Hello everyone, my name is Zak and I've been a diabetic for 30 years. I was diagnosed when I was 5 and used MDI for the first 26 years of my diabetic life. I started pumping with the Minimed Paradigm 722 in 2006 and recently made the decision to "Cut the Cord" with Omnipod because I want the freedom to hop on a kayak if I feel like it without leaving my pump (pancreas) in the car. I might want to kayak once a year, but knowing that I can't started to eat away at me...
I wanted to write my story of how it's going, the positives, the negatives, and the issues I've had with switching. If I write something that you can help with, I'd love to hear from you.
I'm a control freak with my diabetes and a lot of the issues I have with the Omnipod stems from:
a) it's different than Minimed
b) it doesn't handle numbers the way I expect and want it to
I have a stated goal of having an A1C come back at 5.9. I've reached 6.0 before, but I haven't broken the barrier. It's my 4 minute mile, I just haven't been able to get there yet. Hopefully my work will pay off in the coming months...
So here goes...
Background:
My pods arrived and I put them in the closet because I know you're supposed to be trained first. I heard from my pump trainer and she told me it would be 2 weeks before she could see me. I told her that I wasn't happy with this and I proposed that I start using the pods and come to our education session wearing a pod and be able to ask any questions I had during the session. She agreed and I went home that night and put in my first pod.
PDM Setup:
Worked about the same as setup on the Minimed. Lots of menus, lots of information that needs to get put into the device, but no problems.
The pods are easier to put on than the Minimed infusion sets. The big benefit with the pods is that the catheter insertion is painless (it's only my 3rd pod, but so far no pain). It actually feels (and sounds) like an alternate site BG prick to my forearm. It couldn't hurt less. It's wonderful. It's not that the Minimed infusion set insertion process hurts (some a bit more than others), but it involves more steps than the pod does. I wouldn't eliminate Minimed because of this during an evaluation process, but
Omnipod gets a big thumbs up for the setup process.
The PDM:
I must say that when I first saw the pod size, I wasn't upset. They were actually smaller than I expected them to be. However, I can't say the same for the PDM. The PDM is huge and it looks like it was designed in 1990. My first thought was - so this is what they're doing with all of the old
Palm Pilots that people are throwing away, but then I realized that my old Palm Pilot was smaller... In this day and age, there is no excuse for poor product design. I know that the PDM is designed to perform a function and for the most part it does that (more on this later), but the look of it screams
"Outdated Technology." Compared to the cool looking Pods, the PDM is a failure.
Basal Functions:
To my knowledge, the administration of basal rates is identical between Omnipod and Minimed. Nothing to worry about, nothing to comment on.
Bolus Functions:
Wow... This is a problem for me and to be honest I don't believe that I would have decided to jump to Omnipod if I had known about the bolus calculation issues that I'm going to write about.
Problem 1:
The first problem I ran into has to do with low blood sugars. I tested during my first afternoon and got a result of 62. Now, I'm not a brittle diabetic and 62 isn't something that I freak out about, in fact, I
don't freak out about a result of 42. I treat them the same way - take 15 grams of quick acting carbs and test in 15 minutes. Repeat if necessary.
So when I got the result of 62, I took my carbs and selected Bolus=62 and selected Yes to use for Bolus Calcs. Well, that didn't work... Hmmm.. Ok, I canceled out and put in Bolus=62 and selected No to use for Bolus Calcs. The PDM then asked me for how many carbs I was eating and I put in
15. It then asked me to confirm a bolus of 1.4 units of insulin. WAIT A MINUTE. I cancelled out and went back to the main menu. It appears that the PDM will not let me enter my carbs for a low blood sugar... This doesn't make any sense. On the Minimed 722, the pump is a computer that takes all the data I can give it. It takes my BG and my carb intake and calculates a recommended bolus (and
for a low blood sugar, that's almost always 0.0). The Omnipod doesn't seem to work that way.
So I called my Omnipod trainer to ask the question. She told me that the pump isn't designed to do that. She said that Omnipod wants you to treat your low and not worry about the numbers. Well, this is unacceptable to me. Telling a diabetic to not worry about the numbers is like telling a teenage
driver to not worry about the speed limit. It's a disaster waiting to happen. So I pressed her on how I can get the PDM to do what I want to do. She told me I could adjust the following:
Settings > system Setup > bolus/basal/calcs > Ratios/factors/targets > Min BG for calcs
I had it set to 70 and that means that any BG below 70 will cause the pump to prevent me from bolusing for any food. She told me I can set it as low as 50 and that would allow me to input my 15 carb correction with a BG of 50 to 69. If I'm below 50, I'll unfortunately "lose" the 15
carbs from my daily total.
I want to take a second to talk about why this is so important to me. I'm a geek, plain and simple. Electronics are a part of my life and I'm very happy that technology has gotten to the point where so many of us are using insulin pumps successfully. But in being a diabetic geek, I'm aware,
perhaps more than the Insulet engineers who designed this system, of how important every bit of data that I can collect about my care is.
I learned a long time ago that this is my disease. My Dr. can make recommendations, but it's up to me whether or not I follow them, because if I don't take care of myself it won't be my Dr. who loses his vision or has a lower limb amputated. It's me... I take this VERY VERY VERY seriously and I
hate it when some engineer or product specification writer somewhere decides to
do something out of "safety" and does not consider that somewhere there is a diabetic who no longer has access to the data that helps him/her to not just manage and live with diabetes, but master and thrive with diabetes.
