I’ve seen a number of threads about this, but many seem to be older. I’m hoping someone with recent knowledge and experience can help. I’m on MDI and debating between an omnipod or t-slim. I have a Dexcom G6 and like the idea of integration.
Any word on how soon Omnipod will integrate with Dexcom? If so, will you be able to upgrade your PDM or Dash for free? (I’ve read “summer” but my educator said late 2020 was more likely. Has anyone heard anything else
Will the integration include something like Control IQ and Basal IQ like the t-slim has?
If you have a Dexcom, where do you typically put your omnipod if you’d prefer not to use your arm? Does it feel overwhelming having both on your stomach?
I’m leaning a little toward the omnipod since I think it might be an easier transition to just having another pod vs. something with a tube, but I’m not crazy about waiting so long for the integration.
If you have the new dash, how many things do you have to carry if you have a Dexcom? Right now, I have my Dexcom receiver, regular meter for backup, and pens. I have an android, which doesn’t seem to work with an Omnipod apps. Would I just add the Dash to the mix? Does that show your Dexcom #s or is that to come?
While the integrated technologies keep improving every month but still have a long way to go you may also want to consider a digital pen as an upgrade to what you have but not yet commit the 5 years to a given pump/cgm system. European digital pens dose to 0.1U increments while US only does 0.5U increments but still a pretty good upgrade from where you are now. I am MDI on a Korean digital pen that can only be ordered in Europe and shipped to US and it is not US FDA approved but works awesome at 0.1U increments.
I keep hearing soon on the integration of Dexcom and Omnipod, so I’m pretty sure that means you can’t tell if that will be next year or two years or??? I would hope that it seems the way the trend is going that they do it sooner versus later or they will be behind the times.
But I can help you with where I place my Omnipod and Dexcom. The Omnipod is approved for more places, but people really put them all over the place. I suppose it’s whatever works. I had a Libre before the Dexcom so I was used to the Libre on my arm and the Omnipod on my stomach. So I put the Dexcom on my arms and move the Omnipod all over my stomach. The Dexcom stays on longer (less territory on my arms) and the Omnipod has to be moved every 3 days.
I don’t wear any of these items so I have no personal experience to offer. Trying to take concrete actions now, like funding a flexible spending account (FSA) for next year, can be risky. While diabetes tech on the horizon can end up being ephemeral as a lake seen on a desert horizon, we do know some things.
Tandem’s introduction of its hybrid closed loop system, Control-IQ has long been promised for late this year, 2019. Since today is November 12, I can see that they’re not planning to surprise us early. I’ve not read any company communication tempering our expectations so I think it will come out by December 31. I would feel comfortable making an FSA commitment on this one but you must accept some risk that it may not work out.
Insulet’s Omnipod, however, seems further out in 2020. When the expected timeline goes out that far, I don’t think it should be used to make any financial commitments like funding next year’s FSA.
If it were me, I’d place my bet on Tandem’s Control-IQ, but I don’t have any problem living with insulin pump tubes. Good luck with your choice!
Here’s a diaTribe tech forecast from last June, a bit dated but provides useful context.
Terry4 Thanks, that’s definitely helpful! It turns out I had to submit my FSA amount super early this year, so I went with a number that would be okay if I decided not to get a pump. So far, t-slim has run my insurance and given me #s, but I haven’t talked to omnipod yet. I’m unclear about the upfront costs with omnipod since the pods are disposable - is it just the dash/PDM? T-slim was going to run me about $1128 after my deductible and 10% co-insurance.
@CB11 Omnipod got the status of the pods changed a while back so it falls under the DME category I think for all insurance companies? I believe they have said they will help you with the classification if needed? The pods cost can be a trick. It depends on your insurance. But they have never cost me anything being classed under DME under my insurance. But I didn’t have to pay for any deductible for my PDM/pump either at the beginning.
It totally depends on your insurance. Medicare classifies Omnipod as a glorified syringe and you can only get it through Part D pharmacy benefits. Omnipod is much more expensive on Medicare than tubed pumps which are covered by DME.
Hi, I have the G6 and the omnipod. Chose not to go with Dash cause it doesn’t change the technology, just a different looking device. My endo says they have the integration basically done, but have to improve security so the device can’t be hacked.
