Accu-chek Combo or Insight

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lizabetic

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Relationship to Diabetes
Type 1.5 LADA
Hello

I used to post on here quite regularly but haven't done so in a long time although I still lurk 🙂

I am due to switch to a pump sometime in September and had a meeting today with my DSN discussing options. I have just the option of Accu-chek which we know just do the Combo or Insight. I was planning on Combo initially, having got friends who use it and I do use an Expert Meter so there was that familiarity however after today and getting to see the pumps and handsets up close my goodness the Insight Pump looks a million times better. Despite hearing its set backs with the handset I am seriously considering.

I have gone through the Pros & Cons below, pretty thoroughly, some I recognise are general pump related things but i'll highlight pump specific.

COMBO
PROS -
  • familiarity of handset
  • use of apidra
  • holds 315u for 6 days
    (with my current TTD would be 10 days worth though I understand why not)
  • more cannulas available
    I am quite active although not sporty so whilst i'm unsure on manual insertion may possibly be neccesary
CONS -
  • larger pump size
  • handset AND pump battery powered
  • pump clip bulky
  • time tubing prep
    one that is equal with most pumps
INSIGHT
PROS -
  • pump 100x more aesthetically pleasing
  • cartridges easy to carry spares
  • pump better menu functions
  • chargeable handset
  • bigger screen, handset
CONS -
  • only takes novorapid
  • 160u insulin
    may actually be a pro although would be 2 days worth
  • touch screen
    hmm, i am an iphone/ipad user
  • handset supposedly slow
    youtube video verified that :(
  • battery life
  • heavier

You can probably see I have ALMOST talked myself into the insight. The ease of functions such as tube and cannula priming seems appeasing for a first time pump user, although part of me thinks that is something I should be able to do if I was ever to get another. The biggest drawback is that I currently use Apidra and the insight only currently takes novorapid pre-filled cartridges; my thoughts on this are that the filling system that is in the pipeline (supposedly) could sometime be available and then I could go back to Apidra. I could also ask to switch back to Novorapid in the meantime - my main qualm on injections was that it took an awfully long time to work for me resulting in spiking 20+ before it kicked in.

At the moment I am thinking perhaps to trial novorapid again however I only have a week to decide which pump so if it really is no good and I choose the insight i'm stuck. Anyhow, I would appreciate any opinions, ideas, reviews etc., on either pump. Thanks All 🙄
 
Personally I wouldn't touch either with a barge pole but that's just me, but which ever one you choose you will love or hate as the case may be but have nothing to compare with.
You also need to check which cannulas are available for each pump. The combo has a lure lock on the cartridge which means you can use other makes of cannula if Roche ones do not suit you.
 
I am in a similar quandary except that I have already been using the combo for nearly 2 years and before that the Spirit. Today I was told that the device for filling cartridges with Apidra has no expected release date so for me that's the end of the story. I tried Novorapid on MDI and it had an awful slow start and a longer and unpredictable tail compared with Apidra. I am not willing to change and if I was just starting on a pump I would worry that these two factors would make getting the initial setup right more tricky.
The other thing that puts me off is that at 160u when I'm eating normally and allowing for priming a tube, that is just over five days worth of insulin so I'd be changing the cartridge out of sync with changing my infusion set and cannula, meaning instead of having to faff about with the pump every three days it becomes every 2-3 days. I have enough trouble remembering where I'm up to as it is!

I didn't know about the other differences though so thank you for the useful summary!
 
We have just got a new Combo, for me there are too many potential problems with the Insight and it sounds a bit scary, whereas our first Combo was brilliant, never had any trouble with it, and we already know all about how it works so it was a quick changeover and no extra training required. The rep did say that the only people who find the Insight horribly slow are people who have previously used Combos; anyone who has never used an Accu Chek pump before is none the wiser. Yes the cartridge filling and priming is a bit of a faff compared to other pumps, but to me that's a small price to pay, I can do it pretty quickly nowadays! The insight handset needs to be charged every day which I think I would find rather inconvenient (I can get two and a half weeks out of the Libre between charges! Which reminds me, I need to do it...). With the Combo if you get Roche to send you the lithium batteries then they last ages, we can get 3 MONTHS out of both pump and handset on those, even with the Bluetooth on all the time. I also like the larger cartridge size of the Combo, daughter is hitting the beginning of puberty now and her insulin requirements have increased exponentially so a full 315u cartridge only lasts 5 days, with 160 we'd be having to refill every other day! Presumably you don't have that problem though 🙄
Those are just my thoughts, obviously you'll choose whichever is right for you, if it's your first ever pump you'll probably love it whatever it is 🙂
 
