Medtronic Paradigm Revel vs OmniPod

Diabetes Technology Insulin Pumps
1

Never used a pump before, but considering either the Medtronic Paradigm Revel vs OmniPod. I'd like to know if anyone has any experience on what I see as the pro's and con's on these. Any feedback you have is greatly appreciated!

MEDTRONIC:

* The CGM feature sounds nice, but I've read some people saying it's painful and/or inaccurate. Anyone care to share any positive experiences? Do you use it all the time? Are the CGM notifications discrete (I don't really want everyone in the office hearing beeps or loud vibrations whenever my BG is out of range)?

OMNIPOD:

* The tubelessness sounds nice, but it looks like the size of the pod vs a smaller patch connected to tubes could be a tradeoff. Anyone who has gone from tubes to pod or vice versa - happy with that decision or regret it?

* Is the food database useful and do you use it?

OTHER CONSIDERATIONS IMPORTANT TO ME:

* I like active / semi-physical sports (basketball / flag football). Anyone out here play these type of sports with it, and have anything good or bad to say about it as opposed to other pumps?

* If you remove it to play sports, is either one more easily detached and reattached?

* Any comments on comfort, ergonomics, etc? One of my hesitations about getting a pump for so long has merely been the thought of having it attached to me all the time. So the comfort of the Pod vs Tubes would be important to me - particularly for playing sports and sleeping.

Thanks!

Alex

2

I have used the Minimed Revel for the last year and love it. I briefly considered the Omnipod but read about so many issues folks had with the pods. In addition, the pods are not that small and when I got a sample pod, I was really turned off by how large it is. In addition, my endo said she would not work with the Omnipod because of the number of issues people had (and she was scared it would result in me going into DKA).

Regarding the Minimed Revel -

  • I did use the CGM briefly and I loved the fact that it was integrated into the pump (as opposed to the Dexcom, which meant that I had to carry around another device). The Dexcom was more accurate than the Revel's CGM, but not by a huge margin in my experience. The sensor was a little more painful to insert, but not horribly so. For me, though, the accuracy of both CGMs was not worth the price (literally and in terms of developing scar tissue). I'm pretty small and have a limited amount of real estate to work with. So I stopped using the CGM. I do have a few sensors left and if I'm having a particularly rough patch will slap one on and see what's happening, but I haven't had to do that in awhile. I generally find that the pump and just a lot of finger sticks every day does the trick for me.
  • The notifications were loud enough but you can adjust the volume. I believe you can also set it to vibrate.
  • I am very active and, for me, the Minimed pump has not been an issue. For the sports you play, you could easily put your pump in a spi belt (used by runners) and tuck the tubing in. I've done this plenty of times and not had any issues. You might not want to play tackle football with it on though. The Minimed pump is really durable and that was my primary reason for selecting it. These things are TOUGH and I've put mine through plenty of abuse and it still works great.
  • The Minimed comes in 2 sizes - one that holds 180 units of insulin and another that holds 300. I believe a pod only holds about 200 units of insulin at a time. Keep the capacity in mind when selecting, because you want a pump that will keep enough insulin in it to get you through about 3 days.
  • Tubes really do not bother me. The tubing annoyed me a little at first, but I found creative ways to deal with it and can wear just about anything and still conceal my pump. Like anything else, you work around it. I also recently purchased an aquapack so that I can wear my pump when doing water activities (like at a water park).
  • I really like the low-profile nature of the infusion sets on today's pumps (a far cry from what they had 10 years ago!) Even with a tight dress or shirt on, you can't see the infusion set because the profile is so low. This means that it also is more apt to stay on when physically active.
  • One great thing about the Revel is that you have multiple infusion sets to choose from, so if one doesn't work, you can find another one that might. Lots of folks have allergies or sensitivities to adhesives or the canulas. You don't have other options with the Omnipod.
  • You cannot remove a pod (without wasting it) when playing sports. once it's on, it's on for three days. But you can easily detach a Revel (or Animas ping for that matter), leave the infusion set in, and then reattach when you're done. For sports, I find that I can actually detach for an hour, provided that I give myself a small bolus first. If I need to stay detached for longer, I periodically test and then give additional small boluses (equal to my hourly basal rate) to stay within range. Been doing this for a year and more or less figured out how to make it work when I really want to detach for some reason.

