Switch to omnipod

Type 1 and LADA
1

Hi everyone.
I have used several pumps in 30 years, and 6 months ago I got a mobi and loved it. The size the exact same settings and working well same as my T2 except small and easier to use.
I could go through security at airports with no alarm and it’s been great.
I flew to Canada a couple of weeks ago and I used a sleeve to keep it attached, well the pump tubing broke and the pump came out and left on the airplane.
Could not go back to get it because I was already through customs.
Long story short. It’s lost, they never found it.
My insurance won’t replace it so I’m now on omnipod.
It bills through pharmacy instead of durable equipment which is quite a bit cheaper for me.
Lucky there is this option because I didn’t have $7000 US to get a new one. Tandem would not sell me a refurb or any help in any way,I didn’t really expect them too, but I asked.
So now I’m on omnipod 5 and so far I like it. I don’t really care if I lose a pod, however 30 years pumping and I never lost a pump before.
Today is my first full day. So far so good. Keeping me in range.
It’s much more comfortable to wear.
No tubing is better than I thought. Hoping the algorithm works as well
The one thing I hate is using the controller until the phone ap can accept iPhone with g7. This was a surprise to me, but it’s supposed to be fixed in a month or 2.
I would never have switched if I didn’t have to.
6 days on injections has me at 70% in range when I’m used to 95%.
Average a1c is 5.8. Let’s hope I can keep close to this.
If anyone has any suggestions or tips, please let me know. Esp anyone who has gone from tandem to omnipod.
I know you shouldn’t preload cartridges because plastic degrades insulin, but while traveling, I’ve done it on tandem many times.
Is that even possible on Omni pod? Not sure what starts the timer. Is it insulin fill, or breaking the tab?
Can I send unopened pods in the X-ray at the airport?

Thanks in advance for any input.

2

@Timothy, I started using OmniPod in 2009. I love it. The biggest improvement was my switch to DIY Loop. At the moment it only works with the older OmniPod Dash pods. I can use any sensor. I use Dexcom G7. I don’t even have an OmniPod controller. I use my iPhone exclusively. More importantly, I can configure my target blood glucose value as low as 87 mg/dL. I no longer get Dexcom alarms during the night, because the algorithm that runs on my iPhone adjusts the insulin in response to the blood glucose value that it gets from the G7. Installing DIY Loop on my iPhone is a little bit of a hassle. I might switch to OmniPod 5 once I can set my target blood glucose value to at least as low as 100 mg/dL. I am not willing to run high A1C just for the sake of convenience. My A1C for the last 5 years typically was 5.0. That is normal, not pre-diabetic. Obviously, once Insulet stops selling OmniPod Dash, I will no longer have a choice. Tubed pumps are out of the question for me. In regard to travel: pre-filling OmniPods does not work. If you don’t start the OmniPod soon after filling, it will refuse to start. I don’t know how long this time is. I don’t want to lose pods just to find out. I typically take one OmniPod per day of vacation with me. On my last cruise I took 30. You can tell that I am paranoid. For some reason, failures are much more frequent when I travel and I also eat more carbs. Going through X-ray at the airport never was an issue. Nobody has ever asked me about the content of my carry-on bag which I use to carry all my pods. sensor and insulin.

3

Great to hear. Omnipod 5 only allows me to set my target to 110 or higher. I would likely target 90 or95 if I had my way.
So far my algorithm is working quite nicely. I had some Chinese food and that is always difficult to dose. I eat plant based and I avoid fat but I had some tofu and veggies and even some noodles. And I’ll see how it works out.
I tried to do a dyi loop on my old revel Medtronic pump. It worked relatively well but it was a lot to manage. I’m sure it’s better now.
I’m happy with a1c at 5.8 and I don’t know if going lower is any better for my health. the risk of going low is why they don’t want to target over under 110. There are a lot of differing opinions.
I do think that under 6.5 really does make a difference.
I was in the mid to low 7 range for many years before cgm
There is an implanted pump in clinical trials with Medtronic that claims to have better control because insulin is delivered to the duodenum and absorbed faster.

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4

I believe its the insulin fill, which will be followed by 2 beeps in rapid succession. The pods will timeout. Don’t try to prefill the pods w/ insulin.

Airport X-Rays have never been a problem for me. But bring extras because if you are in a very busy area w/ a lot of Radio comm, sometimes it can break the bluetooth signals and kill the pod.

5

I 've used the Omnipod 5 for over a year and as of about 6 months ago I was able to switch to my Iphone instead of the dreaded controller. So much easier carrying one device! Good luck!

6

Way to adapt! Here’s how the Omnipod 5 works Omnipod 5 Tips - #2 by spdif
Really short version is it only adjusts basal rates in auto mode, up to you to bolus for Chinese food.
Maybe call around to few different DME companies to see if anyone is selling the Mobi for less than full price?
If you look at Loop or Trio you have to be 110% comfortable with troubleshooting phone/app/cgm/bluetooth/pump issues and any insulin delivery problems they may create. For people that can handle that and need automated bolus they are a great option.

