By Gary Scheiner
I’ve always felt that it takes three things — I call them the “3 Ts” — to manage diabetes effectively: Tools, Techniques, and ‘Tude (attitude… but I needed something that starts with “T”). If any of the three is lacking, diabetes management tends to fall apart. Insulin pumps fall into the “tools” category. Pumps are viewed as one of the more powerful and effective instruments at our disposal, but it still takes the skills and desire to use a pump optimally in order to achieve better glucose control and quality of life.
Since most people stay tethered to their insulin pump longer than the average marriages lasts, it pays to shop around. There are now SIX different insulin pumps on the U.S. market, and there are differences between them – distinctions that have both clinical and convenience implications. That’s why we have a detailed set of pump comparisons at our website.
Recently, I’ve had the opportunity to use one of the “new kids on the block” — the Snap insulin pump from Asante Solutions, based in California’s silicon valley. I believe the name comes from one of the key attributes of the pump – how easy it is to set up and maintain. Unlike other pumps, Snap is modular. The “brain” of the pump (called the controller) is the only part that is not disposable. The controller has a full-color display and buttons that correspond with the on-screen icons. The controller also stores historical information for on-screen review and downloading.
Asante Snap Controller
Since a brain isn’t of much use without a body, Snap utilizes disposable “pump bodies” (really… that’s what they’re called!). Each pump body holds a 300-unit prefilled Humalog insulin cartridge; plans are underway to offer pump bodies fitted to hold Novolog cartridges as well. The pump bodies also contain a battery, drive mechanism and memory chip for storing the pump settings. The infusion set tubing is retrofitted to attach directly to the pump body. As the tube is attached, insulin is driven through the tubing, so minimal priming is required. Snapping the pump body and controller together creates the Snap pump. The pump body and tubing may be used for the life of the 300-unit insulin cartridge, but infusion sites still need to be changed every 2-3 days.
The Snap Pump Body “snaps” into the Pump Controller
What’s beneficial about the modular design? Plenty. Because the controller is the only durable part, the upfront cost is approximately 80% less than other pumps. Use of prefilled insulin cartridges and the automatic tubing prime makes change-outs super fast and bubble-free. Having a memory chip in the disposable pump body means that you’ll never have to search for your pump settings. If the controller ever has to be replaced, just snap an old pump body into the new controller, and voila. The settings are transferred instantly.
Snap shares many basic features with other pumps – temp basals, dual/combination boluses, and so on. It also has a number of unique elements not found in other pumps: A built-in flashlight (great for finding lost keys!), an ultra-lightweight design, very rapid bolus entry, and options for deducting IOB (insulin-on-board) from meal doses or correction doses.
Of course, no pump is perfect. Although the upfront price is relatively low, replacing both pump bodies and infusion sets on a regular basis creates a higher overall long-term cost. Downloading data from the pump is complex and not yet doable from home. Humalog is not approved on every drug formulary, and many people have simply developed a preference for Novolog or Apidra. There is no direct link (yet) with a glucose meter or CGM, although Asante is planning to integrate with the next generation Dexcom G5 system. Infusion set options are somewhat limited, and the pump lacks a vibrate mechanism.
Overall, I have been more than pleased with the Snap. To me, easy/quick bolusing and cartridge/tubing change-outs are essential qualities in a pump, and Snap really nailed both of those features. The company’s support is outstanding, and the management is very open to suggestions. Unfortunately, this is something we’ve seen fade over time as small pump companies become big ones or are acquired by large corporations… hopefully it will remain a strong point at Asante.
One other note: Asante is the only company to offer a 30-day no-cost trial. They even supply the disposables and a coupon for free insulin cartridges. If you’ve been hesitant to commit to pump therapy or are due for an upgrade on your current pump, it’s a great way to sample Snap without any obligation.
Snap sounds good. Is Medicare on board with this pump? If not, what are its costs?
Nice review Gary. A fair balanced look at the pros and cons. No one pump fits and works for everyone’s lifestyle but shedding light on each of them helps us all make an informed decision.
Love the 3 T’s! Will look good on one of my slides but I promise to give you the credit!
I had been on the Asante Snap the past year. I really liked how simple it was to operate, put insulin in with auto-prime, and not worrying about bubbles. The company is excellent and so are the reps. However, with all the great things I liked, I still had issues. Here are my 2 issues:
1. The supplies come in a pre-sized kit of 10 infusion sets & 4 pump bodies. The bodies are to be used 1 per week. Just drop a bottle in. The body is not retractable, so when the bottle is empty you must start another body. For people who use a large amount of insulin they will have to by a second kit, maybe a third kit. I am one who has to buy 3 kits. I have 2 extra boxes of infusion sets every month which I don’t need but have to pay for. There is no other way to get pump bodies than to buy them with the infusion sets included. If they can fix this, this would have worked so much better for me.
2. My insurance did not cover this pump so all costs were outside the coverage and did not go to fill my deductible. It costs $80 per kit, which was $240 monthly. I was told by my Asante rep that there was good news, that my insurance is going to start covering it. They did. They sent me 2 kits for $917. I still need a third kit. This becomes $1,350.50 per month. After I would meet my deductible I would then be paying 25%, which is now $343,88 and ordered every 90 days for $1,031.63. The cost for me was just too high.
I really liked this pump, and the company. If my situation was different and I used less insulin, maybe I could afford the supplies. Maybe other insurance plans offer a better price. But if Asante redesigned their pump to retract for another insulin bottle the costs would be more economical. So in my case I had to look for another pump. I doubt it will be as easy to use, or look as cool, and may not have the great company behind it. Hopefully one day I can return as a customer.