Hi fellow POD family. I have excellent control. My A1C is always under 6 and for 10 years have been using a Medtronic pump. I switched over to the Pod last spring and just find myself getting so frustrated with it. The freedom is amazing but the lack of absorption is ridiculous. I feel like I bolus and it goes nowhere. Even being very very lean I personally feel the cannula is too short at that angle. If I have my old pump which I have to keep putting back in to stabilize I use different infusion sets (using some that go straight in or others that are on an angel and varying lengths) depending on where on my body I am placing it.
Wouldn't it make sense to have the same choices for the pods.... I'm at a loss of what to do. Also after changing a pod I usually have about 6 hours (even with mini boluses) when my blood sugar spikes and I basically don't eat to prevent my blood sugar from going over 200. Is this just me or are there other who have these issues.
I find the only good spot that seems to work is my arm. If use my sides or stomach I usually get a day or day and a half before I have to change it out cause my sugar will just not come down. I usually have to put on my old pump cause I am desperate to just get stable.
Any thought would be much appreciated.
I'm intrigued by what you've shared. I was a Medtronic pumper for over 8 years before trying the Asante Snap from 10/2013 to 01/2014. I had lots of failures while I tried to sleep while using the Snap. I switched to Omnipod about a year ago. I love the freedom it offers with no tubing, and I've finally managed to go several months without failed pods. With Medtronic, I consistently had an A1c that was around 6.0; in the past year, I have seen my A1c jump to 7.8. I really enjoy my Omnipod, but I'm curious about absorption as well. I also have the challenge of having to use the Lantus Solostar Pen for my basal. My insulin usage causes me to change pods about every 2-2.5 days just from boluses with the 200u capacity of the pod. My medical provider and I discussed my concerns at my appointments in September and again in December, and we'll be watching what happens at my next appointment in March. I'm not a Medtronic fan and am not sure what I would do if I had to change back to pumping with tubing. I'm hopeful that the integration of Dexcom CGM and Omnipod will be sooner vs. later so that I can monitor more effectively. I have used Dexcom but mine has expired. I decided to purchase a new device in hopes that the integration will be soon. It all can be so confusing--"chicken or egg" issues, it seems. Thanks for posting your situation, and I hope others weigh in.
Other people have this problem; posted 2 hours ago:
http://www.tudiabetes.org/group/omnipodusers/forum/topics/could-it-be-this-box-of-pods
The pod change issue is well known, although for me it got a lot better with the new pods and I no longer see any spike (or, if you prefer, delay.)
I'm moderately lean but my feeling is that this means that the cannula is too long for some locations; even at that depth I'm worried about going intra-muscular since that radically changes the adsorption (based on the few occasions I accidentally did it while on MDI.)
As I said on the previous thread, some, maybe a lot, of Omnipod users do a bolus at the pod change (personally I suspect bolusing with the old pod is better) to deal with the temporary delay that might/does occur whenever the infusion site is changed.
John Bowler
The FreeStyle test strips were reading low, prior to the Omnipod-specific recall, at least in some cases. If you swapped from a different BG meter to the PDM you may have been getting consistently different readings and that alone would explain an HbA1c change, though a jump to 6% to 7.8% corresponds to a BG of 7(126) to about 10(180) and that seems large.
Since you are using the Omnipod just for boluses (including, I assume, correction boluses) the change of algorithm for insulin adsorption will also cause major problems. Medtronic use an algorithm that tails off, so assumes that your BG will drop more rapidly after a bolus. Insulet uses a linear algorihtm and so the PDM assumes you BG will decrease steadily over the same insulin action time. If you programmed the same insulin action time into the PDM that you programmed into your Medtronic pump you will get radically different correction boluses; much less from the PDM because it assumes (falsely) that the insulin hasn't worked yet.
John Bowler
Thanks John
Would you mind sharing which sites you use that seem to have best absorption? I am assuming if I use my hips and butt it would take FOREVER to actually absorb so forget that! My stomach and side (under ribs area) should be good and yet seem worthless. Wondering if I should be putting in some crazy off the typical recommended areas.
I think some guy in the Olympics had it on his chest...
I've only used the Omnipod pumps, but added a Dexcom CGM about 1 year ago. Before the CGM I could get under 7.0 on my A1c, but it wasn't easy. With the CGM I'm at 6.0 now. I don't think the problem is absorption overall, though I will state that I find my control is different depending on where I wear a pod. For instance my arms seem to absorb noticeably faster than my abs do. Anyway, what the CGM showed me was how the Omnipods worked overall. It took months to get the idea, and to tweak my control to what to expect from changes and settings on the Omnipod. But, I've found control to be much easier and more steady since using both devices together. I'm now wondering why these devices are sold separately. Seriously, they need to be in the same package and only sold together.
