Ongoing Omnipod Problems

[CaregiverDaughter]

Thank you, SherryAnn! I’m so glad you mentioned the Omnipod Dash, because we’ve been very curious about how that works relative to the old Omnipod. (I know that it’s eventually supposed to work with the Dexcom G6 as an artificial pancreas system.)

If you don’t need to do the priming bolus, maybe that means the Dash is less prone to the problems with the cannula?

My concern, though, is that the system will be too confusing for my mom, besides the fact that there’s yet another device she’d have to carry around, since I gather the meter and pump are no longer integrated?

[SherryAnn]

@CaregiverDaughter

If you don’t need to do the priming bolus, maybe that means the Dash is less prone to the problems with the cannula?

My concern, though, is that the system will be too confusing for my mom, besides the fact that there’s yet another device she’d have to carry around, since I gather the meter and pump are no longer integrated?

The DASH system works basically the same way as the old OmniPod system as far as putting on a new Pod is concerned. The Pods are almost identical, and the way that you prime the Pod and push the buttons to start the new Pod is the same. After having said that I do not have to take an initial bolus with a new Pod, I found my glucose up today when the Pod I put on two days ago occluded, so I ended up taking a 1/2 unit bolus after I started the new Pod. (Sigh.) Life is what life is. I really do not think that the new Pods have any more or less technical problems than the old system. If a person has problems with one, he or she may have the same problems with the DASH system.

The DASH system is a bit more work since the meter is no longer included, and I have to take extra steps in order to sync the meter with the new PDM controller. The DASH controller is smaller than the old PDM, and I like that aspect better; however, learning to use the new controller does take some time because it has different screens. I could understand that it may be confusing for your mother, so for that reason, I would suggest that you show her the videos online of how to use it and let her tell you if she is at all interested in it.

[CaregiverDaughter]

Hi, SherryAnn, it’s some corollary of Murphy’s law; as soon as you say one thing, Murphy proves you long.

Thanks for the further advice on DASH. It sounds like we should stay with the regular Omnipod (since the DASH is o better), and just try those boluses immediately after putting a pod on. We have a pod change tonight, so we will try it then.

[Laurens]

Hi Caregiverdaughter,

I’m from the Netherlands and an omnipod user for 5 years now.
The issue you describe seems like a though one.
My experience with the omnipods are mostly positive. Sometimes I thinks that when the pod is altmost at his 3 days limit the insulin working curve is more slowly. I think this could be because of the same insertion site for 3 days. Your body has to absorb the insulin trough the layer of fat and maybe that’s more difficult after 2 days ore more.
I always place my pods above my waist at the front. The most effective way to a good working insulin is to stay physical active. But when you are 83 that’s not so easy.
I hope you will find a solution for this problem. Keep in mind that sytems like the omnipod are not perfect but for lots of people a far more better solution than 4 times injecting with a pen. Kind Regards, Laurens

[Lorraine]

Hello!

I’m so sorry to hear about your mom enduring a coma. How horrible.

My son has been using OmniPod for about 13 years. He is currently 16. There have been times when it seems like no insulin was delivered. I’ve never even considered that it actually did not deliver - as if the OmniPod system recorded doing something that it did not. I’ve always started with the assumption that the insulin went through the cannula and the issue must be something else - fatty food, growth hormone, less activity, bad insertion, stress, the list goes on.

If I’ve followed the conversation well enough, it sounds like the cause is hard to discern other than it happens with a new Pod - is that correct? We do not have that issue, but I’ve definitely heard of it as others here have stated.

Another thing to consider is about basal insulin. Although it may seem like it’s a bolus problem, it could be a basal problem. Through the years I’ve learned that if basal isn’t enough, then boluses work like saline - here’s where I am presuming the insulin was delivered it’s just not working. Another way to look at it is that a rising blood sugar (which will exist if basal is inadequate) needs much more insulin to correct than a stable one. This can look like a sustained high number that isn’t budging and lead to the conclusion that boluses aren’t working.

This would definitely be an issue if new sites take some time to facilitate insulin absorption. Basal delivered immediately after insertion will not be enough because it’s not getting absorbed as efficiently as it does after it has time to settle, therefore the start up bolus that others have mentioned mitigates against that.

I’m sorry if I’ve repeated what’s already been said. I did start to scan some of the later comments.

