Those who have switched FROM Omnipod to Minimed Revel; thoughts/opinions?

Diabetes Technology Insulin Pumps
1

Good afternoon everyone!

I've been been using the Omnipod for a little over 2 years with success for the most part. I immediately went on weeks after a Type 1 diagnosis (25 years old, 6'2", 210lbs, sorts came out of nowhere).

Due to various circumstances (Moving from FL -> HI -> NY) and simply not being on top of my diabetes management as I should be (my A1C had jumped back up into the high 7's, low 8's from low 6); I'm floating the idea of moving to the Minimed Revel to gain the benefit of a integrated CGM for better visibility into my food and exercise as well as some addition pros/cons.

I've seen various accounts, but without much detail, of those who have gone to the OmniPod from the Minimed as well as the other way around... I know OmniPod has been saying new/smaller pods with Dexcom integration, but I've also seen rumors that it's pushed back into 2012 and there's almost no literature guaranteeing anything. So here are some pros and cons I'm looking at of adding the Dexcom to my arsenal vs. going to Minimed...

Pros:
- Gain CGM integration (the big win I'm aiming for)

- Consolidate what I carry to a single device (the Minimed pump, vs PDM & Dexcom receiver), this actually frees up a pocket and I lose the concern of "Do I have my PDM with me?" (which it always is, but I'm quite paranoid when traveling....)

- I can say goodbye to faulty pods and losing significant amounts of insulin (I've been on a good run, but recently had 3 pods go on me 3 days in a row)

- Batteries (1 AAA vs. 2 that need changing more frequently, not a deal breaker by any means)

- Hellllllo hot tubs! (I can remove the minimed vs. a pod stuck to my hip, preventing me from enjoying a hot tub)

- No more pod snagging, ouch (though I'm sure tubes catch on things as well; but the pod is a much larger target)

- Fewer finger pricks with the CGM (the number needed to calibrate daily will be less than what I do on a daily basis now (5-7).

- Costs may be lower (luckily, I have pretty good insurance, the monthly out of pocket costs for infusion sets per month I believe is going to be less than a box of pods)

Cons:

- I gain tubing... the biggest and obvious con, which will require getting used to (primarily when sleeping, though rolling over on a pod isn't that pleasant either...)

- I need to adjust to a new workflow and hardware

- No more showing off a very cool piece of technology

- Minimed may be less accurate than the Dexcom (not sure if there's enough science to prove that, simply reporting what I've researched)

- Running out of cons... which is why I came here...

So I welcome any thoughts, suggestions, opinions, corrections on my assumptions above, etc etc. Purely on the topic of the pump switch though, I have a great endo and we're working on what I need to do in order to get my diabetes under control properly. I appreciate your thoughts!

2

I have only briefly used the pod. I was actually on the MM first before trying it out. Honestly, you get used to the tubing. It takes some time, but within a few months it will probably not be a big deal for you. The MM CGM takes a lot more ‘tweaking’ than it probably should (experimenting with sites, insertion angles, etc), but I’ve got it working reasonably well for me as do others on here. I had slightly better results on my trial of the Dex, but it typically ‘overshot’ my bgs whereas the MM usually ‘undershoots’ my bgs. I do love the integration. It’s a great feature. BUT, I’d say that it’s probably like the tubing, once you’re used to it then you’re probably used to it.

Right now, the biggest con for MM for me is the company itself. I’ve had so many customer service issues with them over the last year (billing issues, lost supply re-order forms, misplacing virtually every form me or my doctor sends them). But I’m trying to limit my MM rants. My sanity over the next 2 years depends at least in part on the hope that they’ll eventually get it together over there…

3

Thanks for the quick reply Tom. I didn’t take into account customer service… Insulet has been pretty good to me. Never question when I report a bad pod and instantly get a replacement in the mail and have sat with me on the phone discussing pod placement options after not having much success with my waist and arms (which is when I moved to my lower back with a lot of success).

Thanks again!

