We are looking into getting my 14 year old son a pump. We are interested in the Omnipod. We would appreciate any recommendations or feedback on all the different options to help us make our decision. Thanks!
There are several pumps available in the US right now - Omnipod, Animas Ping, Minimed Revel, t:slim, and Accuchek combo.
Some things to consider about each:
Minimed Revel - This is the only pump that currently has an integrated CGM. It's an extremely reliable pump, and Minimed has been doing insulin pumps for a long time. It has Carelink, which is a great online software system for managing data. It also comes in two sizes - one that holds 180 units and one that holds 300 units. I am about as rough on my pump as a 14 year-old boy and I have the Revel. It has definitely withstood every bit of abuse I have thrown its way! The pump is water resistant, BUT NOT waterproof. Basal and bolus increments go as long as 0.025, which is important if your son is very insulin sensitive.
Animas Ping - The Ping holds 200 units of insulin. It is the ONLY pump on the market that is completely waterproof. The Animas Vibe is the next model that is supposedly coming out next year and will be integrated with Dexcom. It also has low basal and bolus rates of 0.025. The meter it comes with can also function as a remote, which I know a lot of folks love. This video does a great job of comparing the Ping to the Revel (http://www.youtube.com/watch?v=2M0KeIqdYro). Anecdotally, it does seem to me that the Ping is a little less durable than the Revel (based on the number of people I've seen on this site who have needed their Ping replaced). But it seems to be a pretty solid pump. If your son spends a lot of time around water, this is the pump to go with.
Omnipod - I know a lot of people love the tubeless aspect of the Omnipod, and if tubeless is your son's top priority, this is the one to go with. HOWEVER, the pods can and do fail. Right now, the pods are fairly large (although I think they are coming out with smaller pods very soon, if they haven't already). Each pod holds 200 units of insulin. I know some people have complained about the way the system works (because the pod expires after so many days, and it's easy to waste insulin if a pod fails). My endo would not recommend the Omnipod for me because I have a tendency to go into DKA very fast and the pods just have a lot of issues. That said, if tubeless is THE most important thing, this might be the right pump for him. I will say that I am very active and the tubing on my pump has never bothered me. The pods are waterproof, but the PDM that communicates with the pods is not.
t:slim - This pump is very new. It just came out last year and has only been in widespread use for several months. The cool factor is definitely there, but it is tubed and doesn't really offer features that are mind-blowingly better the Revel or Ping (IMO). The touch screen is nice, but would make me nervous. Also, I'm wary of any new company. Pumping can require a lot of support and this company hasn't been around long enough to prove that they can do this. Also, the pump looks cool, but I would question its durability, especially around a 14 year-old. The pump uses rechargeable batteries, so your son would have to remember to charge it (other pumps use batteries you can just throw away, which is less environmentally friendly, but easier). Also, I don't think the t:slim is waterproof. But if coolness is a factor for your son, and you think it would encourage compliance, you might want to consider this one.
Accucheck Combo - I don't know much about this pump, but I do know the meter works as a remote (similar to the Ping) and it has the largest capacity (I believe 315 units).
Some things you want to consider when selecting a pump:
- lifestyle (does your son plays sports or spend a lot of time around water?)
- what will motivate him to comply with pump therapy (cool factor, something without tubes, etc)
- Total daily dosage - if your son is really insulin resistant (common in teens) and has a huge TDD, he's gonna need a larger reservoir.
- CGM - is he using a CGM now? Does he want to use one? If so, is his preference to have an all-in-one device? For me, the less I have to carry around, the better!
I would recommend narrowing it down to 2 or 3 pumps and then getting information from each company. Make sure you look at all the features and consider whether they match your son's lifestyle. There is no one perfect pump. It's about finding the pump that is right for the individual user.
I've only used the Omnipod so I have no point of reference or advice to give on any other pumps.