One more thing to consider, and I understand your situation seems more precarious since you are working at a distance, but we have a sense if a bolus isn’t working and we won’t wait too long to take more aggressive action. It sounds like dexcom is a great help to you. I know it was a game changer, specifically the Share option, for us.

My best to you and your mom!

[lainiep]

Wow! Lorraine, your son is 16! I was active on Tu years ago, just getting back in, and remember you as a fabulous and knowledgeable advocate for your young child! Time gets away from us!
A few questions concerning this discussion. I have been noticing crazy highs as if insulin is not effective or being delivered in the last few months also. I eat healthfully over all, usually cook vs eating out, but it is not unusual for my meals to contain fat. Like your mother, Caregiver, I was diagnosed later…at 50. I’ve used the Omnipod for over 10 years. Using extended bolusing, I had high fat meal dosing down for most of that time, even pizza or the rare burger and fries. 15 years later, I’ve had to up my bolus 25% for those type meals. Could it be an insulin resistance with age scenario? Someone suggested a less site tolerance with age situation. Ouch! I hadn’t considered that. I absolutely suspect a day 3 thing, too. I find myself dosing like a madwoman to get that extra 8 hours. Lots of possibilities for problems.
One more question for those of you recommending back up injections…does your Medicare or other insurance cover some of the cost of both pens and pump supplies? I’m already paying a fair amount out of pocket for Opod and Dex.

[Marie20]

You have the insulin you fill up your pod with, you just need pen needles for pens or syringes for vials to use it as a back up. It’s cheaper for me to just buy a box at $20-30 than to go through insurance for them since I use so few.

[Jackie_Muhlstock]

Hi, I’m 81 and was diagnosed at 78. I have resisted getting a pump because I’m willing to keep doing finger sticks and injections. I’m on short acting Humalog and long acting Toujeo. My feeling is that as long as I’m capable of doing it this way I can better manage my blood sugars. Just a thought if your Mom is able.

[T.Speth_FF]

My wife is T1 Diabetic. Uses Omnipod and G6Dexcom.

Since 7pm she has been over 500. The Dexcom app only shows up to 400. Glucometer showed 574. she continues to give the suggested insulin with no change. This is NOT the first time this has happened. She switched pod sites, I am now suggesting going back to the syringe and see if that will confirm my suspicion of the pod hardware not delivering although it records that is has. Any feedback is greatly appreciated.

I have over 50 screen shots of incidents like this bot hypo and hyper. When she would go see her Endocryn (I attend most with her) they do adjustments and sometimes it helps sometimes not as much. I just have my doubts and concerns about the devices performing as it should.

[mohe0001]

I think you caught this kinda late.
Otherwise, I would try and determine the cause. But its too late for that. Gotta fix it right away.

First thing to to do is go on syringe insulin with a brand new bottle of insulin.

Defective Pods are very rare. If she is seeing this level of repeated failure, there’s something more to the story.

Lets check the basics, then I’ll try to call out to the peeps who had similar issues…

1.) Why isn’t she adjusting her own insulin? Its questionable judgement to let some random Doc, who doesn’t know anything, do it. That’s a recipe for disaster.

2.) Why is the sensor and the pod cutting out at the exact same time? Suspicious. Make me think there is potential for interference with the wireless signal. Are you in Portland or somewhere with a lot of police radio interference?

3.) Lets talk about her body type. This is one of the most common causes of omnipod hardware failure. Omnipod is NOT a good fit for all boy types/sizes.

4.) Where is the pod located on her body? Does it fail repeatedly in that location? Does she think she might have scar tissue there? How long has she been on a pump? How long has she been diabetic?

If I can be frank with you, I’m feeling some red flags here, that she might be kinda ‘burned-out’ on diabetes or not engaged with it. I think that you are right to be concerned. I feel worried about her. Why do you think that you are making this post instead of her? Does she hate diabetes and taking care of it? I ask for your sake. That’s a long, hard road for you if that’s it.

I’m not trying to judge - I’m super burned out on diabetes, myself, lately. This has that feeling about it. Its just a feeling. Gotta ask because some problems are physical and some are more mental/emotional. Gotta ask.

[CaregiverDaughter]

Sorry to all for my delayed response. (It’s been a surreal few months.)

I wanted to report that the suggestion above – making sure to give a bolus promptly after putting on a new Omnipod pod – has worked totally! My mom’s pod, which would sometimes apparently fail to deliver boluses, has behaved perfectly when she’s followed this procedure (and not behaved on the occasions when she’s messed up the sequence of events).