I change my basal rates whenever I have enough data to prove that those rates need to change. But with the Omnipod, I can no longer guarantee that my total carb counts for the day are accurate. With Minimed, I can track over the course of a month that on days when I consume 100 carbs, my average BG is 133 and on days when I consume over 140 carbs, my average BG is 152. This data allows me to learn about my body and how effective my basal/bolus programs are working. It allows me to adapt my care to get my numbers closer to my goal of 95. The Omnipod is preventing me from keeping this data in a single place and is making it more difficult to fine tune my care. This is not good...
This isn't a show stopper and it's not something that a lot of people may have a problem with, but it's important to me.
Problem 2:
My first 6 days on the Omnipod I ate breakfast before my shower, so I would test, get my result, put the result into the PDM along with the carbs I intended to eat, and then get a Correction + Carb bolus amount fromthe PDM's calculator and I would use that amount to bolus for my breakfast along with my calculation.
I then took my shower and after getting dressed made breakfast for myself. Now on my Minimed 722, in this case, I would do a quick bolus - select "---" for my BG (effectively not entering one), and
then select 45 carbs and the pump would calculate the amount of insulin needed
to bolus for the 45 carbs.
I can't seem to get the Omnipod PDM to do this... I tried to bolus without a BG entry and it wouldn't let me. So I put in "95" as my BG into the PDM (since 95 is my target goal and I've already delivered a
correction bolus to get me to my target amount 20 minutes earlier) and put in 45 carbs. The PDM recommended that I give 0.15 units to cover breakfast. That's obviously wrong. My Minimed pump would have recommended 3.2 or something similar for 45 carbs. So basically, I had to guess how many units of insulin I would need to cover my breakfast.
Now I know... I was on MDI for 26 years, and I spent a lot of time guessing how many units of insulin I would to cover some food that I ate. Don't get me wrong, this is a calculation I can do. However, it's also a calculation that I haven't needed to do in 4 years since starting pumping with a Minimed 722. I expected the Omnipod to do the same thing, but I just can't make it happen... Can anyone help me?
Overall:
I simply love waking up in the morning, without the need to yank on a cord to find my pump before hopping out of bed. I can't tell you how cool that is. I'm wearing my 3rd pod on my arm right now. Again - HOW FRICKEN COOL IS THAT?
I have never felt so free as a diabetic, and that's an amazing thing coming from a diabetic starting on his 4th decade with the disease. An amazing thing coming from someone who used beef and pork insulin. An amazing thing from someone who used Lente and found Lantus to be a complete sea
change in diabetes care. And even more amazing considering how my Minimed 722 revolutionized my life. I felt free with my 722. Yeah there was a cord, but I didn't have to carry vials, I didn't have to store used syringes. And along this long journey of mine, Podding it up has take me to a level of freedom I
have never felt before as a diabetic.
And because of that freedom, I can handle the fact that the PDM feels like an electronic dinosaur from the Diabetes Age. Let me try to classify just how ancient this PDM feels to me... I remember having to put a gigantic drop of blood on a gigantic test strip and then having to wait 2 minutes to get a result. I remember having to use BG lancing devices that looked like medieval torture devices. It's that bad to me. And let’s face it, self image and how we feel about ourselves is vitally important in how we live
our lives.
You may think I'm exaggerating, but feel is very important in my life and in everyone's life I think. When I feel healthy it makes all the difference. And one more thing to add into the mix.
I'm an outgoing diabetic. I'm a proud diabetic. I'd do anything to have a cure drop into my lap this instant, don't get me wrong, but I'm a diabetic and I have no problems having the world be completely aware of it. I've tested my blood sugar in a meeting at work, drawn up a syringe, walked to the door jamb that I needed to use to tense up my skin so I could inject into my arm, given the injection, capped the syringe, and walked back to my seat and went back to paying attention in the meeting. Life doesn't stop for my diabetes. I'm a part of it and it's a part of me.
I hate this PDM. Looking at it makes me feel like I'm sick. I can't explain it. I wish I could. But I don't like the PDM.
But I love the Pods... :)
However, the bolus issues I mentioned above are a nightmare for me. I need to have a pump that lets me be able to care for myself in the best way I can. So far, it doesn't feel like the Omnipod does that.
Perhaps my Minimed pump is only 4-6% better at storing information and calculating boluses. It doesn't sound like much, but over a lifetime with this disease, I'm afraid that using a pump that is a few % less effective than another will cost me. I'm afraid it will cost me 3-6 months of complication free life in the long run.
So that's where I'm at.
I'm trying to decide if I should stick with the Omnipod or if I should go back to Minimed and just use the Pods when I want to take a "Podcation" or go on vacation or maybe just for weekends.
I'd love it if anyone who has some insight into how to get the PDM to work the way I want it to could let me know.
Thanks for reading and I hope my experience helps one of you who may be thinking of switching to the Pod!
Zak
Omnipod only calculates IOB as correction factor stuff. Any bolus you give for carbs it’s assuming you have calculated correctly so all of that insulin is “spoken for”. When I am exercising heavily (cycling/running) I often wish it would give me total insulin on board so that I would know if a certain bolus was a smart choice based on my increased insulin sensitivity, etc. But it doesn’t. It’s not a deal breaker for me, but it’s definitely on my wish list.