Replies to This Discussion

Permalink Reply by jattzl on November 23, 2012 at 5:59pm

I completely relate to absolutely everything that you reported about your experience. We even started the Omnipod at the same time. I can't tell you how much I appreciate you documenting your experience as it really validated everything I have dealt with. I would also add that I am an experienced pumper (18 years) and T1D for 42 years. We both seem to have serious gastroparesis complications, too! In addition to what you have noted, I have had trouble with pain at the site. There is a poking from the cannula and also an overall pain from the pod pressing on whatever it is up against. I have changed many pods because of it. I don't know if it is due to neuropathy pain sensitivity or what but it's very uncomfortable.

I am still using it as of now but will stop soon.

Thank you, again, Terry

Permalink Reply by Terry on November 23, 2012 at 6:42pm

jattzl - I'm sorry to read that the Omnipod is not working well for you either. Pain from the cannula poking and the pressing of the pod against your skin sounds like it could be neuropathy; whatever the name, it certainly sounds irritating!

Letting each other know that we are not alone is a major benefit of TuDiabetes. I'm glad my account helped you. I don't write these kinds of things just to bellyache. I try to frame things in such a way as to effect positive change.

If you stop the Omnipod, what method will you use to deliver insulin? I often wonder if I could go back to MDI. When I last did that, there were no rapid acting insulins and no Lantus or Levemir basal insulin.

Thank you for your kind response.

Permalink Reply by jattzl on November 23, 2012 at 7:02pm

Your positive intention is what came across. Very well done.

I used the Medtronic Paradigm with Quick-Sets. Like you, after so many years, I was having absorption problems and hoped the Omnipod would help with some new sites, which I think it did. I am eligible for an upgrade and will probably go back to Medtronic but have not researched it yet.

There have been a few times in the past when I decided to take a "vacation" from being tied to the pump and used Lantus with Humalog. It was a nice break and blood sugars were pretty stable. The "vacation" only lasted for 2 days though :) That's all it took to remember all of the great benefits of using a pump. I am very insulin sensitive and obviously there is no way to inject .05 of a unit accurately let alone doing the math lol.

Thanks again. Nothing better than the peer support and information we get from sites like this.

All the best,
Joanne

Permalink Reply by tebbemae on November 25, 2012 at 2:14am

This post could not have come at a better time! When I started Omnipod in September I decided to give it a 6 month trial run. After nearly 3 months I am debating on ending it sooner.

I too am greatly frustrated with the over 200 post pod change highs that can take over 6 hours to treat. My current system of prevention/treatment for this works well sometimes (numbers stay under 140 through the change only to rise above 250 12 hours later) and other times-even though I change nothing about my routine-it doesn't. I've also begun to experience insulin absorption issues after 48 hours no matter what site I use. Over the 72 hour life span of a pod I probably have 1/3 of that time spent in control-the rest of the time I am fighting to lower my BS. I did not have these issues with my Medtronic pump. I knew once I changed my infusion set with Medtronic that I could enjoy 3 days of great control. I originally switched to Omnipod because I was running out of sites to use after 11 years and, when I did encounter problems with my pump, it was typically due to tubing.

Like you Terry I decided 6 months ago to eliminate other variables to make my diabetes management easier (adopted low carb approach, kept food diary, etc.). Because I made these changes (and feel confident it is a lifestyle I can continue willingly) I am seriously considering returning to MDI. The last time I was on MDI-2000-I used Humulin/Humalog. I too wonder if I will be more responsive to newer long acting insulins combined with Novolog or Apidra. After almost 12 years on a pump I am worried how my body will respond to the switch but I know that another pump will not eliminate the issues I have with absorption.

Again-thank you for posting. It is comforting knowing I am not the only one experiencing these issues!

Permalink Reply by Terry on November 25, 2012 at 11:29am

tebbemae - I'm sorry that the OmniPod could not deliver good performance for you. There is a large group that it seems to work well with.

If you had good control with MDI then maybe that would be a good choice for you. When I look at my basal profile, especially in the early morning hours, I fear that there's no background insulin that could deliver that. I would definitely have to split my Lantus or Levemir doses into two, maybe three per day. I've never used Lantus or Levemir so I'd have to do detailed logging to discover what works for me. I'd probably look for a day-by-day email assist from a CDE too.