That being said, I find the Omnipod to be fantastic. I'm going on 3 years of use now and I would not consider another pump at this point. I do not know what it's like to have a tubed pump, but the Omnipod goes as well as I could expect with my lifestyle and activity level. For the three day stretch that they are active, I simply do not have to worry abput ever having to disconnect for showers, workouts, meetings, airports, swimming, or even full live training in Jiujitsu.
The smaller pods are already in use in Europe and are expected here in the U.S. around the end of February.
Admittedly, it wasn't set, forget, and go for the first 6 months or so. A lot has been made about the rate of failure and I did see scary failure rates for the first 6 months or so. Personally, I think a lot of that for me was user error and finding out that pod placement and site choice are absolutely key. A pod that works perfectly at one site will not work at all if it is shifted over a couple of inches for the next pod. Now that I've worked out my rotation through 6 or so areas that still have probably five useable sites per area, my error rate has dropped to practically 0. I haven't had a failure in over 6 months now. Before that, I had one or two failures per 90 day supply.
Still, on the Omnipod site, there are some that have just plain given up on the pod, so YMMV.
If you find one or two pumps that you are more interested in, I would call the companies or your endo's office to see if you can set up a trial period with your local rep. This is a sure way to find out if you like the pump by getting to actually use it. I've used the MM and Animas in the past and am currently on the OmniPod. They are all good pumps, it really comes down to personal preference. I absolutely love the tubeless factor of the OmniPod but some people find it too bulky. However the new smaller pods were recently approved just not available to users just yet. MyBustedPancreas listed a great list of features for each. If you have any specific questions, feel free to ask me :)
Hi there, my son is also 14 and started on the omnipod abut 2 years ago, it was the only one he would consider, he tries to be incognito as possible with his D, generally to his detriment but that is another story! We had a few ups and downs with the omnipod at first be overall we are very happy. Unfortunately there is a new layer of concern with any pump vrs MDI, pump failure! However the pros far outweight any cons esp with busy teens looking for more independence. so much better to wip out their PDM and do a quick bolus. The biggest issue we had was highs after pod changes, alot of people experience this but it is resolved with a small bolus after changing the pod without food. It is great for swimming, may need to add some extra reinforment we like tegaderm for more "vigorous" swimming or activity, but once they have a sense of this new thing on their body it gets bumped alot less and that pretty much becomes a nonissue. If he is currently pretty stable the transition should be pretty smooth, some endos recommend a saline week to get used to it, we did this. and they start with a slightly lower basal at first so their are some adjustments. dont expect perfection, expect some frustration and extra testing at first to figure out setting but also through a throw out the lantus party!! as this is my only experience it is all i can share, please ask away if you have more questions. along with the 14 year old ...we probably have more to share at another time! best wishes! amy
My daughter has been using the Cozmo pump for just over four years. We loved it but as you probably know, it is on longer being manufactured or supported by Smiths Medical. Today, we switched to the Tandem t-slim. It looks like it is going to be a great pump. Very intuitive and easy to use.
Wow! Thank you so much for all the info!
The t-slim is another one we were interested in, let me know how it goes. Thanks!
Thanks! I appreciate all the comments, will definitely help with our decision. Jared is an ice hockey goalie, and is very active so the Omnipod does sound like the best choice for him. We ordered a sample to check it out.
When the pod fails, what exactly happens? Blood sugars go up? How long does it take before you realize it fails? Could it cause serious problems if we don't get it right in the beginning? I really think the Omnipod will be best for him, but I want it to be safe and not make anything worse for him. Thank you for answering!
Two additional item to consider:
1) the pump should have insertion sets that your son likes. I'm needle phobic and need a angled set and the Animas Inset 30 really meets my needs. If the sets for a given brand don't work well for your son he will have more bad sites than necessary which will not make either of you happy.
