I am wondering whether anyone has made use of Medtronic's pump upgrade program. Money is a little tight right now and Eric's pump is only 2 1/2 years old, but I'm eyeballing the smaller increments available on the Paradigm 523 and thinking... hmmm... that would be nice to have. So if anyone has done this, can you weigh in on the pros and the cons? Cost is an obvious con, so I'd really like to know if the pros make it worthwhile.

Tags: Medtronic, Paradigm, Type1, child, pump, upgrade

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Yes, I am currently in the Medtronic "pathway" program. Your pump has to go out of warranty. Last September they called and said I can can now get a new pump and return the old one for a $500 credit(no cash) to my account. They would send a return mailer for the old pump in 6 to 8 weeks. That never happened. I called in late November, twice in December (we're busy with supply orders), and now twice in January. In my last conversation they again verified my info and would email a label which they did. Had to go to Walmart and buy a bubble wrap mailer. Sent it out 10 days ago, and still no credit on my account. So here I sit waiting.and waiting. and waiting...........
And by the way, the CGM transmitter goes out of warranty in mid March, so I guess I'll be getting another call sometime in the next year or two.

As for the smaller increments on the 723, it's of no use to me.

Mike - There are different upgrade programs depending on if current pump is under warranty, so your situation is different.

When under warranty, the 'upgrade' pump is basically a replacement, and the original warranty date stays the same. In that case, the 'upgrade' cost is not covered by insurance, and is around $400-500 out of pocket. (they used to list it on the website, but I don't see it now). Last year I considered upgrading my 522, but decided the new features weren't worth it, since I don't use their CGMS. Many of the new 523 features are related to CGMS alerts.

Once it's out of warranty, you are basically buying a new pump, at full price (or with insurance coverage). The $500 credit for 'trade-in' is an incentive to keep you from going to another pump company. (although other pump companies also offer a credit if you 'switch' !). If you have insurance, the 500 is credited to whatever your part of the payment is, but won't exceed it. When I did that many years ago (when I got my 507->508), they had to receive the old pump before a credit was done. That was years ago, so possibly they will now credit 'your account', to be used for other supplies, but that would be a change from how it worked for me.

Elizabeth - If you're not sure of the cost, you can call Minimed to confirm.
Always a tough decision when it's more of a 'nice to have'. The only key feature I thought almost made it worth it, was being able to see active IOB from the status screen, rather than 522 which can only see via the bolus wizard.

But now my 522 is out of warranty, so I'm still considering other pumps, or to stick with MM and get the 523.

Yes, I saw that there were different programs for in vs. out of warranty pumps. Eric's is still in-warranty and the feature that has my attention is the smaller increment of delivery. I've had all too many times when I needed to tweak a basal rate or a bolus by less than 0.05 units, and can't. So then it's, do I give him the extra 0.05 and watch for lows, or skip it and treat a high 3 hours later? We do use a CGM so having more flexibility in the alerts would be nice too. Guess I just need to do more research.

Hi Elizabeth,

I don't know if it's worth the extra work, but here's an idea to 'simulate' .025 on the 522.
If you do a bolus, and it's a bit more than you want, you could set a temp basal for 1-2 hours that would be maybe 50% (you'd have to calculate what percentage would make the correct reduction). That might reduce the risk of lows. (So if current basal was .50/hr, then 50% is .025/hr, or a .025 reduction per hour -> So kindof similar to a bolus reduction of .025.)

For Basals, you can set more incremental time slots.
For example,
1-2am 1.05
2-3 am 1.00
3-4 am 1.05
4-5 am 1.00
The net average per hour from 1-5 would be 1.025.

Great to hear you also have CGMS, as that definitely will help catch the lows and highs, and you can make corrections as necessary. Since getting my CGMS (Dexcom), I've done more temp basals and dual/square waves, based on the trends on the CGMS.
I've been T1 since age 5, but back then, only took 1 injection per day. No BG meters, pumps, pens,or CGMS ! What a difference is it for parents and kids today.

I used the upgrade program when I went from my 511 to the 522 and it works really well. However I know they only push it for pumps that are out of warranty, which mine was. I would call and talk to Medtronic, they have always been great to work with. I was laid off and didn't have insurance for about 8 months and they were great to work with.

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