The piston rewind also takes longer with the Insight than it did with the Combo. It isn't touch screen like anything else you've ever had BTW - you have to stab at it hard - I find that hitting it smartly with a fingernail works best for me.

Yes the Combo reservoir has a max capacity of 315u - but if you don't need 315u in 6 days - then just fill what you actually need! ie TDD x 6, plus a bit, plus 2 or 3 cannula primes (only last 2 days on me, poor absorption) and probably 2 tube primes on top 'just in case'.

Changing a cannula takes about 30 seconds and the only time you touch either pump - is to prime the cannula once you've detached from the old un and reattached. Changing the reservoir does of course take longer with the Combo - cos you have to fill it in the first place.

There are absolutely NO advantages with the Insight over the Combo other than simply that. I don't see anything better about the menu functions frankly. It certainly isn't intuitive - and the Combo is. If you ask me the Insight is a bit too clever for its own good. Frankly if I need to change a basal rate, I doubt VERY much if I would ever be able to identify the timing of where I need the adjustment, down to the exact 15 minutes. (I know, I'll increase my basal by 0.05u/hr between 21.45 and 22.15 - that should make one HELL of a difference ..... )

The Combo is and always was - both virtually bomb proof and virtually idiot proof.

You want me to choose today ? - have the Insight back and gimme a nice new Combo. Ta !

Incidentally - you need to charge the Insight handset every couple of nights - if you EVER let it go flat - you've killed the battery completely. Also, the one AAA battery in the pump goes down to 70% and then almost immediately after dies completely and it alarms in the middle of the night, in the middle of a funeral service, job interview, meeting with important client ...... and will NOT shut up. You have to change it RIGHT NOW. With the Combo - you get a couple of hours leeway after it first warns you it's a bit low.

It works, OK - but quite honestly the ease of pre-filled cartridges does not excuse or balance out, the crap.

Oh - and Sally is correct about battery life in the Combo - I kind of used to wonder when I'd last changed em it was always that long ago, so I changed em for the hell of it usually. Always had new ones before we went on holiday - and we go for a few months when we can - and though I took spares - never needed em till after we returned home.
 
Radders said:
I am in a similar quandary except that I have already been using the combo for nearly 2 years and before that the Spirit. Today I was told that the device for filling cartridges with Apidra has no expected release date so for me that's the end of the story. I tried Novorapid on MDI and it had an awful slow start and a longer and unpredictable tail compared with Apidra. I am not willing to change and if I was just starting on a pump I would worry that these two factors would make getting the initial setup right more tricky.
The other thing that puts me off is that at 160u when I'm eating normally and allowing for priming a tube, that is just over five days worth of insulin so I'd be changing the cartridge out of sync with changing my infusion set and cannula, meaning instead of having to faff about with the pump every three days it becomes every 2-3 days. I have enough trouble remembering where I'm up to as it is!

I didn't know about the other differences though so thank you for the useful summary!
Click to expand...


Thankyou Radders, it was really helpful to hear from someone who has Apidra! I pretty much have the same issues on Novorapid, who knows why?

Also, I am assuming that if you fill up your cartridge then you don't have any problems with Apidras longevity as I have read it is only approved (?) for 48hrs in a pump? That would be a concern although now I understand you don't have to fill it completely so that is a plus 🙂 Also wondering if you find you can't disconnect as long as novorapid due to its lifespan?