I wear my G6 sensors on my hips, it’s the perfect spot and totally out of the way. (I use an extra patch to keep it secure). That leaves my stomach and lower back for the omnipod. I will put either on the back of an upper arm if I need to give a spot a break.
To be honest I’m not actually that excited about integration. That may sound crazy but hear me out. For example, my sister who is type two, has been on an integrated Medtronic system since basically day one. She doesn’t have the first clue to how to make adjustments as a result of the machine doing it for her all the time. She is very dependent on her doctor to make decisions for her. I’ve been doing this for 40 years so probably won’t forget quickly, but still it’s something I worry about.
I’ve had an omnipod for about ten years now. I will never ever go back to tubes. I would go back to shots before I would do that.
so since the g6 works with your iphone and the omnipod works with its device you always have to have both available correct? trying to see if this will make things easier for my daughter… we always keep the iphone charged and available so we know where her bg is… do you basically keep both always close by or does the omnipod device get used only when giving a bolus? keeping my daughters iphone close to her is an ongoing battle, having to keep 2 devices will be even harder lol
Hi there, yes, you do have to have both the Omnipod Controller and the G6 controller (or your phone) on you. That said, your basal rates and anything else programmed into the Pod, will continue to happen even if you don’t have the controller on you. So for instance, when I’m at work, I don’t carry the Omnipod controller around with me all the time, just my phone. If I need to change something, I can run back to my office to get the Omnipod controller and make the change. So as you said above, the Omnipod only gets used when giving a bolus.
There was a long time where I would temporarily lower my basal when low, till my BS came back up. I have found lately though, it just results in a rebound high, so I don’t do that anymore. If that was something your daughter was used to, she might want to have the controller with her.
Anyone play sports with the Omnipod? Currently am MDI and having difficult time lately keeping my numbers <200 after meals. Does come down after meals nicely however after 2 hours rises again. May be an absorption problem and may need to wait longer to inject. My question is I am active in sports and am concerned as to being away from my phone for length of time when out on the baseball/soccer field. How eill I monitor insulin. Also the pod continuously gives small doses of insulin throughout the day so what experiences have any of you encountered if the pod malfunctions or is removed from the site? I have G6 and at times it reads high when BS are actually 50pts lower aeb fingerstick. That concerns me. Any safety measures built into the omnipod
I am on Omnipod and my sports are snorkeling once a week and an exercise bike 10 miles every day. I only have ever been on an Omnipod because I only wanted a tubeless pump.
A pump makes sports way easier because you can suspend or what I like the most is a temporary reduction of insulin while you are active. Personally a pump makes it easier to maintain a lower BG level after meals for me too. Although there are plenty of people that do that on MDI too.
But a pump makes it easier to give small doses in steps for meals, I just didn’t do that as much with a MDI shot. So I give a prebolus, and a bolus when I eat. You can with an Omnipod, give yourself 2 separate bolus amounts or you can give a 2 dose set up with picking your prebolus amount and doing an extension or release of bolus insulin over an amount of time. And a CGM allows you to watch and give any adjustments as needed. Any instructions are programmed into the pod and you don’t need the pod until you want to change something or take another bolus. But it is so much easier during the day and the variety of what our Bg’s can throw at us to give those little correction doses as needed throughout the day.
So my basics to snorkel I do a 50% reduction of basal a half hour before I snorkel for 2 hours and I snorkel for an hour. This has worked extremely well for me. I had read that it is better to reduce insulin versus stopping to stop the rebound rise in BG after activities and it seems to work. Keeping in mind I do have to do a few adjustments depending on my starting Bg level which I do need to increase to snorkel etc. And how hard that exercise will end up can vary for me.
As for your CGM being off. Some people have better luck than others with it’s accuracy. Mine I am able to usually keep within 5 points. I always calibrate it when I have a straight arrow for at least 15 minutes. I also always only calibrate it when I am 95-105 as that is when I want the most accuracy out of it because that is when I am doing my dosing for meals. I don’t even pay attention to it’s accuracy when I am at 140 etc, because for me I just don’t care? I either have spiked up because I ate and mistimed my dosing so it’s explained or it’s because I guessed wrong etc and I know that and need an adjustment. But mine is never far off either. In the past I have found it becomes more inaccurate at the higher numbers.
