Omnipod question

Hi!
Looking into “untethered” pumping. Even though I know the dash is tubeless, that’s the only term I’ve read to describe the idea. Anyone have any advice for omnipod dash + MDI Tresiba?

Currently MDI (Tresiba & Fiasp) & G6 Dex

My reason: to insure that I have background insulin if pod fails. As someone who has only been MDI, I believe that is a common concern when switching to a pump, especially after reading about the many pod failures.

To clarify- I would give MDI Tresiba, and use the pod for food bolus. I like to micro bolus with my pens. So I’m just tired of sticking myself 10 + times a day and I often only need half doses to correct and I’m having (well it think it is) absorption problems.

I use fiasp in my inpen now, so I’m guessing I would use fiasp in the pod. From what I’ve read you can set 0 temp basil in the dash.

Any insight would be helpful.

Also, can I loop w the dash? Need to the whole idea. I just know I want tubeless. I live in the US, if that helps.

Thank you🤙

@Laurie_S, I am on the OmniPod for 12 years now. Injecting long lasting insulin as a safety net never crossed my mind. Dexcom is my safety net. If you don’t have a CGM yet, I highly recommend one.

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Hi! @Helmut! Thank you.
I do have the G6, just worry about the pod failures, and trying a pump. With my pens, I know they are always reliable.

@Laurie_S, pods are definitely not 100% reliable. I always have a backup plan in mind. If I leave overnight, I always take spare pods with me even if the current pod will not expire before I expect to return. If I can make it home in 6 hours, then I just take the risk. My plan is to not eat anything after a pod failure. I used to always take a couple of syringes and an insulin vial with me. I have just gotten complacent since I never had a problem away from home. It all depends on your lifestyle. I am close to home almost all the time.

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@Laurie_S, I was very hesitant to switch from MDI to a pump. My wife helped me to get over the hump. She said: “You don’t have to stay with the pump if you don’t like it.” Realizing that trying OmniPod was not tied to any commitment was key for me.

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If you do that, I would suggest reducing your Tresiba to only a portion of your basal needs. That way you can still have some ability to adjust basal.

For example, if you took 50% of your basal from Tresiba, you could then adjust your total basal from the pod’s to be anything from 50% all the way up to whatever higher percentage you needed.

You’d always have 1/2 of your basal in the background as a safety net, but you’d still have the ability to adjust basal a little bit.

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I made the switch from MDI. I have made sure I have a couple of bottles of lantus around just in case, but I’ve never really needed it.
When a site fails, I just get a new one. My dexcom will alarm.
I wouldn’t be without insulin for very long.

It was different before cgm. I had a se come out a few times and started into dka.
Even then I was able to correct it.
You can still take injections of humalog if your pump fails too.

I suggest you take a long weekend to make the switch. Where you are home and you have everything you need.

Remember switching is a bumpy road. It takes a while to get the settings right.

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@Laurie_S, if you are adventurous, look into OmniPod DIY Loop. It would require that you use the older pod version (Eros) instead of Dash.

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I love my Omnipod, but they do fail. But a pump makes it so much easier to give small corrections, extend your bolus, have different bolus rates for different times of the day etc. And also have a different basal rate for different times of the day. But the Dex is the game changer and you get alarms of highs and lows, so a great prevention tool.

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I mean, yeah, occasionally a pod will fail (very rare) or get knocked off. But I just…put a new one on. My son has been on a pump for 13 years and we don’t even keep a long lasting insulin in the house. Again, if a site fails for him, we just change it out. As long as you have a CGM, there’s really no need to do a shot of long-lasting every day.

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Thank you all for your helpful tips and suggestions! I think I just need to get out there and give the dash a try!

@Terry4 Hi!!! I think it’s been a while since we last chatted. I think I read an old post of yours, that you did a similar thing in the past. Do you have any insight here for me?

I have been using Loop for nearly two years now and absolutely LOVE having the older omnipod eros pods can talk to the Dexcom G6 and automatically adjust insulin needs as necessary. There are people here using loop and a few different FB groups that offer awesome support.

You are correct that the pods are not 100% perfect. For that I typically carry a backup pen.

Hope this helps. Feel free to ask any other questions you may have.

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@Laurie_S – Sorry that I didn’t respond when you posted your latest comment. The “untethered” regimen has come up a few times in the last month or so. I might have responded to one thread and totally overlooked this one.

Using a basal insulin together with a pump is an excellent tactic to guard against going into DKA due to an undetected pump failure. It’s easy to overlook a leaky infusion site or an infusion set occlusion while you’re sleeping.

I think your idea to add Tresiba to your Omnipod regimen is definitely worth trying. If you’ve already done this, please report what you have found.

Thank you!!

Hi @Terry4!
No worries! Thank you for your response.

My endo wants me to just give it the regular go! He said we could try my idea if I struggle. I just don’t want to worry about bad sites, but will I know? Won’t my dex read high? How long is the learning curve to get that sorted out?

Honestly, I’m so torn. I do like the idea of different basal rates bc I need double in the morning. However my Tresiba is spot on at the moment.

