Another annoyances, improvements for next generation thread

Diabetes Technology Insulin Pumps
#1

I really am very satisfied with the Omnipod. Of course, there will always be things that could be improved. Please add your own ideas to this thread -- I'll collate everything after a month or two, and send it off to Insulet.

First item is managing insulin not delivered by the pump itself. The PDM should handle tracking and managing IOB for bolus entries when there is no active pump. Otherwise, dealing with contingencies using an injection -- for whatever reason -- becomes very difficult when the pump only accounts for insulin it delivers.

I've run in to this situation several times. Pump goes screech owl middle of the day, I'm not in a position to change it, so I grab my humalog pen and bolus for lunch that way.

Unless I wait past the duration-of-action setting before bolusing anything from a new pod, I risk hypo if not paying close attention.

I wound up taking a 1 week pump vacation because of this issue a few weeks ago. Laziness got in the way of putting a new barnacle on, and then it was just too inconvenient to get it going again during those limited windows when I had no IOB during the workweek.

The PDM should provide a means to enter insulin doses no matter what the source, and then track it no different than insulin delivered by the pump. This could be a feature that could be locked out by an Endo or CDE for the patient that wasn't savvy enough to avoid mistakes (like taking Lantus, and registering it with the PDM as if it was a Humalog dose).

#2

Dave...I'll think on it, but am anxious to hear others' thoughts. Love "barnacle," BTW! May I use it?

#3

Hey Dave, I love the "barnacle" analogy. I haven't had many issues with pod errors (maybe 10 total since starting 4 years ago), but the one thing that bugs the hell out of me is when I experience an occlusion and I'm forced to change the pod. More times than not, my occlusion occurs when I move a certain way, so I'm pretty sure that my movement is causing the cannula to bump into tissue causing the build up of pressure. I would like to see them add a "3 strikes then you're out" feature to give us three tries to get delivery started again. My Cozmo would error out when an occlusion was detected, but then I could wait a few minutes (after pinching up and rolling the infusion site between my thumb and finger) and then restart delivery. Worked like a charm. The only other thing that I would like to see them do is develop a PDM with a drum based strip system and integrated lancet device. I see this as a major convenience having everything rolled into one form factor so we don't have to carry a bag with all of our goodies if we don't want to. And of course finally, integrate a CGM.

#4

Wonderful thread, Dave. Many software companies (I work for one) use a voting system to prioritize which user requested enhancements should be developed/implemented first. It's a simple technique used to create product road maps for future features and fixes.

May I suggest that we do something similar before submitting the collated list to insulet.

Not every member of this group will have a unique idea, but folks can certainly vote for an improvement which they feel will improve their experience with Omnipod the most.

I'm a new Omnipod user (have used it only for two weeks so far), but I'd certainly like to see the following changes:
- Remove the need to hit confirm when powering up the PDM. If it's an FDA requirement then make it a configuration option.
- I ran into a POD error yesterday in the middle of a bolus. After replacing the POD I was expecting that it would continue to deliver the left over bolus, or at least give me an option/reminder to resume bolus when the new pod was activated.

thanks,
D

#5

Hi water proof or resistant pdm is a must.. Longer pod life maybe with the the ability to refill while attached....

#6
Love "barnacle," BTW! May I use it?
Did you see one of these © on it?

(just ribbin' ya... I stole it from someone else myself!)

#7

So I may just have fond memories of the old system but the two new things that kill me are 1) The need to confirm that it's mine when it turns on, especially when testing blood sugar and 2) The need to acknowledge it 1.5 hours after pod activation. We didn't have to do these in the old pod system so I'm not sure why they HAD to be added. They are great options to include in the alarm menu for those who want them but for those of us who do not they just create more difficulty.

New things I'd like to see: 1) More fine tuning of basal rates, especially at low ratios. There's a huge difference between 1 unit for every 3 grams of carbs and 1 unit for every 4 grams of carbs. 2) Alarms to tell you if you're ALWAYS correcting for high blood sugar at a certain time of day. If I'm consistently high at 3pm it would be nice if it let me know... less major but an added bonus.

#8

Great idea, who! In a month or two when we've beat this to death, I'll put together something on surveymonkey or equivalent and post the link so everyone can go over and vote. Perhaps we can build some momentum and get folks on other sites to vote too, then point Insulet to the results.

Remove the need to hit confirm when powering up the PDM. If it's an FDA requirement then make it a configuration option.
Uh-oh... you have no idea the large disc of cow-plop you just jumped in to with both feet!