Overall, I've been very happy with my Revel. I did A LOT of research before going with the Revel and while the Animas Ping has some nice features and the tubeless nature of the Omnipod was enticing, I have ended up being VERY happy with my Revel. I do a lot of backpacking, hiking, and traveling, so more than anything I just wanted a pump that was reliable. I definitely got that with the Revel.

But nothing in life is perfect. The screen on the Revel is a bit archaic and hard to read sometimes. They need to improve on that. I wish the pump was completely waterproof like the Ping (although I'm not sure I'd submerge ANY $8,000 device in water, regardless of how "waterproof" the manufacturer claims it is). Even with a Ping, I'd probably still use an aquapack, just to be safe. My feeling is that if I'm fortunate enough to have access to this, I'm not wasting any money.

But these are really my only complaints about the Revel and they are small. My pump has been amazingly reliable and I've had good experiences with Minimed's customer service. I am in love with the Carelink software.

3

I've found the Medtronic CGM accurate enough to be useful? I am sort of used to it and it sort of engenders a "feedback loop" where it's more accurate if I don't get too crazy so I don't get too crazy? I did Tae Kwon Do with it for about a year, it was not unusual to lose 5 lbs at the Friday night class. It survived the classes where we'd do 3x 5 minute rounds of free sparring, no "stopping for points" or anything, just going at it. I got a black belt, had one spectacular bike wreck with it on (which afforded me to check if the blood gushing out of where my lip had been torn in half was aligned with my fingers, which it was!) and run and bicycle a lot and haven't had a any problems. I've found the predictive alerts on the 523 to be useful. If I run, I'll get a "predicted high" one mile into say a 5 mile run, when the small "hit" of carbs I had beforehand start to hit, and then the "predicted low" by the end of the run, when it's burnt off and then another predicted high when it goes up at the end? I was clueless about pumps (and carb counting basal rates, boluses, etc.) when I got my pump but it was very useful.

The notifications are discrete, unless you ignore them, and then they'll tweet louder, to an R2D2, "OMG it's Darth Vader" level. The 523 will allow you to turn that off to sleep too...

4

Great advice! Thanks!

5

My first pump was a Minimed with the CGM, and I now use the Omnipod and Dexcom CGM. Here's my pro/con list.

Minimed Pros: can insert infusion site just about anywhere because it's so small
* IOB algorithm includes insulin you've given for food
* can re-use reservoir from one infusion set to the next (I use very little insulin so sometimes I would have leftover insulin in the reservoir when it was time to change sets)
* can choose from multiple types of infusion sets (angled, straight, 6mm, 9mm, etc)

Minimed Cons: tubing (I was constantly getting large 1 inch bubbles in the line, most likely caused by cracking in case caused by clip that Minimed gives you for using on belt)
* not waterproof (i.e. must detach to shower, swim, etc.)
* CGM is painful to insert and is not that accurate compared to Dex
* certain clothes can't be worn easily or without much planning ahead (i.e. skirts and dresses) - this probably doesn't mean a whole lot to you, though

Omnipod Pros: waterproof!
* no tubing which means no bubbles in line which means no large periods of time you don't receive insulin
* can wear whatever clothing I want without any planning ahead
* makes me literally forget that I'm diabetic (many times I forget to bolus before eating b/c I have nothing connected to me that reminds me I"m diabetic)

Omnipod cons: IOB calculation is WRONG WRONG WRONG (although I've read that this is changing when the new pods come out w/ a new PDA)
* can have errors (I rarely have them, though); must toss entire pump when errors occur
* 85 unit minimum (I only go through ~65 units during the 72-80 hour pod time)
* can't go past 80 hours with pod - it will shriek at you that it died at that point

I much prefer the Omnipod/Dexcom pairing. Insulet is waiting for the FDA to approve the smaller pods, which will be coming with a new PDA that does things a little better from what I hear. Unfortunately, the FDA has decided that medical devices should get much more scrutiny which is holding up lots of technology for us diabetics. My biggest complaints about the MM pump were bubbles in the tubing - a 1 inch bubble means I get no insulin for hours - and the inaccurate CGM. I rarely have bad pods. I never use the food database. I prefer the pod for exercise. The last straw for me, though, was when MM sent out a bunch of reservoirs that they then recalled for improper functioning (delivering too much insulin), and then didn't have enough to resupply everyone. Their customer service was horrible during this time - I distinctly recall being "yelled" at by a rep just because I was trying to figure out when I would get reservoirs that I needed in order to use my pump.