I do have one question on the difference between pumps. How fast was a bolus from the Medtronic? I'm wondering if the Omnipod boluses faster or slower? And what difference would this have, if any?
unfortunately, I don't have any advice for you, but I can totally empathize! I've only used the omnipod and LOVE the freedom - when it works. but whenever I change pods - it's always a guessing game - is the pod working or not?!? I can't tell for several hours as my sugars rise. only after a few hours, if my sugars come down, I know it's working.
lately I've had similar issues with boluses - it seems to take a while to kick in; very frustrating.
I don't use my arms, but I do use my abdomen, legs & buttocks. I also have frequent pod failures.
but when it works well - it REALLY works well!
My Medtronic was instant. In fact most days I didn't bolus I am lower in Carb and health lean proteins. I can sail though the day like a champ with my basel which is prob a little high. But I like it that way.
I am almost sure this is cannula length. With my Medtronic I can use a 6 mm at 90 % angle in my sides and a 9 mm in my butt but if I used the 6 mm it would never get to the fat tissue. I had it so down pat my A1C was 4.9 and the doctors made me get it higher in fear of low BS on the road. With this POD I am lucky to stay under 6.0
Hi,
i have been on the POD since Nov 2014 and totally sympathize with your feelings. Prior to the POD, I did manual injections. I have been diabetic for 50 years. My A1C in the last few of years with manual has ranged between 6.2 & 6.8 and prior to that,in the 7 range. My Dexcom CGM a few years ago was a great addition to my managagement tools.
But my endo kept saying "change to the pump, it will make your life easier" and at a level, it has made my life easier. It is so easy to take my insulin when I eat and do corrections by just pushing a button.
On the other side of the coin...It seems that the POD sometimes has a mind of its own. I calculate carb and bolus, but my BS doesn't go down or doesn't go down enough--sometimes. Other times everything works beautifully. I have changed my IC ratio and correction factors and ended up with low BS reactions...Where I'm at now seems to keep me the closest to normal.
I use my arms and just above my butt for POD placement. I find I do much better on the arms than on the butt, although my arms are leaner.I too am relatively petite....Not tiny but in pretty good shape. I wear my Dexcom on my stomach, so I have never tried the POD there. On my butt, I run into POD "failures". I don't know if the POD is actually failing or if the cannula is getting dislodged in my sleep.
I am interested to see what my A1C is at my next endo visit. I don't think I could adjust to tubing so if I do anything, I will go back to manual....
I don't have any anwers for you, but you are not alone....
50 years amazing <3 I don't think it is a "failure" but that's what I call it too. If you pull your POD out it would still be clicking away into nothing and insulin would come out. I would consider it site failure. I wish they was a better deliver system. I don't mind living as a diabetic. It keeps me healthy. :)
Thank you for sharing I might try my upper butt.
Scott; do you still enter the BG readings into the Omnipod when you bolus, or do you just enter carbs without letting the pod add/subtract insulin on board?
It seems to me that the weakness in the Omnipod algorithm is the handling of insulin on board. With a CGM you can watch the post-prandial spike in BG and the following trough then know when it's safe to start doing corrections.
John Bowler
With the sites I'm using and with the new pods I don't see a pod-change delay and I haven't ever perceived any adsorption differences. I.e. there may be some but I haven't noticed them. I did have post-change spikes with the old pods and I did change my upper arm site and stomach sites slightly, but I didn't correlate the post-change delay with a particular site.
My current six sites are:
1) The back of the arm with the cannula over the triceps, the pod pointing down and the end of the pod below the deltoid muscle. If I orient the pod any other way I get pod failures (not occlusions, failures) with the new pods.
2) My back in the region of my abdomen towards either side. I was using the front of the abdomen but many years of MDI have left my periumbilical region like a pin cushion. I avoid it because I actually expect adsorption issues there; the subcutaneous part is so damaged.
3) My chest with the pod pointing down over the upper part of the pectoralis major muscle.
I can't use the front of my thighs; when I was young that is where I did MDI and I was using pre-GMO pig or cow insulin. As a consequence I have hardly any subcutaneous fat there (a pinch of skin is 1/4") and I don't know what condition it is in, but it's lumpy.
Any area where a pinch of skin is 1/2" or so should be fine for adsorption; the rule is that the cannula ends up in subcutaneous fat, however we tend to be active and that severely constrains were we can put the pod.
I don't know if really deep layers of subcutaneous fat will slow adsorption down, though it certainly seems possible. I've never tried my butt and I don't have more than about 1/2" of skin pinch anywhere else.
John Bowler
Ali, there was a discussion last year about placing the pod on the inside of the breast (cleavage side). Lively discussion. Many women absolutely loved the location. You might benefit from reviewing that discussion.
Thank you Dave. I am having some good results with in butt towards the upper side for lack of a better description. But I will look for that thread!