Replies to This Discussion

Permalink Reply by Scott Wilkins on November 18, 2012 at 1:11pm

This is basically why I found a new pack that would allow me to carry not only the PDM and BG testing supplies like the provided pack does, but also an unused pod and other supplies if ever needed. I wish the provided pack was a bit more roomy for all needed supplies and such. I've not had to use them in this way yet, and have yet to have such a failure. I do believe they are actually rare. Sorry it happened to you Terry, hope you have better luck in the future.

Permalink Reply by Terry on November 18, 2012 at 1:33pm

Scott - Thanks for the reply. I'm glad to hear that you've not experienced a pod deactivation failure before. What I didn't mention in my post is that I this is my second failure of this type. I had another pod deactivation failure on November 3.

I've been trying to hold back a rush to judgment on the Omnipod system. While yesterday was a setback, I will wait and see. As of now, I'm leaning toward going back to the Animas Ping with the Contact Detach stainless steel cannula infusion sets. My next opportunity to reorder infusion sets is January 1.

Permalink Reply by Alisonisayoshi on November 18, 2012 at 1:26pm

I had deactivation and occlusion issues when I started too! I think we all do. My endo prescribed me a 2 day pod change so my insurance would cover more pods a month. That means I don't stress waiting on replacement pods. It helps a lot. Also as I got more used to the system I found errors (occlusion failed error ect) came less often. I went into Omni with my "eyes wide open" to its flaws. It's benifits (to me) out weighed its risks (flaws). That being said, they usually can't tell you why, they just send you replacements. I keep a syringe just in case, a pod just in case, and I've alarmed in classes, at my kids school events ect. I just fix it. My life is so much simpler now. I have a toddler so I'm happy to not have tubes. Nothing to yank at, no buttons to push on mommy, easily swim with my son ect. If you can't say these are my reasons for THIS management system, maybe it's the wrong one for you? Not that it's you by any means, but if the pros don't out weigh the cons then maybe there might be a better system for you?

Permalink Reply by Alisonisayoshi on November 18, 2012 at 1:31pm

Also if you want a reason behind an error ask your pump rep. Mine is available to me via email or text and almost always has an answer for me. Customer service is just there to send my replacement pods :)

Permalink Reply by Terry on November 18, 2012 at 1:48pm

Alison - Thanks for the tip about contacting my pump rep. I also have a prescription to change pods every two days. I'm reluctant to do that now since I've been dealing with figuring out how to preempt post pod change hyperglycemia. I was having 8-12 hours of highs when I changed pods. Once I got my BG down, the last thing I wanted to do was change again at 48 hours.

Luckily, I've found that using a syringe bolus at pod change time seems to be limiting the post pod change highs. I need a few more pod changes to verify.

Did you know that both Apidra and Novolog insulin package inserts recommend infusion site changes at 48 hours?

Permalink Reply by Alisonisayoshi on November 18, 2012 at 2:03pm

Actually my endo said the pods work better in his experience with certain insulin (I'm not saying which because I'm not a doctor)! So yeah I knew that some insulin "expires" (not goes bad but loses efficacy) in pods supposedly. I don't know that this is true or false or just my endos observation but I have found that I've had better "luck" with my pod than a lot of other new users and I really think a lot of it comes down to my care team being really knowledgable about the systems flaws (including my rep who was open and honest even when "selling" me the pod). I think Omni users are less pumpers and more a breed of their own in terms of pumping we are more "poder's" and we have different new issues with a different new management system.

Permalink Reply by jla on November 20, 2012 at 9:48am

My information is that it is Apidra and Humalog that recommend that their insulins not be in a pump reservoir more than 48 hours and that Novolog oks up to 6 days. I've been using Omnipods since Oct. of 2008. I used Apidra until January of 2012. I have had much greater success with the Novolog. On Apidra, the last 18 hours of the 72 hours of a pod, the BG would rise significantly. I actually am getting 80 hours of effective use out of most pods now. Also after I put on a new pod, I inject 1 unit as a "primer" dose, check the BG in one hour and make any corrections. (I also check the BG before I change and dose accordingly.) If my BG was low I cut back on the primer dose.

Permalink Reply by Terry on November 20, 2012 at 10:34am

Hi jla - Your comment about which insulin brands recommend 48 hour limits for insulin pumps sent me back into research mode. Here's what I found:

Apidra -
Source
"Based on in vitro studies which have shown loss of the preservative, metacresol and insulin degradation, APIDRA in the reservoir should be changed at least every 48 hours."

Novolog -

I initially found this FDA link that lead me to believe that the manufacturer recommended changing the infusion set/site every 48 hours. Looking at it more closely I realized that this was 2006 info.

Source
"In-vitro studies have shown that pump malfunction, loss of
cresol, and insulin degradation, may occur when NovoLog is maintained in a pump system for more than 48 hours. Reservoirs and infusion sets should be changed at least every 48 hours."

Here's the current recommendation from Novo_Nordisk:
Source
"NovoLog® is the first fast-acting insulin that can be used for up to 6 days in a pump before it needs to be changed. The table below shows how often to change NovoLog® in a pump. Please be sure to check the instructions that came with your pump.
Pump component Time frame
Reservoir Up to 6 days
Infusion set and infusion set insertion site Up to 3 days"

Humalog -
Source
"Based on the updated label, people with type 1 diabetes using Humalog for pump therapy can use the insulin in the pump reservoir for up to seven days and should change the infusion set and infusion set insertion site at least every three days. The previous label indicated that Humalog in the external insulin pump reservoir should be replaced and a new infusion site selected every 48 hours or less."

While Novolog says that 6 days is OK with insulin in a pump reservoir, it does say to change the set/site every three days. For me though, this is a moot point, as I found that I am allergic to Novolog. I developed "pump bumps," red and swollen tissue at the pump infusion site.

It's interesting that you found absorption problems with Apidra in the last 18 hours of a three day period. I'm not sure what to attribute that to but it is consistent with the problems I've personally observed.

Thanks for relating your experience.

Permalink Reply by barend on November 18, 2012 at 1:58pm

Terry, like you I have been on the Omnipod system since last July. In general it works great for me. However, sometimes an unexplainable thing happens. I am afraid we have to live with this. Unfortunately there is no such thing as an ideal world. Sofar I am happy with the Omnipod - better BG, less insulin - and every problem is solved adequately by the European distributor of Insulet.

Permalink Reply by Terry on November 18, 2012 at 6:35pm

barend - I realize we live in a less than ideal world. I get that. I also know that things can get better and the way to make them better is to reach for the ideal. While perfect is unattainable, better can usually be achieved.

I don't speak out and register discontent simply to blow off steam. I believe speaking up on forums like this and creating sentiment for improvements will, over time, have an influence on companies like Insulet.

I'm glad you're happy with the Omnipod system. Anything that makes the lives of diabetics easier is a good thing!

Permalink Reply by barend on November 20, 2012 at 5:53am

Terry - I fully agree with you.I always inform the Insulet distributor in Europe when I encounter a problem. Let's keep them sharp and come up with better products. BTW I can't wait to start with the recently received new pods. They are much smaller!

Permalink Reply by meh_mtl on November 20, 2012 at 10:32am

the previous 2 pods I used, have done that to me as well when I had a couple of hours left. I started to think the box of pods was a lemon. it's annoying, but I have just changed the pod and bolused again. I have never called to find out why, I just change the pod. but it would be intresting to know why. I think I shall fire off an e-mail to my rep and seee what he has to say. if I do get any useful info I will let you know.

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