu. (I keep wanting to find it in the stop menu.)
I really like the alerts that Snap offers. My favorite is that, if you turn on BG prompt in your setup, it will ask you if you'd like to be prompted to check BG in the time you chose when setting up the device. Unlike what I remember with Minimed or Cozmo, it won't just automatically remind you at the ___ hours past bolus mark every single time you bolus. If I'm correcting a fasting in the morning and plan to bolus for my breakfast about an hour later, I don't need a prompt for three hours from now. At lunch however, a reminder to check in post-meal during that long stretch of afternoon is handy. So I can just click yes or no when it asks if I'd like a reminder. Too annoying? You can turn the feature off entirely.
Key beep volume is adjustable, alert tones are pleasant and designed to be heard in a range of frequencies. Innovation alert: The pump will actually alert you if it detects that it has suffered damage from a drop, from water seeping into the housing, or if the controller and pump body are separated. Also, expect a persistent (and growing in volume) alarm if the cartridge is empty.
And if you need a replacement controller (the non disposable portion), you can save an old pump body and instantly program your new controller with ALL of your settings just by - yeah, you guessed it - "snapping" it on.
|Snapped and Unsnapped.|
Bren Kern, Asante's Director of Manufacturing, gave me a tour of the rooms with the gadgetry where people smarter than I put the devices through extreme conditions and make adjustments. I saw their production lines, their post-production testing area, and from a distance, their sterile areas for assembling their infusion sets (6 or 9mm cannula, short or long length tubing, angled or straight insertion options). I'm a 9mm, short tube, straight set girl. (And I like my coffee with Splenda and cream.) They make all the parts in house and ship through their distributors.
Oh, and it has a flashlight on it! Its purpose is to illuminate the infusion set to see that the pump indeed primed itself in the time it takes to screw on the cap. But it's also good for finding lost toys under my nightstand.
As you can see by now, I will try any pump. And I will try to find what I don't like about it. So far, what I dislike the most about Snap is that there is no quick way to put the pump back into its offscreen/sleep/blank screen position. If I've followed a menu series down a rabbit hole, I might have to click exit, exit, exit, exit to turn off the screen to slip it back in my pocket/the leather case/the belt holster.
|Leather Holster vs Pump Clip - both w/ vertical/horizontal options|
|Snap and the One Touch Verio IQ|
Cartridge change procedure explained (42sec):
Low profile packaging (unlike Tandem and Medtronic) means less to carry, too. And a tiny glass vial that I can easily draw from with a syringe in an emergency? Again, awesome.
|All you'd carry with you would be a spare cartridge,|
spare set, & spare pump body (clockwise at 12, 1, and 2).
I plan to subject Snap to Thanksgiving dinner on Thursday. Oh the boluses. I bet that 300u cartridge of Humalog runs out sooner next week than it did this. :)
If you're interested in doing a trial like I'm doing, it's as simple as going onto their website and filling out a trial request.