2) insurance companies often have funky rules that raises the costs of the supplies for one pump or another. Blue Cross Blue Shield of MA will only cover Bayer test strips as an exception at the highest co-pay. This raises the cost of using the Revel. If your insurer doesn't support One-Touch at the base co-pay level you'll pay extra if you use a Ping or Omnipod.
MyBustedPancreas couldn't of said it better. It all does depend on the lifestyle, etc. I am on the animas pump. I like it and only had problems with it a few times. I like that its waterproof and the meter is a remote. Makes it easier for me to deal with. The clip however I've had to replace a few times and decided not to replace it again as it just keeps on breaking. Even tho it holds 200 units its, 206 after it finishes rewinding and 186 units when its loaded up, and when you prime its less than that. So its not a true 200 units.
Another factor is your insurance company. You may want to find out which one they cover the best, etc. Right now my current insurance the test strips are more $$ for me.
What exactly happens could be an unsolveable mystery, but the pump usually alarms. For me, most of the failures are occlusions where the canula kinks and cuts off the flow of insulin. I've had failures where the alarm does not go off because, although there's an occlusion, the insulin still flows, but it ends up leaking from somewhere upstream. In those cases, there will be the unmistakeable odor of leaking insulin and other tell-tale signs.
The only other failures I've had are priming failure where the pump fails to load the insulin properly before being attached. In thos case, there will be a definite alarm and priming failure alert.
Then, there are any number of occasions and mishaps where the pod becomes physically dislodged.
As with any case where insulin supply fails, BGs can go up, with all the associated problems and dangers. How long it takes to notice rising BGs, I imagine, is mostly dependent on the indivudual.
I think of wearing the pod as an art-form rather than a science. Half the fixes I use for whatever issues have arisen are probably not even applicable to the next user, but there are probably any number of precautions and fixes that they could use that wouldn't work for me.
Due diligence is absolutely required though, but with some planning and a bit of trouble-shooting skill, I've had very few problems, relative to MDI anyway.
I have been using my Omnipod for almost a year now and I LOVE it!! I haven't had a single pod fail during that time and hopefully I never do. :) I did have a Medtronic Paradigm pump for two years before that and hated the tubing. I forget i have it on alot of the time actually. The smaller pods are coming out in a few months and I'm excited to give them a try.
I can definitely say that an Omnipod would work well in your son's situation. Once it's on, you no longer have to fiddle with the pod itself. You can tape over it, wrap it up, then cover it in pads and 4 layers of clothing, and it can remain fully functional and running through it's basal program, unaffected.
For me, that's one of the biggest advantages of having it and going through my day's activity. As long as I make sure it's adequately protected, and that may take some effort dopending upon the day's activity, I'll never have to disconnect it or worry about not having my insulin supply or my basal program working.
My jiujitsu instructor tells me that another T1 in his classe disconnects his tubed pump for lessons and training. Since my lesson and training may run for two hours straight, that would simply not work for me. I've had occasion where I've done all day activities which would have required intermittently connecting and disconnecting as needed. With the pod and remote PDM, I jucould adjust my basal rate according to activity, and still bolus as needed, without worrying about it.
Another OmniPod user here... I've been podding for almost exactly one year now after 25 years of MDI and am very satisfied with OmniPod. I stayed on injections so long because it was working for me and I didn't want to be connected to tubing.
When I began having hormone issues due to menopause, I really had no other choice than to go to a pump so that I could vary my basal rate through the day and night. I did not consider any other pump other than OmniPod because of the tubing. One of the other posters mentioned that her son likes to operate "incognito" with his diabetes - after about 26 years of this, I still like operating incognito as much as possible. OmniPod helps me do that because if you look at me and don't know me, you would never know that I'm diabetic. You might think I'm just playing on my cell phone (aka PDM) alot - and I can just stash it in my purse or backpack until I need it.
I also like that the insertion process with OmniPod is automated - you literally stick it on you, push a button on the PDM, wait while you hear 3 clicks then POP! (feels like a rubber band pop) and it's on and functional - you never actually see a needle. I have heard that some of the insertion sets with other pumps are "scary" to look at but have no first hand experience with inserting those sets.