7

I can’t use my iPhone ap just yet because I’m using G7 sensors and it’s not capable through iPhone yet, so I’m stuck with a controller till then.
The algorithm is really quite good almost. 3 days and I’ve kept in range 97% mostly because I miscalculated my lunch bolus.
Also I can’t really see it yet because the pod is still on, but I’m not getting an irritated site like I normally do by day 2 on my mobi.
Does anyone know if the omnipod 5 learns my behavior? Because my predawn effect is getting better each night. I was able to set my bolus higher on tandem, but the omnipod doesn’t have that ability.
I peaked at 175 first night, 167 my second and it peaked at 150 last night.
My predawn spike is very predictable at 330 am and is done by 4 am.

8

I’ve tried, once, preloading an Omnipod (Dash, not O5) and had it rejected when I later tried to link to it. The 80 hour countdown starts when it beeps so far as I can tell. The pod can’t detect the tab removal; I’ve activated a pod after doing it.

I use insulin pens to fill the pod (with, currently, 5/16" needles). This is the arrangement I came up with my endo last visit; prior to me hitting the medicare entry (still a WIP for me.) This would seem to be illegal but I shall see how that works out (I enter medicare on April fools day.)

The financial math depends on traditional vs “W” medicare; going for an “Advantage” plan seems to shift the numbers back to the $8000/year OOP in additional to the “insurance”.

I’m trying to get the A+B+Medigap(G) setup; this does not have a tie-in so, given that the Medicare world is up in the air at present it seems safer.

On that system the CGM comes in as Part B (legally, though who obeys the law round here?) so is subject to the Medigap OOP and the Omnipod plus the insulin comes in as D/G OOP. Given the costs both the Medigap and the PartB hit the OOPMax so the math is simple.

I send all my supplies through the X-ray; I take them all as carry-on. The pod and the G7 walk with be through the metal detector (I’m TSA-pre, another expense). Never had any problems.

BTW: Medicare is insanely complicated and everything has a letter or a marketing term. It’s like buying a certain companies computers, but worse.

9

I’ve never tested this, but I was told when I started my first pump that pumps don’t need to be insured because home insurance would cover damage to the pump.

Loss outside of the home could be a different story, but maybe worth checking?

10

It happened in Canada, and I live in the US, so it was not covered by my home owners insurance. And there is no one out there selling pump insurance. At meant none I can find in California, they all say it’s in your home owners policy.
So I suppose there might be some travel policy I could buy.
I think if I had to do it again, I would put an air tag on it.
But now I using omnipods, I don’t think I worry about losing one.
And the algorithm seems to be pretty good, however I do think the Tandem control IQ is a bit better esp with regards to the ap.
But I’m in good control with the omnipod 5 and I think I have the settings figured out.
Also I don’t get the irritated sites like I did with the sets from tandem.
And best of all because these go through my pharmacy benefit, it is much cheaper for me to use omnipod.
If I got my MOBI back , I would use it and use my pods for travel or emergencies.
But I can do just fine this way.

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11

I jumped about 1 year ago, and I love the Omnipod 5. what I do not like is that i cannot use the Omnipod apple Iphone app with the G7. I press them all the time on their public posts and continue to demand the update.

When are pump companies going to understand they are in the software business and they happen to sell pumps. Think of Microsoft who sell computers. But, they are int eh software business. The pump companies still think they are in the hardware business.

Its the software that matters. The hardware is simply a way to communicate the software.

12

It gets worse. I just got a new iPhone 16 and the omnipod ap will not work at all with iPhone 16. I’m using the controller for now, but I hope they include the iphone 16 when the new g7 release comes out.
I know it takes a lot to get software approved when it’s medically regulated so I understand, but still it’s frustrating

13

This is perhaps getting off-topic but until an admin splits it out…

The crucial issue here is that pumps and CGMs are manufactured by different corporations these days. Pump manufacturers have demonstrated that they can work with Dexcom, at least (do any support the Libre’s?) AndroidAPS and TidePool et al. have demonstrated that one software application can communicate with arbitrary pumps and CGMs and implement an overall control algorithm that is independent of both the specific pump and the specific CGM. In the US the FDA does appear to be amenable to working with TidePool.

So TidePool is quite a lot like Microsoft; it only does software. Other software does what Microsoft did; using an Eros pump with separate control software is possible but it requires a communication device developed by the control software community just as Microsoft ended up manufacturing its own mouse. Remember that Microsoft did not do that to make money; rather just to enable the Microsoft software it sold.

The crucial missing links for us at this moment are the standards. Microsoft started out with the IBM PC and a contract to develop an operating system, the IBM PC was the de-facto standard but it has never run just one set of software. Indeed right back at the beginning Xenix was developed to run a half-baked Unix version. These days almost every machine that runs Windows can run Linux too, indeed machines that can no longer run Windows still work with Linux.

