Omnipod occlusions

Our son had two of them during the last two changes. The last one was at school. You can imagine what we had to go through to change to a new pod. His sugar levels had reached 300. There was no choice really.

I had heard of occlusion with Pods, but didn’t think we will have two in a row in less than 2 months of use. Had Minimed pumps for 9 years, not a single blockage. In fact, we switched to Apidra two months back with an understanding that Humalog may cause occlusions, but not Apidra.

Does anyone has any experience / comments / suggestions here? Occlusions can happen anytime. How do you keep yourself prepared for it? At one time, I thought of giving him a pre-filled backup pod for an emergency situation, but Omnipod won’t let you do that either!

Omnipod agreed to replace the pods, but the insulin? In fact, I am just not too happy at the amount of insulin we waste (30-50 units every change). It would have been easier if the PDM gave us the exact amount of insulin at the fill time. All the pumps we have used have given us this very useful info. Don’t understand why Omnipod decided against it (BTW daily totals are not much of use if you change in the middle of a day).

You’re lucky that Insulet agreed to replace pods because of occlusion, as occlusion does not represent a failure of the pod, just “bad luck” (or even possibly user error, if it was placed in a spot with too little tissue or too close to muscle). The only time I asked for replacement for an occlusion, it was denied (quite reasonably, in my opinion). There really is nothing they could do to prevent occlusions.
It seems that some people experience more occlusions than others; for example, in almost 2 years I’ve only had 3 or 4 total, while I’ve heard others who have that many every couple of months.
As for wasting insulin, after about 6 months of usage I had figured out my normal 3-day usage to within 10-20 units. Now my pods typically have around 20 units (plus or minus 10) remaining when I change. I seldom waste more than 30 units. I think after a while you’ll find your son’s “magic number” and get good at filling only that amount.

When you say occlusion, do you mean it resulted in an actual occlusion alarm? I have had site difficulties that resulted in abnormally high BGs, but I only consider a true occlusion to be signaled by the pump alarm.

Those were real occlusions. The PDM even deactivated the POD, all by itself. This, of course, caused high BG levels.

You did put on a new pod as soon as the occlusion alarm went off, right?

“As soon as” means asking wife to bring the supplies at my office at UT Dallas, waiting for his class to be over, and changing the POD in the middle of the parking lot. This whole movie-like scene lasted for about an hour and a half.

This is what worries me the most. What if we were an hour away from home or something like this.

Avanti -

I am having a little trouble figuring out your son’s age. I ask only because if he is old enough is there a reason he doesn’t carry insulin and a pod on his own? I have been carrying a vial of insulin on me since I was 13, just wondering on that.
As to which insulin is better in preventing occlusions that depends on who you speak with. I would suggest that you visit the websites of Apidra, Humalog and Novolog and read their info for “pump usage” . You can also visit the FDA website and see when each type of insulin was approved for pump use.
There is a lot of information out there regarding the differences between the analogs and Apidra. In the end it really comes down to personal comfort.
Not to be a pest on this but was it an actual “occlusion alarm” or a pod alarm that occurred? In both situations the pod stops delivering insulin but they are very different alarms. Also, the pod actually deactivates itself in these situations.
As for the insulin waste, you do not have to fill the pod with a full 200 Units. Once your son gets a groove going as for insulin use over the three days surely you can fill it that amount plus a % to cover for the occasional trip to the ice cream parlor!
Lastly, if they are occlusion alarms that are happening is there any chance that it may be due to pod sites? You do need a little bit of fat in the pod site area for success, especially in the beginning. Pods located in lean/muscular body areas tend to occlude easier (as do standard pump infusion sets as well).
I wish your son great luck with the Omnipod, it is a wonderful tool for diabetes management.
my best to all of you…

He is 18. Was diagnosed at 9; has been wearing a pump since then. From day 1, I have been handling his case, so now even when he is an adult, I still take active interest in his diabetes.

I didn’t even check the PDM. He told me that it was an occlusion by reading the PDM info, so I am assuming it was that. Now that we have gone through these occlusions, will pay special attention to factors like choosing an appropriate site. Also, he may have to carry a change with him all the time.