T.Speth_FF, besides this, we’ve noticed another problem with my mom (who is now 84). Whenever she has a minor illness or infection, her number goes crazy high. On those occasions, if I am present, we administer very large doses of insulin for a couple days to keep the number down below 300. If I’m not, we follow the doctor’s advice and send her to the ER.

But hopefully, in your wife’s case, following the sequence of pod change then immediate bolus (which needn’t even be large) will help.

[CaregiverDaughter]

Mohe0001, I think T.Speth_FF’s wife is having the same issues as my mom (and as others above have reported). The sensor and pod haven’t both failed simultaneously – it’s the pod that is not administering boluses; the sensor only goes up to 400, and above that reads “HIGH”.

I have no idea why this weird fix works, or why Ominipod doesn’t either correct the problem or make the required sequence of events clear. (I gather from previous googling that there has been litigation.)

But trust me when I say, this fix really saved our bacon. I come from a family of doctors and techs, and we all applied our training to this problem, to no avail, until I went on this board and found this solution.

[mohe0001]

Could be a coincidence - but the sensor data craps out around the same time as the pod.

I never did see what you uncovered in this post. i’ll need to re-scan it. Did you get a steel cannula? Or, was it the “push down and apply tape?”

Make sure that you are sending omnipod that broken hardware. They will want that. They will send a replacement if the hardware is broken. They take it apart and figure out why the failure occurred in the case of hardware failures.

[T.Speth_FF]

Mohe thank you for the feedback and questions so no hard feelings.

“Caught this kinda late”…

• I can’t argue that, What I will say is that my wife has dealt with diabetes since she was 3 years old (now 32) so outside of her appearing altered I tend to make suggestions based on how she is presenting to me.

“Go on syringe insulin with new bottle”

• We tried a new pod first in a different site to see if possibly that would have a different outcome. Our next move was going to be syringe and this morning agreed that we would do that first. What difference would a new bottle of insulin suggest?

“Level of repeated failure”

• Apoligize for misleading you, Incidents such as what I described has happened 3x. Once while pregnant (not a big surprise), about 2 months ago, and last night.

1. She does adjust on her own at times but just slightly until she can see her Dr. She has been seeing him for over 6 years and we trust his judgment and IMO does a good job reminding us that a big part of dosage is trial and error and can change.

2. The sensor has a “warm up” period which takes an hour or two. This happens anytime she changes her GCM. So she goes back to finger pricking and enters the results in her Omnipod device.

3. My wife is 5’ 4" 120-25lbs. Is not a cross fitter but is active every day outside of being a stay at home mother.

-Last nights incident as shown on the photo above her pod was between the lower right flank and right butt cheek. The incident prior placed in the lower abdominal area.
-As far as scar tissue goes I assume you mean from repeated placements of the pod? If so she has at least 4-5 different sites she will place the pod but something I noted.
-She has been on the pump for 3-4 years.
-Diagnosed type 1 at age of three. Both of her parents were type 1.

The burned out vibe has shown from time to time accompanied with some mental health battles. Mental health has been night and day better over the last two years with adjustments that were years overdue, a baby that has given her so much motivation and “purpose” and she no longer is employed in an environment that really was at the core of some anxiety and frustration. But I do believe times of feeling burnt out was a factor.

According to my wife her A1C… (im sure I botched the correct verbiage) over the last 2 years has been in the best range ever ; This came after a diet change to vegan.

Why did I make this post?

• I love my wife and I leave for work 48hrs at a time sometimes longer depending on what’s going on around the state. She never complains but I know she is exhausted with a teething baby at home. I simply took the initiative while she was going thru an episode that has happened before and am now looking for some feed back from the DM community. It has been a big challenge but like her we have had to deal with losing a parent before the age of 15 so we are as “accustomed” to things not being as ideal. I embrace the “hand” we have been dealt as a couple, a big reason why I chose the line of work I am in.

THANK YOU for asking those questions, I really do appreciate it because you are right in that snowball that can happen to anyone.

[T.Speth_FF]

I asked her if she already gives the bold right away and she said she never has. She did mention a “warm up” period that takes a good hour or so though. Not sure if that makes a difference or can be worked around.

[T.Speth_FF]

All the replies especially what’s seems to be a common solution or way of preventing anything as such is music to my ears and exactly why I went down the rabbit hole a bit looking for discussions related to this. Thank you

[CaregiverDaughter]

The warm-up period you mention is probably the Dexcom sensor’s 2-hour warm-up. Your wife will have no data during those 2 hours. My mom always does a finger stick halfway through – and last night, her number had fallen to 58 at that time, so we consider that an important precaution.