Ugggggg what to do!!!

So far you are the only one that has really supported my idea. You have always helped me so much. 3 years now and I’m finally like you said -helping others who were in my shoes.

Also-I received the start up kit, but they sent the the Eros, I do not plan to loop since the new omnipod will do that… I wanted the dash, so Monday I have to get it sorted out.

I’ll report my experiences when I get things figured out.

Thanks again,
Stay safe my friend.

You could settle into the new pod routine and then add Tresiba a little later. Are you OK with your endo negotiation? In any case you could unilaterally add the Tresiba if you wish. My relationship style with endos for many years is to independently adopt changes (at least those that don’t require Rx cooperation.) and then tell the endo when I decide to sustain them.

My endo still asks every appointment how often I need to make insulin dose changes. My answer? Every day! It’s as if the diabetes I live with is different from the diabetes my doctor understands.

Aren’t you even tempted to try out the DIY Loop? This fall will mark five years for me on Loop. It’s one of the best decisions I have ever made about my insulin treatment. I enjoy the best control of the last 37 years and only put in half the former effort.

But, the DIY systems are not for everyone. Good luck with getting your preferred equipment and insulin lined up!

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I totally get where you’re coming from. Transition from MDI to pumping is a whole different mindset, there are lots more moving parts involved, and part of you wants to say “I’m doing fine right now, why do I want to go through all the hassle of changing things?”

My own transition from MDI to pump was more of an ordeal than I was led to expect, largely because my trainers (as is the norm) were very apprehensive about raising basal rates too soon too fast, so it was several weeks of tolerating higher BGs than I liked until I finally became comfortable enough to just take over and adjust them myself.

Was it worth the hassle? Yes, in that it gave me control over my basal insulin and allowed me to control what it was doing throughout the day, something you just don’t get with a single-shot of Lantus or Tresiba or the like. Dawn Phenomenon was finally shot down as a problem, and being able to do temp basal is super helpful.

Of course most current pumps are offering various versions of looping, which changes everything. My experience with the first-generation commercial offering of this type, the Medt. 670G was the opposite of going on a pump to begin with. Much worse results than I’d had with my standard-pump+CGI combo, and the controls for adjusting things myself were locked away. I ended up reverting to my old Paradigm, which I’m still using. The choices are somewhat better now, but I’m still hesitant to give it another try (my recent AIC was 5.7) I persist in thinking that the philosophy behind the current generation of pumps is a mix of wanting to make things easier for the patient through automation, but also to make things easier/less scary for the physician by locking the patient out of the controls as much as possible.

TL;DR:
FWIW, my endo, whom I’ve been with for 7 years and trust implicitly, has urged me to wait on my next pump upgrade (which I’m eligible for now) until the upcoming version of Omnipod comes out in the fall. Apparently the BG target is going to be fully patient-adjustable* which was the bane of my experience with the 670G (as well as the crappy Medt. sensor system).

*This information appears to be in error. See @Helmut’s comment below.

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I agree with you whole heartedly.
I was on a paradigm pump too and the sensors drove me crazy.
I don’t know the new Medtronic system, but my Tandem allows me to override the system without shutting off the algorithm.

I have my basal rates pretty perfect. When I bolus, I can take the suggestion or I can increase or decrease it, or just enter what I want.

I usually take my corrections before my Ciq. does.
It makes me feel like I have more control over the automation.
That was the main reason I switched to Tandem. I mean I hear the new Medtronic sensors are better now, but I really like the dex g6.

I tried Omni pods and I really liked the concept. But there is one infusion set only and you can’t see if it’s in right or leaking.
It was frustrating for me. Good news is that you can try them with no outlay.
You get your doctor to write a script and you only pay the copay. There is no big outlay like a standard pump.

I am waiting for the tandem sport patch pump, which allows all the different infusion sets but it sticks to your skin like a pod, only a little bigger. They keep delaying it.
It’s supposed to be controlled 100 percent from a phone. With a single button for bolus if you drop your phone in the toilet or forget it somewhere.

I have 3 years to go on my current pump, so I have time to see what comes out with pods and Medtronic and tandem before that date.

I always get anxious when it’s pump buying time because it’s a 4-5 year commitment, and I just know a better one will come out a month after I commit.

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Wow. I hope that is the case! My correction range is set to 80. I also hope DIA (duration of insulin action) is customizable, and auto bolus is supported! Then it will be very similar to DIY Loop!

Oh, and I hope it can be controlled by one’s phone whether it be iPhone or Android. DIY Loop has a nice, clean, easy to understand UI running on iPhone. But of course, a Rileylink is also required for the Eros pods.

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I watched a very recent OmniPod 5 presentation. In the Q&A part the BG target question was raised and definitively answered: Lowest BG target will be 110 mg/dL with the clear expectation that this lowest setting will result in a higher average BG than 110 mg/dL. I very much prefer my current DIY Loop target of 80mg/dL which gets me to an average BG of about 95 mg/dL.

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