NEED ADVICE: New to Pods and don't think my absorbtion is what it should be.. But wait, there's more!

Diabetes Technology Insulin Pumps
1

Hey DOC!

I’m struggling here! I decided to switch from the Minimed Paradigm to the OmniPod pump ALMOST 45 days ago. In the beginning, it was amazing to not have tubes for the first time in 14 years!

Here recently, I’ve been growing increasingly discouraged because I’m getting random high blood sugars. VERY stubborn ones. I’ll take 5 units for a sugar of 260 and it won’t budge. I’ve done everything - new sites, pinching the skin, pushing on the pod during insertion, new vials of insulin, bolusing waay before meals, increased temp basals. You name it, I feel like I’ve done it.

What is so stressful is that I have until Thursday to decide if I want to keep the OmniPod (they let you send it back if you aren’t satisfied). So, I started to wear my Minimed off and on to see if it was really the Pods fault for my sugars. I feel like I am getting better results from the Minimed for the most part. Then again, I feel like I might be villainizing the OmniPod because I have been in a relationship with my Minimed for 14 years now.

I slept with the Minimed on last night and was a steady 85. I started to feel like I was dropping around 2:30am, so I set a -10% temp basal for 2 hours. Ended up being waaay too much and woke up around 200. Corrected with the Minimed and almost two hours later I’m still around 180 (didn’t eat breakfast yet so that’s not an issue). Now I’m questioning if it’s just me?

I go to the endo on Thursday, so I sort of have to make the decision to keep the OmniPod or not by myself. I have read that many people have had absorbtion issues with the Pod (maybe my body doesn’t like the angled cannula?) I’m scared to be stuck with a system that I don’t love or that doesn’t control my sugars! That’s 4 years of commitment!

Sorry for the novel, as you can tell, this is weighing really heavy on my mind. Any suggestions or advice would be very much appreciated.

2

Hi Carlyn -

I actually just wrote a blog post about this on my blog (www.howsyoursugar.com) - but here is most of it:

Yesterday I had to move the pod from my stomach to my arms. I dread this, because I haven’t had a successful pod on my arm. Either it gets banged up, or it gets very loose from activity. Well Yesterday – I put it on and the insulin just didn’t appear to be working.

So I know the following things:

1) It was a new vial of novolog that hadn’t been out of the fridge. Extremely unlikely its the insulin’s fault.

2) The canula was in me. Could see it.

3) Right after the change, I spiked from 160 > 370. I stayed in the 300s for over 6 hours. I dosed over 24 units and ate 40 grams of carbs (my sensitivity is 1 unit to 12 units of carbs).

4) I finally crashed at hour 7 and had 3 lows and was low from hours 7 >15.

5) Was 100 > 150 all night – Woke up and ate a sugar free bar (And yes, it’s sugar free) and immediately spiked to 290 (which is where I am right now). Despite taking 10 units to try to correct (I was in – “take enough insulin until you crash desparation mode” at this point)

5.5) Walked the mile to work after dosing, still went up to 290.

6) Just ripped the pod off my arm, and put it back on my abdomen despite really need to rest the spot.

So I’m a pretty logical guy, and I generally understand why things happen with Diabetes, but this boggles me. The omnipod has lead to a number of these days (I’d say at least 15 of them) since I started.

When I was on injections, this normally only happened when I forgot to take my lantus, or I was getting ill. I’m not getting sick, I feel find other than the “diabetic rage and grumpiness” that comes from me being that high.

So - I'm in the same boat as you right now.

3

I would be really torn as well. Whatever you decide, I thank you for reporting your experience. It is something anyone considering Omnipod should know about. Omnipod used to be my #1 choice if and when I can afford a pump but over the years I have read enough about post-insertion highs and inexplicable pod failures to make buying the most expensive pump on the market a no-go.

4

Daniel! I wish I could hug you. It sounds exactly what I’ve been going through, the sugars and the troubleshooting. I probably wasted four pods in the last week and an entire bottle of Novolog.

Is this your first pump? If it is, please know that it’s NOT supposed to be like this! Life with my Paradigm was not this mind-boggling (not to say that this kind of stuff NEVER happened, but not as often and usually not for no reason).

Do you find that your pod works okay for you on your stomach? I haven’t tried it there, because sometimes that’s where I put my Dexcom. I also feel like the pod is too huge for my stomach and I sort-of look like an alien :slight_smile:

Good news is, I’ve been using my Minimed for about 12 hours now, and despite my spike because of too much of a temp basal and a small spike after coffee… I’m riding steady at 120.

I guess maybe I should go with my gut and return the pod. Are you planning on switching or returning the OmniPod system? So sorry you’re going through this too!

5

Don,

I was really excited to get a pump without tubes. I read a lot about post insertion highs, but thought maybe it was just the minority having issues. I felt as though I could deal with post insertion highs, too - just a temp basal for a few hours or something.

However, what I’m experiencing is not post-insertion (at least not all of the time). This is sometimes happening 6 or 12 hours after I change sites.

I want to say that by no means am I discounting OmniPod and their product. Customer service has been great, the Rep in my area is absolutely wonderful. Site changes are SO EASY and not having a way to remotely bolus is almost life changing (for my wardrobe…).

I will say though, that no matter how much ease the OmniPod brings to my life, the most important thing is BG management, and for me - I’m not seeing it.