One problem that I'd anticipate with changing to MDI is remembering if I took my dose or not! I just know this would be an ongoing challenge. I often check my pump to verify what the heck I did on the last dose! Double dosing or missing a dose both have disastrous consequences for control.

If you had good luck on the Medtronic pump, why don't you consider just going back to that?

You mention running out of sites. I have the same challenge. One of the reasons I tried the OmniPod was to use new sites. Well, I had such mixed results with using the back of my arms, I was discouraged to try other places. I need to experiment with alternate sites (other than abdomen) but I will wait until I can change to a steel cannula (Contact Detach) after the first of the year.

What was your problem with pump tubing? Was it just a nuisance and getting caught on doorknobs or was it something else?

Good luck with whatever you do. I will be interested to know what you choose and how it works out.

Permalink Reply by garidan on November 23, 2012 at 10:12pm

I think it would be interesting to know from people with bad omnipod experiences which kind of set works now for them using a tubed pump.
I think much of the problems of omnipod come from its fixed sized cannula (9mm diagonal).
If on a tubed pump you have good control only using longer sets, or deeper than 6 mm vertical sets, I can understand why pod doesn't work for you.
In particular I cite Jattzl

I used the Medtronic Paradigm with Quick-Sets. Like you, after so many years, I was having absorption problems and hoped the Omnipod would help with some new sites, which I think it did.

.
What do you think about this guess ?

Permalink Reply by Terry on November 24, 2012 at 6:13am

garidan - I think you may be right about the style and length of the infusion set playing a key role. In fact, with my decision to drop the Omnipod, I've been researching a new infusion set for me. I have been using the Inset 30 with my Animas Ping pump. That set is angled and its cannula is 13 mm long.

Perhaps the shorter cannula length of the Omnipod is at the bottom of all the problems that I and others have.

I did have absorption anomalies from time to time with the Inset 30/Animas combo but their frequency was much less than the Omnipod.

I will next try the Contact Detach infusion set. It's a 90 degree steel cannula and comes in 6 mm and 8 mm cannula lengths. I will choose the 8 mm. Now I'm wondering about the actual insulin delivery depth comparison of the Inset 30 versus the 8 mm Contact Detach 90 degree set. I'll probably just try it and see how I do.

One thing I should note. I had problems using the back of my arms with the Omnipod. This is tissue that I never used before for insulin infusion. I'm not sure what to make of that.

Your cannula length hypothesis may be the right path for me to take. I intend to experiment using it.

Thank you for your comment.

Permalink Reply by Steve D on November 25, 2012 at 8:26am

Whew! That was quite a post! I AGREE 100% and then some!

Just two days ago I was doing a pod change, 1st try) POd had a plastic block over where one injects to fill the pod with insulin (third one in this box of pods!), so I just placed it in my basket 'o bad pods to call in to insulet (usually about 3-4 in there already) ..... 2nd try) PDM signaled "defective pod' during the priming process...just threw it in the basket with the others. 3rd try) didnt hear the double beep after filling with insulin, my directions from my Insulet trainer was if "you dont hear the double beep, dont proceed. We wont be held resposible for anything else that goes wrong and we dont accept responsibility if you hadnt heard the beep-" so into the basket it goes. Summary, took about an hour to change my pod that day, and I had three pods to call in as defective....WOW! This CERTAINLY is NOT making Type 1 a smaller part of MY life!

Permalink Reply by Terry on November 25, 2012 at 11:42am

Hi Steve - Yeah, I had one pod that informed me that it deactivated just after I finished filling it. It only happened once to me but it seems you really hit a bad string. At least the Insulet customer service is not stingy with their pod replacements. But getting the pod replaced was not as important to me as dependability and consistency. I'd much rather prevent the failure in the first place.

I wish you luck with whatever you decide to do.

By the way, I'm nearing the end of a three day site run on my return to the Animas Ping. My CGM shows a flat line at 102 mg/dl. The site is obviously not stale and I sure do like not dancing to the absolute 72-80 hour O'pod duration limit. So far, so good. I hope my luck holds!

Permalink Reply by Benjamin McLaughlin on December 3, 2012 at 12:10pm

Terry, I haven't had the problems that you had, but I have some feelings that are similar to yours. I am opposite your situation in every way. I was diagnosed in February at the age of 25. I did MDI for 3 months or so, then was approved for the pod. I couldn't wait, because I would be able to be a lot more "free" and not bound to all the shots. Well turns out, being free is all relative. I have quickly found out the fact is no diabetic is free by comparison of how I was before I was diagnosed.