Kidding aside, this was one of the biggest complaints when the new system came out last year. It was a new "feature" that the old system didn't have. Rumor is that it was an FDA mandate.

I ran into a POD error yesterday in the middle of a bolus. After replacing the POD I was expecting that it would continue to deliver the left over bolus, or at least give me an option/reminder to resume bolus when the new pod was activated
Thanks!!! I forgot about that one. I always run mine dry before changing them, so they usually alarm out in the middle of a bolus, and I have to go into My Records->Insulin Delivery, find the pod shutdown event, select it, hit '?' and find out how much was remaining. Then start a new bolus.

It would awesome if there was a "resume interrupted bolus" feature. Even nicer if it came up automatically after changing a pod in mid-bolus, but I'd be happy if it was simply a choice on the main home menu.

#9

My request would be Mac/iOS software and the ability to communicate via Bluetooth for synchronizing data.

#10

Yes, yes, and yes to all three.

I believe the 3-day limit is an FDA-imposed reg for the class of devices, hence the requirement to change out infusion sites every 3 days for tubed pumpers, and of course for us, a new pod.

The batteries certainly have plenty of juice left (I've taken apart and reverse-engineering about a dozen). The pump mechanism is dirt-simple and a very reliable design (the "motor" is an SMA wire that simply pulls a little ratchet back and forth -- think of the pendulum mechanism in a classic old wall clock).

All we need is a port on top to inject more insulin, and some relatively simple design changes to the resevoir to allow the piston to move back while being refilled.

#11

x2 Bluetooth Smart, would be an excellent upgrade. They should also just make the Pods bluetooth smart and allow a phone app to prime and control a POD!

#12

However, due to insulin resistance there are a lot of podders that get less than 3 days out of their pods. An "XL" version would be a tremendous improvement for those of us with this issue.

#13

Bluetooth would be universal. That would allow not only Insulet to write software, but others too. Might even allow integration with the new iOS 8 health monitoring features just announced for portable Apple devices.

#14

Dave,

First, there are a few threads here in the Forum on this same topic, so make sure to look for those and get all the good ideas there too.

#1 for me would be Dexcom integration. Or at least some other CGM, though Dexcom is by far the best CGM on the market right now.

#2 would be an XL version of the pod for those with insulin resistance issues. Seems to me that a 300 unit reservoir would allow many of us with this issue the ability to get closer if not reach 3 days wear. And, not make the pod that much bigger (maybe even still smaller than the original much larger pod)

#3 would be a massive improvement to the PDM and/or Bluetooth ability for smartphone control. The PDM is a sadly poor device in terms of modern electronics. It's way too big for the purpose it fills, and it's buttons are horrendously bad. Plus the programming could use a major overhaul, as recommend by other's suggestions here. Of course, Bluetooth/smartphone abilities would be the pie in the sky solution as exampled by the overwhelming support/questions here in the forum.

#15

FDA comments can be made via: http://www.fda.gov/AboutFDA/ContactFDA/CommentonRegulations/default.htm

#16

Scott, are you delivering basal with your pod? I have enough meager beta cell function to let my pancreas handle fasting basal, which allowed me to go from 2 days to the full 3. My basal is nominally 1U/hr (different in the early AM to combat IR). By experimentation, I was able to reduce this way down and save 16U a day, which got me over the hump to 3 days.

Of course, if you're a T2 who's pancreas has deserted the battlefield, this won't help...

#17
#2 would be an XL version of the pod for those with insulin resistance issues. Seems to me that a 300 unit reservoir would allow many of us with this issue the ability to get closer if not reach 3 days wear. And, not make the pod that much bigger (maybe even still smaller than the original much larger pod)
Werd (doing my best gansta :-))

Have you taken one apart? Increasing the volume of the reservoir by 50% would be a snap, and could be accomplished by widening the overall barnacle by sqrt(1.5) = 22%.

Increasing the reservoir capacity by 50% would require increasing the total area (WxL) of the pod by only 14%, keeping the same height profile (I suspect no one wants it to stick up higher above the skin).

#18

I agree with the PDM improvement to the 21st century - It really looks like something from the 1950's

#19

One pod, controlled by an iOS device, for both glucose monitoring and insulin delivery would obviously be AWESOME!

#20

40+ year type 1 here. My basal is at least 2u/hour and I have a 14 to 1 carb to insulin ratio. On a good day I use around 100 units. There are others here with MUCH higher usages. There is a "U500" insulin" but it has problems that don't outweigh the benefit unless the case is serious.