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Report about the insulin pump Deltec Cozmo
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I got this two-part report with the agreement of the author from the diabetesinfo.de forum. It describes the experience
of madie with the insulin-pump, called Deltec Cozmo.
21. September 2005
Although I’m a newbie in dealing with insulin pumps, I want to write about my first impressions I’ve had with the Cozmo:
First of all, the Cozmo is bigger than other pumps and the freestyle-clip will probably make it even bigger. I think that the leather bag isn’t much good, because the clip is firmly fixed and thus makes the bag bigger than before. One should consider neoprene bags which may be better. Or, one should try to use a mobile phone bag which is available for some Euros (the Hama Exxter II, for instance); it fits very well and covers the pump almost completely. The Luer-Connect fits through the hole of the connecting lead of the bag. To use the pump, one has to open the bag or one even has to take out the pump completely (since there are different buttons). However, this is not too bad since the bag has a magnetic lock. The colours of the pump are actually very hideous. The grey one is the only one which is not too bad, but at the moment I have an atomic purple one – gggrrr!!!!...but it’s not more than a pump for testing...
What I like is the operating concept. Although it’s not the ideal pump, it can replace the diary function of the OTUS if you’re smart. It records every operating step which is unfortunately almost too much of a good thing: in case of a bolus injection about gKH, there are already five single entries in the logbook. And in case of programming with the help of the PC and a new recording of the program, the pump recognizes it as a new manual entry. The analysis function isn’t much good, I think, but the program stores the data in Access 2000 (coded under “deltec”). Some time, I will establish a makro which changes the file into Diabass or SiDiary and can thus filter the most important entries. This would make a whole diary function possible. Perhaps, this has even already been done by anybody (it has been a long time since I made something with MSAccess).
The good thing of the pump is that it’s completely programable with the help of the PC. This even filled my doctor with enthusiasm which usually is only the case with the Animas 1250 that does not yet exist in Germany and has recently been rejected in the USA. The coming out of the Spirit pump is obviously still in the stars. Another positive thing to mention about the pump is the correctional function that can either work from top to bottom or the other way around, always considering the prepared duration of insulin supply and the time referential correctional factors. With a blood sugar value of about 2,9 mmol/ l, for example, a bolus would possibly not have been suggested. The suggestion is perhaps only reliable in case of the right factors. Not to forget are the various remembering functions, just as the little alarm clock. Unfortunately, the Cozmo has no possibility of time referential BU factors. It just calculates with gKH. However, this can be avoided by pushing the speed for gKH to 3 (= ¼, ½, ¾, 1, ¼, 1 ½...BU). In this way, one can enter BU’s and calculate bolus suggestions after a user defined factor. User defined factors can also be chosen manually and at different times. An example of what I programmed is the following:
| 1. morning 1,5 8g/E |
| 2. morning 1,2 10g/E |
| 3. midday 1,1 11g/E |
| 4. afternoon 1,2 10g/E |
| 5. afternoon 1,3 9g/E |
| 6. evening 1,4 8,5g/E |
| 7. late 1,3 9g/E |
| 8. BU 0,0 200g/E |
For breakfast I then choose the BU factor 1,5; in the afternoon I choose 1,3 and so on. In doing that, the Cozmo notes the entered BU’s correctly as gKH. I put 10g/E and a speed of 5gKH on the Xpress button and 6g/E as well as 3gKH on the standard bolus. With the help of the entered gKH there’s only one calculated bolus suggestion which can of course be changed into real insulin values.
Concerning other functions, there are hardly any differences in comparison to other pumps. These are only small things just as the exact display of the reservoir state. Moreover, one can sometimes add a second bolus, although the first one is working. Other small differences contain things just as the own naming of the pump, of the user boli or of the basal rates and also the self design of messages, the display of the emergency number, for example. The background lights can only be called up out of the screen saver which makes it a bit difficult. Other things that could be interesting in regard to children are program locks and menu restrictions that can be entered. And the one who has to squirt a lot, will be very happy that it is possible to enter the hole duration of the bolus supply (15 chosen IU can be distributed in 5 minutes, for example). Unfortunately, the chosen 1 IU will also be distributed within the prepared time of 5 minutes (thus, it would be better to eat slowly in case of low doses- which is also more healthy!).
That’s it so far. There are certainly many things I’ve forgotten to mention, but you can just ask. [Questions to: webmaster@diabetesindex.de]. The best thing would of course be to test the pump yourself! I’m sure that Deltec would be pleased about your interest since they want to sell them.
27. Januar 2006
Meanwhile, I’m not so much a newbie in dealing with insulin pumps as before. For 1 month I have the okay from the health insurance and thus I own my final pump. I’ve stayed with the Cozmo, although I also tried the Spirit and the Minimed Probe.
First of all, I think there’s no “perfect” pump, anyone of them has its advantages and disadvantages. My first test – Cozmo was, for instance, broken in about 2 weeks, even though it was a new pump. Several things, just as a system error, continual alarm and batterie problems were the symptoms. Within 24 hours, I got a another one which was second hand. Thus I continued testing. After 4 weeks I was told that the error of the first pump was meant to be an error of the processor. Even with the Spirit pump, I had two times a “mechanical error”. This leads me to the differences between the two pumps (I just want to mention some of them): Advantages of the Spirit: more clear and better readable display; disadvantages: difficult menu; very little display; difficult reservoir function in comparison to the Cozmo; no programming and selecting of data with the help of a PC; no BU factor calculator; only one remembering alarm clock; only one temporal basal rate. I can’t describe the differences regarding the Minimed in detail, because I must have lost my notes. What I liked was the BU factor calculator. Decisive for the decision against the Minimed was, besides the size, (which I consider as being too big) the lack of the programming and the log function with the PC.
I still use the log function of the Cozmo. I don’t have any written diary. I just read the log of the pump and the blood sugar machine regularly (in Diabass or SiDiary) and even my doctor agrees ( probably, he usually does not get such complete and proper “written” diaries). [...]. I think that Alf [member of the Diabetes.Info.de-forum] is about to establish an own solution for an import of Cozmo in SiDiary (oops, do I have told too much J ?!).
Although I still use OTUS as a blood sugar instrument, I actually only get the blood sugar data from it. It is only seldom that I note special things with the OTUS. With the described setting and the consequent use, the pump reads many BU values, any correctional- and eating boli, changes of the catheter, sportif activities and also affections. If the pump offered time-referential BU factors for the x-press button, one could use the log function in this way and mustn’t usually watch the display (another possibility would be to chose another BU factor).
Translated by Kristin Henke
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