We, the whole community, desperately need standards. We need a standard protocol to communicate CGM data and to control the CGM. We also need a standard protocol to control an insulin pump. Standard so that a third party piece of software (think AndroidAPS or TidePool etc) can use any manufacturers CGM and pump without having to write new software. Without having to write new software; this is what happens at present because every new piece of hardware needs new software. The protocol didn’t change much from the G6 to the G7; the code in xDrip+ seems to have only small changes, but the changes were required. A standard obviates that.

The FDA seems to have shown a willingness to understand this with TidePool. The principle is already accepted; when we use a disposable insulin pen we don’t have to use the pen manufacturer’s needles. Remote monitoring of diabetics, monitoring our blood glucose and transmitted information back to our docs, is a product that really is being sold by the corporations that do it. Those corporations take data from as many sources as they can.

The work has already been done and everyone knows. Now is the time for standards; once we have those it is certification of just the software; not the software with a particular pump and a particular CGM.

Insulet should be particularly motivated to push for this. The real software for the O5 is inside the O5 itself. The O5 communicates directly with the G6 or G7. The software on the 'phone is not doing anything most of the time, certainly not in critical cases like low BG or high BG.

Insulet, unlike Dexcom, really does develop software as do most modern pump manufacturers but the software is inside the pump, every pump manufacturer would benefit from a standardised CGM protocol. Pump manufacturers might like to protect their product against third party apps, but why? They make hardware, ridiculously overpriced hardware; think Apple. Why stop people using other software with it? The hardware will still be ridiculously overpriced.

I guess my PoV is that it comes down to a lack of imagination and a lack of ambition.

14

I have an O5 question that I’m kind of embarrassed to ask because I feel like I should know this. I do understand that the O5 pays attention to total daily insulin almost exclusively. I’ve been using O5 since late September but got frustrated with Auto mode, so I used it almost exclusively in Manual until a month ago, when I decided to try Auto mode full time again out of pure spite. /s It seems to be working well now in Auto except for… 3-5 a.m.

Here goes:

So my glucose has been trending lately between 3-5 a.m towards 150 range. It peaks at 5, then comes down on its own. At bedtime and up until 3 a.m. I’m running nice and tasty at 105-110, and then I see it inching up slowly around 2:45 a.m.

If I set the ISF lower from say, 2-5 a.m., would this help, even if I don’t do a correction bolus? Does the O5 even pay attention to the ISF if you don’t do a correction bolus?

Or do I just sigh and do a correction bolus to bring it down (if the O5 recommends that I do that)?

Any suggestions?

15

https://diabetesjournals.org/clinical/article/40/2/168/138902/Clinical-Implementation-of-the-Omnipod-5-Automated#:~:text=account%20from%20AID.-,Correction%20Factor ,-Up%20to%208
The programmed ICF does not influence AID; it is only used for user-initiated correction boluses. This setting may need to be modified to improve the efficacy of user-initiated correction boluses when using the automated mode.

unless a software update changed this behavior.

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16

Thanks for clarifying.

17

I have the same issue except that mine goes over 200. Called the predawn phenomena.
This is a limitation of pods. On tandem you set basal rates and the pumps makes adjustments to it. So at 330 am I switch from .75 units per hour to 1.3 just for one hour.
On the omnipod, it just reacts to the glucose and in my case, I’m out of range for about an hour while sleeping. It’s not ideal.
However they are working on a new algorithm and I’m hoping to get into the clinical trial. I hope they will address this issue
Seems like Medtronic is gearing up for their own trial of a new algorithm because I got a survey to see if I’m elegible for it and they ask questions like “ would you like your target glucose to be lower and what would you want it to be?
I hope they make it 90. That would be optimal.

18

@Timothy, I would not call the issues that you are experiencing a limitation of pods. I use OmniPod Dash with DIY Loop, which has even more flexibility than any FDA-approved AID system. I agree with you that OmniPod 5 has severe limitations, which is the reason that I will not transition to OmniPod 5 at the moment.

1 Like
19

Agreed but until Insulet publishes the code of their algo we don’t know what it does. AndroidAPS (with Dash) tunes the basal automatically as well. Since it is an established practice I’m sure the O5 algorithm does it too; we (the FOSS community) haven’t patented it although Medtronic pretty much certainly patented what they do (this is their modus operandi.)

We can’t win unless all of us stop giving away our data; our very bodies. Taking a diabetic’s CGM information is a curious form of stalking.

20

Have you considered going back to a Dexcom G6? I’ve never switched to the G7 because being able to ditch the controller and use my iPhone (14 Pro) was more important to me than the advantages of a G7. I was so happy when iPhone finally was approved, I’ll never go back to the controller if there’s a way around it.