I am extremely active, which is why I was attracted to the pod in the first place. But I inevitably would knock off a pod a month, sometimes I would do this when I am out and I didn't have the necessary back up supplies to change pods. Couple that with always doing math to figure out where I will be when the pod will expire, and the pod is a persistent bugger (I mean really, what isn't with this stuff.) Besides the pods being knocked off occasionally, I have had no problems whatsoever. I consider myself lucky. But I decided to go on a pod vacation. I had a few leftover flex pens of levemir and novolog that have expiration dates, so what the heck. To my surprise, I have really enjoyed the "freedom" of no pods. Yes, we all know the disadvantages of mdi vs. pods, but I had a peace of mind knowing that everywhere I went, the insulin I needed was right there. There are so many examples that the pod, although it's not a major nuisance in my life, is a very minor one. I didn't realize after I added up all those minor ones, it equaled a small headache. Now I know after a few weeks or months of mdi, the headaches of that will show its head as well. I guess I have found there's no perfect answer. I'm assuming I will go back on the pump and just take a week vacation every few months or so. I'm going to go on mdi as long as I can stand it just to make the best decision.

Have you decided on what you are going to do?

Permalink Reply by Terry on December 3, 2012 at 3:50pm

Hi Benjamin - I'm glad to read that you're willing to experiment with different treatment modes. To be successful, a T1 diabetic needs to find a happy balance between living life and paying sufficient attention to the nuts and bolts of diabetes management. Since you now have experience with both MDI and the pods you can see for yourself the pros and cons of each. And you can factor in your own personal preferences and lifestyle values. You've also made yourself proficient in both modes and can then switch back and forth to suit your needs.

Each of us has our own unique situation and body. You've just started your diabetes "career" while I've been at it for 29 years. Because of that long duration (26 years of insulin pumps) I know that I have trouble with consistent absorption, particularly on certain places on my abdomen. That was part of the problem I had with the Omnipod but not the whole thing.

I've returned to using my four year old Animas Ping pump and I'm experimenting with some different infusion sets. I'm also going to experiment with using some new sites on my lower back. I talked with another T1D who has successfully used these sites. I'm trying to rehab my abdomen with massage and using a loofa sponge when I shower.

I've placed an order for another Animas Ping. With it I get the option to upgrade for $99 to their next generation pump, the Vibe, when it comes out, hopefully early 2013.

The Vibe will come with an integrated Dexcom G4 CGM. I already have the G4 CGM and it's working out well. When I upgrade to the Vibe, I'll have, in essence, two receivers, the Dex G4 stand-alone receiver and the Vibe pump itself. This will give me two receivers to use at night and then I'll most likely just depend on the Vibe pump/receiver to serve me during the day.

You sound like you have a good attitude about taking care of your diabetes. That is a critical attribute. Good luck to you and thank you for reaching out to me. I fear that I've offended a few people on this site and I'm very happy to give some feedback to someone like you. I'm not that different from you, just a few decades older! I was diagnosed with T1D when I was 30.

Permalink Reply by MaryMary on December 3, 2012 at 9:53pm

We are having the same issues with the Omnipod, and they have started to happen more often than they ever used to. I think that my daughter has been using it for over 3 years now, I'd have to check. I am having to change the pods out early more often than not, and also the highs after changing are more often now too. They don't happen every time though, so I don't feel like I can have her bolusing just because it is a pod change. Sometimes it is right away, sometimes not for a few hours. Just really unpredictable, and this never happened with tubed pumps.

I fought hard to get this pump covered for her, because our insurance didn't want to cover it two years ago when we had to change plans. I am trying to wait for the Vibe, because with her disability, she may make a mistake entering the dose on the Ping. Since she has the Dex 4, I don't really want to go back to Medtronic. She also used a Cozmo, but of course that is no longer a choice.

One problem may be that we can only use her arms for sites. Now that we are using Silesse, maybe I could try another area. The itching was horrible with anything else that we tried, on any area except the arms. I rotate as much as possible on her arms, so I am not convinced that is the issue. Especially when I seem to be seeing more posts about this lately. There is a thread on the CWD parents board right now also.

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