4

We have used both the Omnipod and the Revel with MM CGMS. We are currently on the Omnipod and Dex. The Revel is a great pump, the MM CGMS not so great. Keep in mind you will have a very difficult time hearing the alarms on the Revel cgms at night because they will be under the covers or you’ve rolled over on the pump. The MM cgms for us was not near as accurate as the Dex, and it is more painful and the wear time is shorter.



I would describe the Revel as the “reliable” choice. You won’t have to think about an expiration date, or how much insulin you have remaining, and you won’t have too many pump alarms (although you will have sites that fail without alarms). BUT, you are giving up being tubeless, and that is a big deal for some people. It’s a big deal to my DD, so I am willing to deal with some minor inconveniences because the pod makes her feel better about herself. Also, keep in mind we are still getting used to the pod. I love tubeless, but there are things for us to get used to and we have to pay more attention in some ways. For example, I had to pick my DD up from a friend’s early because they went a bit “carb crazy” and she ran of insulin in the pod.



Do a trial with the pump and cgms and see what you think. Most people who have experienced the Dex do not care for the MM, but you may be different. I highly recommend the Dex no matter what pump you go with.



You know how to remove the insulin from a faulty pod, right?

5

Yes, I do know how tor remove insulin from a faulty pod, though it’s never my favorite option (it always feels “tainted” in my opinion).

And yes, worrying about insulin remaining and expiration dates are often a pain. In fact, this morning, when I expected a pod change around 10am, had my pod expire in the shower, with the PDM sitting on my night stand; doh. I ended up finishing the shower with a nice steady beep from the pod until I could get dry to fetch the PDM. As a result, I went 30 minutes without insulin and had a spike shortly after putting the new pod on (and administering a small bolus). I didn’t hear the LOW reservoir alarm before I woke up, so I suppose I’ll have issues hearing alarms at night either way (my wife is more likely to hear them than I am as I’m a very sound sleeper…).

Great points regarding sites for the CGM sensor and length of time… Fingers crossed that Minimed gets the smaller wire sensor that works for 7 days out the door soon… Though I’m sure it’s in a similar situation as the smaller pods from Insulet… a bit of a crap shoot…

My endo is very familiar with the MM, but I’ll continue to suggest the Dex. Though as of now, my pockets are filling up with devices as it is. If I go with the Dex, I might need a man bag soon! Having it all on my belt would be a nice change and I can keep keys in that pocket without worrying about scratching screens and such… (iPhone is in my other pocket).

Thanks for chiming in!

6

The extra device is a bit of a pain, but for us the accuracy and comfort makes it worth while. Everyone is different though.

It is a crapshoot when the new products will be out, you have to pretty much buy based on what is available now instead of relying on promises from either company (been there done that).

MM has very strong relationships with the endos due to their years of being in the pump market. Dex is a smaller company with less money to spend on marketing. Endos are very comfortable with MM and sometimes a bit closed minded to the Dex (sadly). Dex can do all the paperwork for you. I called our doc and told them to expect a fax from Dex, we decided to switch.

7

I do use the MM sensor for at least 7 days (I just restart it). I find it works better after day 2 or so after it “settles in” and I have heard similar stories of “settling in” with the Dex as well.

8

Just FYI - that Minimed sensor is a beast compared to the Dex sensor. You have to tape the entire thing down because the transmitter is attached at the end of the sensor, rather than being attached to the entire sensor. And it is a bit messy upon insertion (I don’t think I ever had a non-bleeder insertion site with the Minimed sensor).

Also keep in mind, you’ll have to disconnect for any water activities (bathing, swimming, anything near the water) because the Minimed receiver/pump is not waterproof. And you could be trading bad pod issues for bubbles-in-the-line issues.

9

Can’t bubbles in the line be resolved by priming the pump prior to re-connecting (something I’m not familiar with)? Versus having to throw out a pod (which have more significant cost than another infusion set? Batteries, electronics etc vs. plastics.).

That seems to be the consensus though on the MM vs. Dev (size of sensor and the insertion pains…).

Thanks for the info!