Do try to calibrate your G6 and then about 4 hours later check it again in case it needs another one. I just check it immediately upon starting, then about 2-4 hours after. It needs a calibration for me at one of those times, usually not both. Then the next day I fine tune it to be closer if needed. Can you maybe carry the cgm reader out with you so it can give you an alarm when needed out on the field?
Pods or sites malfunction. With an Omnipod you can’t tell what the problem is that caused it really so much as it’s not working well. That seems to show up right away when you first put it on. I suppose it could get torn off during sports and there are overtapes to help stop that. Once it’s off, you stop receiving insulin and that is a problem if you are talking hours. But you can always give a shot and use the pod to get insulin from at that point as long as you have access to a syringe.
Omnipod is working on a loop system, the hopeful release date seems to be the end of next year. That would have a shut off feature that the tubed loop pumps have now. You can do a do it yourself loop system with the Omnipod now. I have a thread I asked what is needed here, starting with you have to have a riley link.
Thank you Marie20 . Good information. Love to hear from those that have done this for a while and the successes and setbacks they encounter along the way. My endo and diabetes educator have never suggested considering changing insulin or using combo. They just play with the amounts of insulin and timing. Also they have told me that I should not take more insulin between initial dose, say after a meal, and to wait 4 hours until next dosing time. I do not see how this is beneficial. If I wish a snack 2 hours after, why could I not take more insulin? Do understand that my insulin, Novolog, has a 1 hour peak and lasts for 4 but what do others do if between meals want a snack? Our pancreas will put out insulin at any time it senses an increase in BG so why not do the same with insulin? Also I am having wt loss, muscle wasting, which is very concering, Already at low end of BMI and have noticed this past year or so 12#. Now I am concerned on exercising due to kcal deficit if wt loss is occurring. I have a high metabolism and need to eat frequently. Question is how do I do this while taking insulin. This forum is great and I cant thank you and all who provide real life experiences. This is fairly new to me since diag 2.5 years ago. I am a Registered Dietitian and CHO counting is easy, the hard part is getting the right regimen with the insulin and understanding the peaks and unknown reasons why mu BG will rise even if no food consumption. Hormones, stress, etc. Arrgh. A1C is 6.5-6.7 and for me too high. Want it around 6-6.5, unrealistic, maybe but need to try. Thanks again
I think the typical conservative Endo is overly concerned with stacking and risking lows. But if you’re able to determine the active time for your insulin and estimate your IOB, there’s no reason not to take additional doses. Some IOB calculators just assume an equal amount is used each hour instead of a curve. I’ve been experimenting with a 5-hour active time for my Humalog, which starts very slowly and peaks hard between 2.5-3 hrs. It seems to be accurate for me.
This is for me, we all can really differ. I always give adjustments whenever I think I need them. I actually have my pod’s insulin on board set for 3 hours. My insulin is mostly done by 2 hours with a petering effect for the next hour. And while it sometimes has a tail that kicks in at 4 or 5 hours, it is usually really small. I will just eat 2 or 4 carbs to make up for it if I am going to drop below what I want to be at.
If I snack I take insulin for it. If I snack 3 times, I take insulin 3 times.
You obviously need more food if you are losing and you don’t want to, so you might try some nice big snacks with some insulin. I still try to prebolus any significant snacks. Experiment. Honestly the longer you have this the more you learn you have to experiment to find what works for you.
Sports are the hardest for a lot of people. It takes some figuring out. A CGM helps a lot for me. Usually for my exercise bike I take a little less insulin so I can ride my exercise bike. It doesn’t always work and I have to eat 2 or 6 carbs to finish. I can easily do that with my bike at home, but not when I snorkel. I play it safe when I snorkel because the risks are so much higher. A pump allows you that versatility.
A really good book about responding to your BG levels is Sugar Surfing by Stephen Ponder, he also has a website that has some really nice information.
Going to the original question (sorry I know this is way late, as in a year or two late) — the Tandem + Dexcom combination is truly incredible. Best improvement in my Diabetes care since I first got Dexcom 12 years ago. Control IQ is fantastic for nights… even bad nights where I get high, Control IQ generally does a good job limiting the upper bound to 180 or so. Most days, I just sit between 90 and 110 and can sleep through the night. Would highly recommend giving it a shot, as long as you can get used to having a pump with tubing.