V-Go: A New Patch Pump for Type 2 Diabetes - villanuevapeaske

I stuck my utility knife into the seam, cut the stamp, and gently wiggled the blade back and forth to untie the cover.

Twathap! In a flash the pod exploded in my face. A large collocate struck my os frontale. Another bounced off my chin. I heard other pieces ricochet off the walls, clink-clopping to the floor. Only the shell of the V-Drop dead pump remained in my hand down. Its viscera were nowhere to exist seen. What the —?

The harbor who was helping me giggled, "Hot thing we're non on the Bagdad Flunk Squad."

Indeed.

This was my first impression of the Valeritas V-Go, one of the new-kid-happening-the-block insulin pumps designed for eccentric 2 diabetics.

I can say press releases about the product and get a glimpse of the system online, and sure there's the whole using it aspect to tell people about… but I'm also a fan of superficial under the cowl of a new heart. Swell, curiosity killed the cat. But satisfaction brought it indorse. And this cat just had to see what was inside this 2010-approved pump. At once, if you've ne'er dissected an OmniPod speckle, I have. It's full of electronics: circuit boards, computer chips, wires, gears, antennas, batteries and more than. It's quite an amazing device for something with a maximum life span the same as a fruit fly's. (Ternary days.)

But Valeritas' incoming into the pump market is something entirely different. For one thing, it doesn't use electricity. For another thing, it isn't programmable. And information technology doesn't even use infusion sets or cannulas.

Is it even a pump the least bit? Fortunate… Maybe. Sorta. Kinda. But not really. To their course credit, while everyone else is vocation the V-Go a patch pump, Valeritas isn't. They ring it a "disposable insulin delivery twist." And although it's new to the scene, if you were to create an organic process tree of insulin-delivery systems, you'd have to put it in-between pens and pumps.

The V-Go is a very puny patch gimmick that holds one day's worth of firm-temporary insulin. It is pre-set to save unity of three fixed and flat basic rates for that daytime (20, 30, or 40 units) and also provides a clitoris that can deport two units per press to help cover meals. The insulin gets into the body via a fixed steel needle about the size of a pen needle.

I never cured sufficient of the pieces that went flying hither and distant to figure tabu how the Sam Hill information technology worked. But quite than finding clockwork-like gears, I saved a handsome spring. And a clear, unclean, gooey, sticky, thick fluid. More along that later.

Who's It For?

The intended market for V-Go are type 2s who already involve multiple daily shot (MDI) therapy: folks who are taking one or two basal shots per day via pens or syringes, and attractive fast-paced-playacting insulin to cover every meal.

That's a lot of people. And with the number of typewrite 2s potentially interested in pumping, the market for the V-Go could be very large indeed.

Victimisation IT is naif decent, assuming it's something you wishing to do.

You fill it with insulin and slap it on your bod. Regular. The V-Run is a cardinal-day device, something that mightiness appear foolish to typewrite 1 pumpers who are used to changing pump sites every three to four years. That same, given the much higher volumes of insulin required by type 2s, many type 2 pumpers connected traditional pumps are changing sites and reservoirs every 48 hours as it is.

Filling a V-Go is a snap. It comes with a pod-woof device. Snap a pod in at one end, and insert a vial of insulin in the other. Force a pry a couple of times to fill the cod. Flake off the sticky back, slap the pod onto (clean) skin, and simply iron out a button to insert the needle and start the flow of insulin.

There's no controller to turn a loss or leave behind. None batteries to switch, charge, or flush it. It's discreet in overt, which is good. Using pens operating room syringes publically is a established barrier that keeps many a type 2s from using fast-acting insulin.

Piece V-Go is three-needled, it's also limited. Or is it? Real, it depends on what you liken it to. A planar-rate basal seems crazy to type 1 pumpers, who are victimized to multi-footstep basal programs. But consider who this is intended for. A flat basal rate is no different than a shot of basal insulin, and the unfailing delivery of allegro-acting insulin may prove to give a smoother profile than a erstwhile surgery twice daily shot of Lantus or Levemir.

The two-unit-per-press meal delivery (patc on the face of it limited to U.S.A type 1s), suits the needs of the more insulin-resistant character 2 well. With insulin-to-carb ratios commonly at 1:5 and 1:8, rounding to the closest two units is pinpoint enough.

But Bequeath Anyone Manipulation It?

Health indemnity insurance coverage for V-Go is already widespread, but mixed. Both plans realise IT as a fancy syringe and include it as a pharmacy benefit. Others classify it as a ticker and lump it into the long-lived learned profession goods benefit. If you were using your wallet, a calendar month's supply would gear up you rachis around 250 bucks. Not cheap, but a fraction of the cost of a calendar month's worth of supplies for a time-honored pump.

And of course, there's no ticker to buy. With a traditional pump's retail price roughly ten princely, this means that PWDs could try V-Go, and if they didn't comparable IT, they wouldn't be retired a whole sle.

Indeed if out-of-pouch costs were tight (and for many people they will be), would type 2s wish to use V-Go rather than pens and syringes? I'm putting my money on Valeritas. IT's unrivalled "shot" a day instead of 4-5. Filling the pod and putting information technology along takes less than a minute. It's easygoing to learn and simple to use. Clicking a couple of buttons on the bod to cover a repast is faster and more discreet than using a write.

I think docs will the likes of IT too, at least compared to conventional pumps. The training clock and learning curves are both short; and the V-Go's fixed delivery makes reexamination visits simpler for the doctor because in that location's no programming or adjustments.

The exclusive downside I can see is that even the big V-Go may non be oversized enough. Some of my type 2 pumpers use 70-100 units per day in basal unparalleled. I've got matchless guy who uses 120 units a day. He'd need three V-Go 40s on his body! That ain't gonna happen.

So What About Traditional Pumps for Typewrite 2s?

We run to think about insulin pumps as type 1 geared wheel, but both traditional tethered pump and OmniPod patch pump usage is increasing among type 2s.

While the clinical evidence for the effectiveness of pumps for case 2s is mixed, commercial message health insurance plans have accepted that pump therapy for type 2s makes financial sense. A half dozen geezerhood ago, getting a pump approved for a type 2 was very difficult at the best—and commonly all impossible. Now most commercial plans cover pumps for type 2s who are already using basal/bolus therapy, although getting Medicare reporting is hush proving to be a trifle cunning.

Meanwhile, rumor has it that several heart companies are workings on high-volume pumps for the type 2 market, and in Europe the allay-in-development Jewel holds 400 units, unitary of the largest pump reservoirs to see.

**Postmortem: What Makes a V-Die Go?**

The second clip I cleft a V-Go fuel pod (cats have got nine lives), I did IT under a labored towel to arrest the "blowup" and catch all the pieces.

Like an NTSB crash detective, this time, I was able to piece it all back together. The V-Plump features an blue-collar-strength 6-inch dual spring that is forced into a incomparable-and-a-uncomplete edge cavity in the fuel pod. This creates pressure on a artificial lake of fusible silicone-like fluent. The plunger that drives the insulin is pushed, not by a traditional push retinal rod, but by this fluid. The flow of radical insulin seems to be controlled by the diameter of the livery needle itself, which pierces the top of the insulin pickup at the same moment it's inserted into the skin.

In a nutshell, the system is more hydraulic than mechanical. It functions on fluid kinetics. It's simple. Somewhat elegant. And for many type 2s, it may prove to be just what the doctor consistent. Literally and figuratively.

Especially if they can obviate dissecting it and qualification information technology explode.