His 3-day 8-hr consumption is around 150, so we try to match that. We changed Minimed pump site only after all the insulin was gone. So, I guess we’ll have to get used to this new way of doing things.

Apidra is working just fine. Somehow, I feel that we have more control with Apidra than with Humalog that we used for 9 years. But with so many other variables, it’s hard to say.

My son is 9, and we do carry a pod everywhere we go - with his current vial of insulin. It’s not pre-filled, but by the time he’s traveling around by himself I’m hoping he can fill it himself. At school he has an extra pod, but I haven’t trained the nurse to fill it. I think my son could probably walk her through it, but we have syringes and insulin at school too - just in case. Can your son do his own changes, but just didn’t have the spare pod and insulin?

Did Omnipod give you the “pinch up” technique? They told us to do that when my son had his only occlusion, but since it’s the only one he’s ever had, we haven’t tried it. I’ve heard other people say that it works for them - you pinch up where the pod injects, a little like you would for a shot.

I had an occlusion day from hell three weeks ago today. I am a software instructor, and my pod occluded just before lunch. I silenced the alarm and kept teaching. The pod was scheduled to be changed later that day, so I wasn’t upset and didn’t waste much insulin.

I was more concerned about going low than high, so I got lunch, ate and then changed the pod at the end of lunch break. I started class, and about two minutes later, the new pod occluded. I silenced that alarm and kept going with class until afternoon break and changed pods again. I salvaged the insulin from the old pod and put it in the new one. About two minutes after I started class again, the third pod occluded. I ended up waiting until after class before changing out that pod. This time I did not salvage the insulin.

Needless to say, I was freaked out. I was on a business trip and thought I might have to have my wife overnight me more pods. I had brought enough pods for the trip plus the two extras I always carry with me (CDE’s recommendation). One more wasted pod, and I would have been toast.

I think at least one of my occlusions occurred when I had the pod too far to the side. I never thought I would have to worry about not having enough fat! I am applying my pods closer to the center of my body now. So far, so good.

I am glad that we got educated on this aspect of the pods. Especially after reading your story, we will carry at least 4 - 5 extra pods when on vacation. We were in Australia a couple of months ago. Imagine running out of pods there! Anyway, we always carry syringes and an extra vile of insulin when traveling.

I was advised to bring slow-acting insulin (levemir, lantus) with me as well if something happens to the PDM and I cannot get basal doses once the active pod expires. This was part of my training when I started on the pump.

You should be able to extract insulin from the failed pods and put it in the new ones… Also, my doctors told me to always have an extra pod on me just in case, along with insulin. I’ve always got them in a backpack. It rarely happens so I honestly don’t think it’s a problem. But it has once when I had it too far to the side as well. It’s all been said… i just thought i’d reinforce it since it is valuable to be prepared.

Extract insulin from used pods (like after 2-3 days of usage)?

My son has been using the OmniPod for over two and a half years and during that time we have had few occlusion alarms. The ones we had were at the very beginning and the one time we tried using his arm. Once we got accustomed to what sites work for him, we have not had occlusion alarms.

I just had a conversation regarding this with Caleb’s endo on Monday. Her experience is of the three fast acting insulins, Novolog results in the least amount of clogging. I have heard of several people myself who have found Apidra to clog particularly in extreme temperatures.

Caleb is 6 and I carry at least 2 Pods and insulin with me wherever I go to be ready to change a Pod. We were just out of town for three days and I brought 6 Pods. During a routine Pod change, two of them failed upon filling (which is a rare occurrence for us). I had thought six was overkill for such a short period of time, but was happy to have them all after that.

There have been times when the cannula is bent or on the third day of use tissue starts to build and we begin to see unexplainable highs. We find we may need to change his Pod early for these reasons, but not because of an occlusion alarm, which is the reason we always carry around backup supplies.

If you were to fill a Pod to have it ready, it will error after a few hours if not activated and thus is not an option.

No, I would recommend against that. I think Insulet does, too. After a couple of days, that insulin has been in close proximity to your body, which can emit quite a lot of heat. And we all know that prolonged exposure to heat can lower the effectiveness of insulin. If you start mixing that insulin with fresh, I think you’d be asking for trouble.