Sally71 said:
We have just got a new Combo, for me there are too many potential problems with the Insight and it sounds a bit scary, whereas our first Combo was brilliant, never had any trouble with it, and we already know all about how it works so it was a quick changeover and no extra training required. The rep did say that the only people who find the Insight horribly slow are people who have previously used Combos; anyone who has never used an Accu Chek pump before is none the wiser. Yes the cartridge filling and priming is a bit of a faff compared to other pumps, but to me that's a small price to pay, I can do it pretty quickly nowadays! The insight handset needs to be charged every day which I think I would find rather inconvenient (I can get two and a half weeks out of the Libre between charges! Which reminds me, I need to do it...). With the Combo if you get Roche to send you the lithium batteries then they last ages, we can get 3 MONTHS out of both pump and handset on those, even with the Bluetooth on all the time. I also like the larger cartridge size of the Combo, daughter is hitting the beginning of puberty now and her insulin requirements have increased exponentially so a full 315u cartridge only lasts 5 days, with 160 we'd be having to refill every other day! Presumably you don't have that problem though 🙄
Those are just my thoughts, obviously you'll choose whichever is right for you, if it's your first ever pump you'll probably love it whatever it is 🙂
Click to expand...

Is there any updates with new combo? I don't expect there to be but am curious if they do tweak things slightly compared to the first ones. I have an expert meter and I imagine i'd possibly find the slowness of Insight the same, I also have a Libre which is increasingly slow - that DOES annoy me!

trophywench said:
The piston rewind also takes longer with the Insight than it did with the Combo. It isn't touch screen like anything else you've ever had BTW - you have to stab at it hard - I find that hitting it smartly with a fingernail works best for me.

Yes the Combo reservoir has a max capacity of 315u - but if you don't need 315u in 6 days - then just fill what you actually need! ie TDD x 6, plus a bit, plus 2 or 3 cannula primes (only last 2 days on me, poor absorption) and probably 2 tube primes on top 'just in case'.

Changing a cannula takes about 30 seconds and the only time you touch either pump - is to prime the cannula once you've detached from the old un and reattached. Changing the reservoir does of course take longer with the Combo - cos you have to fill it in the first place.

There are absolutely NO advantages with the Insight over the Combo other than simply that. I don't see anything better about the menu functions frankly. It certainly isn't intuitive - and the Combo is. If you ask me the Insight is a bit too clever for its own good. Frankly if I need to change a basal rate, I doubt VERY much if I would ever be able to identify the timing of where I need the adjustment, down to the exact 15 minutes. (I know, I'll increase my basal by 0.05u/hr between 21.45 and 22.15 - that should make one HELL of a difference ..... )

The Combo is and always was - both virtually bomb proof and virtually idiot proof.

You want me to choose today ? - have the Insight back and gimme a nice new Combo. Ta !

Incidentally - you need to charge the Insight handset every couple of nights - if you EVER let it go flat - you've killed the battery completely. Also, the one AAA battery in the pump goes down to 70% and then almost immediately after dies completely and it alarms in the middle of the night, in the middle of a funeral service, job interview, meeting with important client ...... and will NOT shut up. You have to change it RIGHT NOW. With the Combo - you get a couple of hours leeway after it first warns you it's a bit low.

It works, OK - but quite honestly the ease of pre-filled cartridges does not excuse or balance out, the crap.

Oh - and Sally is correct about battery life in the Combo - I kind of used to wonder when I'd last changed em it was always that long ago, so I changed em for the hell of it usually. Always had new ones before we went on holiday - and we go for a few months when we can - and though I took spares - never needed em till after we returned home.
Click to expand...

Trophywench it was really good hearing from someone having had both. As you say the combo being idiot proof is probably in my favour as a first time pumper! And errrrrr that does not sound good with the handset dying, let alone the pump, but to kill the battery completely after letting it go flat. Okay.


Thank you all ever so much, I think I will reassess my PROS/CONS list once more and get back to my DSN with my thoughts.
 
lizabetic said:
Is there any updates with new combo?
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Its not a NEW combo, its just a new combo. As in its exactly the same model as before, it is just one that has just come out of the factory.
I dont think they are planning on upgrading the combo - they put too much into the Insight to pull out of that yet.
(I also got a replacement combo when mine ran out of warranty. And I am glad the clinic decided the week before I was due to get it that they would not give out the insight as it was causing too many problems, or I would have got an insight.)
 