6
* I like active / semi-physical sports (basketball / flag football). Anyone out here play these type of sports with it, and have anything good or bad to say about it as opposed to other pumps?

Although the Omnipod can't be removed, it can take a bit of a beating and still function so it doesn't have to be removed for you to engage in most activities safely.

It can, however, easily be ripped off so you may need to add extra adhesives and/or wrap the site in some type of protection. How much extra adhesive and protection you need just depends on your activity and how much of a beating you and your pod are expecting to absorb. When I run and work out in the gym, I don't require much, if any, additional protection for the pod. When I hit the mat for grappling, I require as much protection as I can manage.

Once it's secured, though, there's not much to worry about and you're free to enjoy your activity rather then spending the entire time worrying about your pump.

7

@MyBustedPancreas

No disrespect intended, but I REALLY wish you wouldn't post comments about the Omnipod if you've never used one. Sorry, a sample pod does not suffice. I certainly respect your comments on the Revel because you currently use one, but the comments on the Omnipod are not valid as you don't use one.

I've used BOTH MM and the Omnipod for extended periods of time. Both are excellent pumps and honestly the reason I use and LOVE my Omnipod is because it's tubeless and waterproof. I'm very active as well (hoops, flag football, running, pool with my kids for extended periods, beach) and I don't have to worry about tubes etc. @awp21, I certainly don't have the feeling of having something attached to me all the time, whereas with the MM I did. Plus, I wear my Omnipod on the back of my arms and calves. My pump "real estate" is much greater with my Omnipod than it ever was with my MM pumps.

Also (and this isn't the first time I've read this), the comments about all of these supposed pod "issues" and people being worried about going into DKA are completely overblown. From my experience, I've had a few instances where I have a kinked cannula and delivery was stopped with my Omnipod and I had to put on a new one. But guess what? I had kinked cannula's with my MM pumps as well and had to change infusion sets. It happens with every pump and is not exclusive to the Omnipod. Also, going in DKA takes a long time and I would hope that before you even get close to going in DKA, you'd realize you have a pump issue and swap it out for a new one. Any other errors (very few and far between and Omnipod CS has always been great with replacing them) have been during the priming process and you just grab a new pod. Nothing that would ever lead to DKA. I'm surprised an Endo would suggest that.

Couple other quick hits on the Omnipod :

-Big fan of the automatic insertion process
-Waterproof is big plus for me in extended pool sessions and on the beach.
-The size of the pod is not a big deal at all for me. Plus, hopefully by year end the new, smaller (about 33%) pods will be out.

Having said all this, I will say that it completely comes down to your personal preference. As passionate as Busted is about her Revel, I'm equally as passionate about my Omnipod.

Given the decision factors you've outline above, I think the Omnipod would be great for you. But you will never really know until you live with it on a daily basis. Maybe you can do a 30 day trial on each?

I'm just thankful that we have choices. Good luck and let me know if you have any other questions.

8

Hi Kimberly,
Thanks so much for sharing your experience and comparison of the pump and OmniPod. I am currently on the Medtronic Paradigm no longer under warranty so I'm needing to make some decisions. I don't have any experience with anything other than Medtronic but due to a high insurance deductable I'm also looking at cost. My doctor gave me a sample of the OmniPod which I plan on starting tomorrow. Where do you wear yours, I've thought about my leg or my back but I'm wondering how it will work with pants or jeans. I like the fact that the infusion sets are not obvious under clothing and am a little concerned as to how obvious the pod will be, also I'm wondering it it will be uncomfortable when i'm sleeping, with the pump I just tuck under the pillow or on top of the comforter. What is your experience with these situations?
Heather B.