As others have said, be sure to check with your insurance. I have a BC/BS plan that required me to pay $225 for the upfront purchase of the PDM system and my pods are at no cost to me. So even with the same insurer, your coverage/plan may be different than someone else with that same insurer.
Good luck to you! And try not to get frustrated at the beginning. I believe that many of the issues pumpers run into early on are user error and will diminish in time as you learn what works. I have also found OmniPod's customer service to be excellent - they are available 24 hours per day if you have a pod problem or alarm or question - I called more than a few times at the beginning but haven't needed them in a good while now.
It's like everything else with diabetes, everybody is different and has to find what works best for them. And it takes time with pumping. I would say I'm just now really comfortable that I can troubleshoot effectively *most* of the time. :)
I use the Tandem t:slim and it is awesome. I dont have to scroll through the numbers to enter carbs or meter readings, input the numbers and done, it has confirmation of amount of insulin and reading then distributes the insulin. Charging can be done at home or in a vehicle. The t:slim is smaller than all other pumps and will be integrating with the Dexcom CGM. I used Animas as my first pump and I had it for 4 years then switched to Omnipod, used it for 5 years until the pdm quit and was out of warranty. I tried the Medtronic Revel and hated it, the CGM dangles and hooks on my clothes and was constantly ripping out, the insets caused infections that didnt heal for weeks. I didnt like scrolling through everything and the CGM was alarming low when I was high. Now I have the t:slim and love it, customer service is super helpful and always call people back. I found that after time customer service at Animas was not so supportive(one reason I left them) The waterproof feature was a plus. Omnipod is water proof also, the pdm is not. Medtronic has the cgm integration, but not waterproof. Tandem is checking into the waterproof label instead of being called water tight. At Tandems website you will find information about all the features. Hands on is always better, as the Endo if they have them all to be seen and have a chance to see how they work and what you son would like. Several people have said their kids love the t:slim due to it being like a cell phone or mp3, making them more discrete in school, yet have tubing and teachers realize it is a medical device and not a phone. Only your son can decide what he prefers, but it depends on what works for him also. Good luck in you decision.
I have used both Minimed (722) and Omnipod. I am currently using the Omnipod. The biggest argument I hear against the omnipod is the pod failure rate. All pump brands fail how ever Insult (the company that produces omnipod) produces well over a million pods a year (probably closer to 2 million "10k users using a pod every three days") and for less than $30 each. Yes there will be more failures per year than the other pump companies have. With all of its issues I still prefer it over minimed's products (and I have had issues with their infusion sets and resivours). There is no perfect pump, which ever ya'll chose learn the proper technique to start and apply.
One thing to note about the Omnipod that I recently heard as a complaint from an Omnipod user - when the pod expires (which occurs at a set time), it will intermittently beep until you change it. She found this really annoying because she couldn't always time her changes to occur right when the pod expired, so she would walk around with a beeping pod all day.
I had to smile when I read this because my OmniPod just beeped to let me know that it is time to change my pod.
It really does not "beep all day" though unless you don't change your pod before it "expires". It beeps to remind you ahead of time that your pod will expire in a few hours. If you change your pod before it "expires", no more beepiing.
The pods will give you an additional 8 hours after they "expire". It is during this 8 hour period that the pod will beep every now and then to remind you that your pod is overdue to be changed. This doesn't bother me though because I'm getting the benefit of an additional 8 hours so that I can change my pod at my convenience when I get home or after I shower or after I finish whatever I'm doing.
I figure it's my choice to use those additional 8 hours so I don't mind the occasional beeping... and there are some occasions when I'm really busy and I'm like "oh yeah, I need to change my pod" so the beeping does serve a purpose. It's just not that big a deal to me... but then, I try not to sweat the small stuff. :)