The new Combo is exactly the same as the old one, which was the main reason we chose it, we know it's a good pump and we already know exacrtly how to use it! I think Roche have just decided to carry on making them for a while until they have ironed out all the problems with the Insight
 
I can't see me ever loving it frankly, I hate filling reservoirs, mainly because it sort of takes my head back to trying to get air bubbles out of a glass syringe in 1972, and it obviously affected me more deeply than I'd imagined, cos first time I had to change a reservoir on my own, I wanted to cry. So I thought Jolly Dee -cartridges! got to have one of those. But in retrospect - gimme vials and reservoirs, LOL
 
A long time ago I used to have problems with the Apidra losing its effectiveness around day 5, but This seems to have gone away. Perhaps I had some dodgy Apidra. These days I can easily manage 6 days with no problems, just changing the cannula after 3 days (I use the flex link). I don't fill the cartridge, I just put in what I need for six days plus priming plus a bit.
I did try sticking to 200u, since I would have to throw away anything left in the vial after 5 refills anyway, but I find the alarm useful to remind me when I need to change. The reminder alarm on the meter always goes off first thing in the morning and I tend to dismiss it then forget!
 
I have only had a Combo. Having read a variety of reviews and feedback on here, I am planning to ask for another Combo rather than an Insight. The only irritation with the Combo for me is not being able to put a second multiwave/extended on to no of a previous one, which has been overcome in the Insight. However the familiarity and issues that others have had have set my mind on a replacement Combo when my warranty runs out in Feb 17
 
Ruddy thing had just started delivering my lunchtime bolus today when the handset came up with an orange 'warning' message saying it had lost communication with the pump. I literally hadn't moved and if it could communicate OK to work it all out, what's going on? When it loses communication, it always tells you the pump screen must have timed out (ie gone completely black again, which it does to save power after a certain time anyway) so I took the pump out of my jeans pocket where it had been since I got dressed at approx. 8am - and it was black! So I turned the handset off and turned the pump screen back on and checked on it how much bolus it gave me - the calculated amount. So after lunch, I rang Roche. Helpline said the pump battery must be a bit low. It said 70%!

I said to her, this drives me bonkers you know - they lasted forever in the Combo and only 5 minutes in the insight. She said they recommend changing the battery when it gets as low as 80 or 85% !!! Chance would be a fine thing said I - I've never ever in a year seen it say either 85 or 80 - it says 90% for a while and then - 70%. She says well of course the Bluetooth uses HUGE amounts of battery - so I said explain why it didn't in the Combo then? and added that frankly you expect new models to be an improvement and this ruddy thing, aint.

I didn't know you could add another extended/multi bolus on top of one already running until you just mentioned it - though I have wanted to do a bit of extra standard bolus during an extended one, when I decided to have a pudding after all, so that facility is better than the Combo - but since that's once in over a year - I wouldn't miss it if it still wasn't there, I don't suppose!

I had ordered a pile of pump stuff today and batteries was one of the things - got no Roche Lithium ones left - they are AAA ones and we're currently using some alkaline Duracell Procells with use-by dates of 2014 that Pete came across at the bottom of a drawer, in anything else we need em for in the house - work fine in 'mice' - but then, when I used to replace the 3 Lithium ones in my Combo meter, we could use them in Mice afterwards, and they lasted weeks.

I might well have to talk to my clinic when we're done with holidays - let's just hope it behaves itself whilst we're in La Belle France soon. Never before have I been in the slightest concerned about my diabetes, anywhere in the world I've been - and I don't like it!
 
trophywench said:
She said they recommend changing the battery when it gets as low as 80 or 85% !!!
Click to expand...
That just has to be nonsense! 😱 🙄 How many battery operated products are brought to market with such a ridiculous recommendation? I'm really surprised they got approval after testing! 😱
 
That sounds like an awful faff, Jen. What do people do if they're camping with no electricity with one of these things? I'm so glad they didn't get the cartridge filling gizmo sorted 18 months ago when I was meant to change over to the Insight!
 