Good luck when you do start looking for a pump, they really are great diabetes management tools.

6

Maybe you can ask for an extension of the trial period? I agree that tubeless is revolutionary plus I really appreciate the ergonomics and navigational efficiency of the PDM.

7

My advice would be to switch back to the Minimed. My endo will not work with the Omnipod because of these very issues. I realize the allure of being tubeless, but my first priority is that a pump work and keep my BGs within range. With any pump you're going to have some issues with failed sites and what not. But with a tubed pump, you can at least try different infusion sets and figure out which ones work best for you.

8

BustedPancreas, (ha - I feel like I’m writing a letter to myself :))

Thank you! I am all about wearing whatever I need to/doing whatever I need to do in order to maintain good blood sugar control. I’ve heard a couple of people say their endo’s don’t work with OmniPods. I will say though, that if my endo had told me no, I probably would have switched doctor’s. In the end, it’s my body and my disease and only I can figure out what works for me.

Unfortunately, I tried it out and it’s simply not working. Thank you for your advice, and yep - looks like I’ll be all tubed up again! Been that way for 14 years… I kindof missed my tail anyways…

9

This is my first pod. I switched from being on injections for 10 years - where I was running A1Cs in the six - back in May - and I haven't been at all happy with the results. I didn't expect it to change my life like going to Dexcom did when I started back in Dec, but I expected it to make my life less stressful - not more.

Regarding locations - I likewise wear a Dex7+ which ahs to be on my abdomin - I would guess that I'm a little larger than you at 6'1, 230, so I get about 6 sites on my stomach +1 enough room for the Dex I'm wearing at the time. I've been stomach only as I've mentioned I haven't had a successful pod on my Arm. I've tried about 10 and not one of them has made it from day 1 to day 30.

I'll get my first A1C back tomorrow or Friday, and I'm going to guess I'm in the 8s.

I guess it's good to hear that pumping is not supposed to be like this - because I'm pretty much at the end of my rope with it. I called my CDE (provided by insulet originally) here in DC today and asked to see her again - I haven't in the 4 months since then. She referred me to the INsulet RN in the area who is meeting with me next week.

Honestly - if I don't get some sort of revolutionary information, I don't see me continuing this way. I'd rather have the needles, not have this thing putting holes in me. And I don't think I can do a tube pump at this time...

That's my 2 cents, and I'll share with you anything I learn from the Insulet RN when I meet with her next week.

Regarding my opinion of the Omnipod - if you're riding a smooth 120 with the minimed... It would probably take a crowbar to separate me from that kind of result.

10

I'm a very happy Omnipod user who is getting great results with very few of the issues you have reported. I would also add that my endo wasn't exactly against the Omnipod, it would be more fair to say that he is a big supporter of the Animas syetm. That being said, he did not hesitate to work with me once I chose the Pod and he is also very happy with the results that I am getting.

The bottom line is, if you are not getting good results with the Omnipod, have done everything in your power to make changes, and still get better results with the Minimed, then I would have no hesitation recommending that you go back to the Minimed.

No single system is for everybody!

11

I would not hesitate too to go back to what works, and if you not only feel but DO get better results, I'd be packing the Omnipod back up and saying thanks but no thanks. Being tubeless to me is not worth the issues I read about fairly regularly in regards to the Omnipod. That was the number one reason I chose not to go with it. To many posts of people with post pod changes and high blood glucose, pod failures etc. Yes they can and do happen with every pump system out there, but just seem to me they happen fairly often with Omnipod. Plus I thought it was incredibly bulky as well. Bottom line is you gotta pick and use what works best for you, and gets you the best and most consistent results

12

i am using omnipod and am fed up with the issues and my warranty is up, im waiting for the tandem t:slim to arrive. tubing is not all that bad, i had the animas before the omnipod. since im wasting insulin in the omnipod i can do that with the tubing and it will be less than now with all the failures. absorbtion issues for me just started a few months ago and im just frustrated by it all together now.
I know the excitement of no tubing and now the frustration of the other issues.
we have to do what is necessary to care for our selves and i think for me switching back will be good. like everyone else im tired of the pods failing after a day or so.
good luck to everyone. like it was mentioned, not all pumps are for everyone.

13

Yeah, I totally agree that, in the end, you have to choose what works best for you. My endo was more partial to the Ping but I really prefer the MM pump (fewer button pushes, more reliability, a bit more durable, etc). In the end, she let me choose. I know there are some folks who use the Omnipod and have great success with it. I think that's fine and it's why I am all for having OPTIONS on the market. When I did inquire about the Omnipod, my endo was concerned because I go into DKA very quickly, and she didn't feel that the Omnipod was reliable enough.

To be honest, the tubing really doesn't bother me. I've learned to work with it. I almost feel naked without it on! Funny how you can get used to just about anything. I run, bike, hike and do all sorts of activities with my pump. I even got an Aquapak pouch so that I can now wear it in the water.

14

I have issues like this lately too. It seems like the insulin pools somewhere. I could dose, correct, etc for hours and then 10 hours later even if ive recently ate a lot of carbs my blood sugar randomly drops to 32. I thought it was because I was wearing it on my back so I tried my stomach and it worked ok once, but the 3 times since its been bad again.

I have loose skin from losing over 100 lbs and its all unfortunately in my abdomen, so im not sure if its the pod or that, but I really don't want to go back to tubing.