Medtronic to Pod

Hi everyone
Question! I just changed from a Medtronic to a Pod about 3 months ago. I usually need very little insulin to get through my day (about 13 units max)and was told about how changing to the pod would be this amazing change and even reduce my rate cause I would be using fresh tissue.
Since I have had it I will say I never want to go back to a pump with tubing but I am fighting high blood sugars basically every single day. I often times change a pod everyday cause I am desperate and only see the number correct till I change the pod. It seems to work for maybe a day if then stops absorbing (although I can hear it delivering I clearly am not getting it!).
Any suggestions or people have similar experience.....
Would love to hear.
Ali

That's very odd. Where are you placing them?

From your picture, you look very fit. This usually limits the sites where there is enough subQ adipose tissue to get a good insertion. Upper part of backs of arms is good, butt (just above or below the beltline, depending on how high-waisted your clothing). There's a recent discussion that was quite lively about women putting the ol' barnacle on their breast inside their bra, and this seemed to be quite popular and effective.

Finally, don't rule out a bad vial of insulin. Wouldn't be the first time a pumper was frustrated thinking the pump system was the problem, when it turned out the insulin was impotent.

Thank you for the reply but I have ruled out the insulin cause I can change a pod and see the turn abound within 20 minutes. I spent an entire day over 200 and changed my pod and dropped to 84 within an hour and no correction with the same insulin vile.
I am lean about 25% fat I am guessing and active cause I teach yoga. I've covered upper arms, love handles, upper back (side like under Kidneys), stomach and all with the same issue. I found upper butt area really doesn't do well at all even on the other pump. I was actually thinking is it's long enough to reach the fat cause it is already a short cannula and going in on an angle.
My A1C is 5.5 my control was excellent till I made the change but at this point going back would probably be so depressing I couldn't do it.

A few questions:

  • Is this happening with every pod/site?
  • Are you using the whole-hand over pod, pinching up technique shown in the on-line training videos at myomnipod.com?
  • What is the condition of the puncture at the bad sites when you remove the pod? Swelling? Painful at all?
  • When you remove a pod, is the cannula area on the pod clean, or is there some blood staining on the adhesive pad (around the cannula opening)?
  • Does the efficacy of the system decline gradually over 24-48 hours, or does it work fine to control your BG, then quickly start to fail to control BG?
  • Last but certainly not least, what sort of basal testing, tuning, etc. have you done (I'll bet not much this early into things :-))?
While all of these may be a factor, I'd look very carefully at that last one. Basal management works very differently with a pump+fast acting than on MDI with a long-acting insulin. It's not uncommon for people to have all sorts of control issues when first starting a pump because of this rather substantial change in the way basal insulin is delivered and managed.

Your fellow PWD here on TuD can help a lot with testing, analyzing, and then setting basal programs.

Of course, if, when you hit the wall on this, no amount of insulin bolused from the pod makes any difference, then it's unlikely a basal issue.

Finally, if you haven't taken advantage of Insulet's support team, don't delay! They really want this to work for you too. Give Insulet a call, and tell them you want their local nurse/educator to contact you. That person, and their local sales rep, can be very helpful in sorting issues like this out.

You can adjust the bolus increment. This will deliver insulin faster. I found that helped :-)

I believe you're mistaken.

The Omnipod delivers insulin in 0.05U doses, every time you hear it "click" while a bolus is being delivered. The rate is roughly about 1 click/sec, resulting in a delivery rate of around 3U/min. This rate is fixed and unchangeable.

What you're probably thinking of is the setting that allows you to change the bolus increment for entering a bolus amount. This feature is there because IC ratios vary so widely among diabetics, so it makes it less taxing for someone with an IC of 1:4 to enter the bolus amount directly quickly just like someone with an IC of 1:25.

Dave wonderful question. Almost all of the time when I take a pod off I have a little blood and (for lack of a better word) suction mark in the rectangle shape near the window. If I squeeze it after I think I see a little clear liquid which I assume is insulin just not getting absorbed which is what I feel is happening. I also have significant bruising in some of then. I have one now that is 2 inches long.
The funny thing is a had a 3 week period when most of the pod worked great which is how I know my rates are pretty close to perfect for me. It's been 12 years on mini med pumps so I know how to play and fine tune things. I am pinching which is how my CDE told me to do it but never watched the video but I will look into that. I'm just at a loss if the pod works it may only work for to 12 hours a day and suddenly nothing! Not to mention I almost ran out of pods pulling them out early.

Have you tried it with different insulins? I found Apidra would lose its efficacy after about 24hrs, I would have occasional occlusions with Novolog, but Humalog worked perfectly.

Where you using slant sets with your MM? If you where using a straight set is it the same canula length as the one the pod uses? For me I have found that I need 30% more insulin when using a straight set vs a slant set. If you have changed cannula lengths or angles then you will more than likely need to redo your basal rates, I:C ratios and C.F.s to find what is now your new normal.

That is so interesting I didn't think of that. It seems I must need more with a slant set. I used both in my MM silhouette and sure T. But the sure T would work within minutes and I usually bottom out. The pod seems to take hours before it works.

Could also be related to the autoinserter speed/impact. Especially if you are seeing bruising under the pod. I have had best results with manual insertion slant. Comfort shorts - as I I can control the speed and angle. The straight sets I tried were auto inserts so it may actually be the harder insertion causing tissue damage thus effecting absorption. Do you run temp rate post insertion? I always run a 200% rate for the amount of time I was off pump. It seems to help.

Another thought the Sure T is a metal set if I'm not mistaken, do you have an allergy to the soft catheters which effects your absorption? The silhouette is a soft catheter, what does the pod use?