You need access to 12 volt - and you can now buy freestanding, mains rechargeable, charging 'boxes' for things like X-boxes, Playstations, phones, tablets, I-pads ...... and pump handsets LOL They last quite well between recharges - on DSF we have a member - 'Chas' - who goes trekking/camping up the sides of ravines and suchlike and definitely off-grid - with an Insight - and he manages OK as I do in our Motorhome wich although we can go weeks without EHU, it is usually in more 'civilised' type of places with the occasional campsite thrown in when we need a washing machine or something. They also do 'disposable' 'boxes' which do X number of charges and then you chuck em.

So - it isn't actually a massive problem, that!!

It is an extremely advanced and 'different' rechargeable battery in the handset, in that it relies on only being discharged a small amount (ish) and then being recharged. Totally the opposite of phone batteries, laptops etc - and I haven't come across any other battery items yet, in sort of everyday use, that use this technology. There may well be technical/scientific thingies that use it, unbeknownst to me.

Northerner - it IS ridiculous.

One of the things that has been said is that it's only people who've had a Combo who find it slow - that no-one else does. I wonder it it's true? However if you have to test your blood, then tell your pump the result manually and ditto your carbs, and then tell the bolus wizard on the pump to calculate and deliver it - I suppose that might be true? Not having used another make, I don't know. I do know the Insight takes 3 x as long start to finish from turning the meter on to turning it off again at the end, as the Combo though cos my friend and I did a test of this - she still has her Combo - at a recent social meet we had, with one husband timing us both.
 
I have an Insight pump and I love it.

I had no choice when I got the pump just over a year ago - the hospital only deal with Roche and the Insight was the only pump that they were then going to continue with. Maybe because I don't have anything to compare it to, some of the things that bother others do not bother me. For personal preference a handset that didn't need charging 3 times a week would be great, but I don't find it too much of a hassle as I set an alarm on my phone to remind me to do it every tues, thurs and sun morning.
The batteries in the pump do not last the amount of time I was initially told they would, but they do last 10-14 days. I only ever use the lithium ones that are sent to me free from the careline, and I read in the handbook that using non-lithium ones would definitely mean they need changing more often, although it is handy that the pump can use these if someone ran out of the other ones. The pump does not give you a lot of warning that the battery is going to stop and mostly, I therefore change it when it says 40% rather than let the alarm go off.
Something I am very pleased about with my pump is the use of cartridges and I know I would have struggled with filling it myself. So for me, this alone would have been something that would have made me choose this pump, even if I had been given a choice.
I guess it is each to their own, and whichever pump you get you will hopefully love it, but I did want to put the 'flip side' of the Insight because I feel that it is great and if you do not have a previous pump to compare it to, then how would you know it was slower or didn't do something that the combo did, and if you don't have that to compare then why let it bother you.
I would never really tell someone 'this is the pump you should have', but for anyone who does get an Insight, through choice or because that is the only one on offer, my advice would completely be to (politely) snatch it off them, say thanks very much and marvel at just how much a tiny little gadget is capable of doing.
Curlygirl
 
Absolutely! - any pump is likely to be better than MDI and I entirely agree.

Incidentally I've just taken delivery of a 'Service Pack'. The description of same on Roche's website, is enough batteries and battery 'tops' for 6 months. They sent me 12 batteries (4 boxes of 3 AAA Lithium) and ONE 'top'. Free of course. B good job they are to us, too - cos they put the prices on my Order Confirmations. £25.85 plus 20% VAT, just for that. 4 boxes of 10 cannulas (got shedloads of the ones with tubing and black pump tops) That was all - total bill inc VAT - approx. £350 ! - for 80 days worth of tubeless cannulas were I only using them and of course - they are quite a bit cheaper than the 'tubed' ones ........

Scary how much we each cost the NHS, actually. Makes me wonder - quite seriously - when Dear Jeremy will notice this .......
 
Just think how much we're saving them (us) in not having to treat complications.
 
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