Regarding the boluses, though, I can’t emphasize enough what a difference giving a bolus immediately after changing the pod has made. Before, we had repeated problems with out-of-control high numbers apparently not responding to Omnipod boluses – once, before we started using Dexcom, Mom went into a diabetic coma with a number of 880 and was in the hospital for over a week – and since receiving that advice from this forum, her numbers have been well under control.

A useful tip I received above was that the pod should be changed before a meal, when there would ordinarily be a meal bolus.

[CaregiverDaughter]

T. Speth_FF, I can also relate to your taking an increased interest since you are so frequently away from home. My parents and I live in different states, but unlike your wife, they are of an age where there is naturally some cognitive decline, not to mention generational ineptness with technology. I became involved after my Mom’s coma, got her on Dexcom and installed their “Follow” app on my phone. You might do that if you haven’t already. If your wife has a problem at night when you are away, the app’s alarm will sound and you will know.

[mohe0001]

@T.Speth_FF

What difference would a new bottle of insulin suggest?

Well, she’s just so miserably high that I’m trying to get here back to normal ASAP. In the summertime, when things get serious, I always break open a new bottle (just in case the old one is aging or got left in the car). Every once in a while, your working with a bad bottle of insulin.

@T.Speth_FF

Level of repeated failure

3x is in the realm of ‘typical’ user experience. Are you guys hearing alarms from those failures? If so, call Omnipod and find out exactly what is causing that failure. They can look up the error code and give more specific information.

If your not hearing alarms, then there is something stranger going on that will be hard to uncover and it is more likely to do with her physical body - for instance, she placed the device on top of scar tissue.

2. That’s just bad luck, then. The timing of the sensor restart was at an unfortunate time. That helps explain why it took longer to discover that the pod had failed and contributed to why she got so, so high.

3. Your wife is petite. Petite women and some children tend to see more Omnipod failures. I think its just a big, heavy device that is physically difficult for smaller people to support. I’m 175 lb female and I don’t have any trouble (I’m a large human with a lot of surface area). But, she might be kinda walking the line of not having enough tissue to really support the device. Sounds like she’s doing OK with only 3 failures. But, its something to keep an eye on.

As a smaller person, adequate rotation of the device on her body might be trickier. It will be harder to find good ‘meaty’ spots to place it.

If she starts seeing lots of failures, she might need to take a pump break and return to manual injection. That will give her body tissue time to heal from the trauma of the pump. The tissues and pod sites might need time to recover. So far, it seems ok, though.

Keep an eye on one another during this strange time. Lots of lifestyle changes are hitting everyone pretty hard. Diabetics have a lot of experience adapting to lifestyle changes and are pretty resilient. I’m, frankly, more concerned about ‘normal people.’ But, its good to be aware of one another during this time.

Thanks for being someone who provides support to a member of our community. Your a good dude.

She seems ok, but be aware that your wife is autoimmune compromised (probably) and is at increased risk of covid infection, so keeping stable numbers is important right now. We all have bad days. Her good a1c is super helpful. I think that the Diabetes Technology Society will host a meeting about what we do and do not know at the end of August. Might be interesting. Diabetes Technology Society

DPAC has a meeting tomorrow, it turns out, on a similar topic: Virtual meeting

[T.Speth_FF]

The follow app has has significantly decreased the level of paranioa, worry, when i am away from home! My post are not meant to bash these devices because of what it has done not just for but me as well when away not having that constant thought of is she ok when i need my focus and attention to be on point with a member in my communty that needs our help.

My reference of this happening 3x is not exact but i know this has happened 2x in the last week or two. We always try an rule out any ‘user errors’ First as the possible culprit.

-RSVP’d to the webinar thank you

My post are me doing just that, only im the one asking for help in this situation.

She does a great job storing the insulin in a cool place such as the fridge. Good to know however i do not think this is the case.

I have had more direct, valuable feedback, pertinent questions specific to the issues at hand to my wife in the last 24-48hrs than IMO recieved over the last 3-4 years since her being kn the pump. Thank you all for taking the time to RESPOND and not afraid to ask me or suggest something that could be easily taken as an attack, resulting in the “?” Or advice never being offered!

Aplogize for my long winded-grammar punctuation error loaded response