10

My experience with both CGMS systems is there is a "settling in " period for both.
I believe the learning curve needed to effectively use either sensor is MUCH higher for the MM. If you are an inpatient person I would suggest the Dex.

11

I made the switch from Cozmo (no longer produced) to MM 722 pump (without CGMS) a couple years ago. While the MM is a fine pump, I actually find the software to be a bit behind the Cozmo. I have never used OmniPod – so I can’t offer you a lot of advice, but at first, I felt that I switched from a computer to a typewritter (I stole this line from another member who shares my opinion).

I don’t mean to bash the MM pump. I’m using it now, I’m happy, and I’m able to get good results with it, but I miss the extras like customizable alarms etc. I know that they made some improvements with the Revel (over the Paradigm pumps). I think that if I could choose again, I would go with the Animas Ping.

There does seem to a consensus that most people strongly prefer Dexcom to MM CGMS, but I think the other posts have summarized that well!

12

Matt, I have had a MM pump for over 4 years. I just received a new one last week. And I have to say that I have never had trouble with customer service at MM. They were absolutely terrific when it came to getting me my new one. I know sometimes things don’t always go smoothly for everyone, but I just wanted you to know that I haven’t ever had trouble with them.
And you mentioned a con above of “no more showing off a very cool piece of technology”. I must say, the omnipod is cool, being tubeless and all. But the MM pump is also very cool. The technology is amazing. It has so many different features. You can get it in a variety of colors and there are cool skins you can purchase for them. But yes, getting the tubing caught on a drawer nob does suck big time! And if you are in the water for TOO long, the sticky on your site may come loose.

13

I’ve often heard this about the cozmo…seemed like it was really ahead of it’s time. Sad to see a vendor drop out of the market.

14

Yes, the company that produced Cozmo (Smith’s Medical) mainly produces items that are sold to institutions (hospitals, airports), not directly to consumers. As far as I know, the Cozmo pump was their only consumer product, which made it expensive to market and provide support for. It’s a pity that they couldn’t at least sell the design to someone else. In my (not so humble) opinion, it was the best pump on the market. Most Cozmo pumpers that I have talked to agree. (Well, I guess most of us love OUR pump best!)

Still I miss my Cozmo :frowning:

15

Just wanted to let you know what my friend does at night so her son hears the Dex alarms. She places it in a metal bowl at bedside. No suggestions for the Revel CGM but I know this works for the Dex.

16

I too went from Cozmore, to Animas now to Omnipod. Even with the occasional pod failures I don’t think I would go back to tubing. The Cozmore was further ahead of the pack technologically in my opinion; however, the Omnipod is the more accurate and predictable of the three that I have used. (The Animas was pretty but didn’t work well for me.)



I have also used the Dexcom for a short period (about 2 months) and although it was good for predicting the “future” it isn’t accurate and they still tell you to test your BG before you eat. So I went from about 6-8 tests a day to 4-6 which isn’t worth the expense it put me through.



I have never used MM as the several times I have talked to them about getting one I did not appreciate the answers I got to my questions.



And to quote Kristin, Still I miss my Cozmo :frowning: and to go a step further I would consider going back to tubing for the Cozmore.

17

I ended up going with the Minimed and it arrived last week. My training is tomorrow. I’m quite excited to get moving with the CGM; I’ve been impressed with the hardware and even though it all requires Windows (I’m going through a VM in OSX), it’s nice having the USB Carelink to wirelessly transfer all my data. I can’t wait to get some 24 hour graphs of the CGM and insulin delivery.

The training CD-Rom that came with the Minimed was nice as well… Very clear videos for setup and explanations.

As much as I enjoyed the OmniPod, it needs a bigger insulin capacity and CGM tie in (without carrying two devices) for me to consider it again.

Here’s to a healthier me and lower A1C’s! Cheers!

18

I agree with you about your Cozmo.When I made the switch it was like going from 2010 to 1990. My Cozmo was like a trusted friend and I miss that friend.Ive gottan used to MM but every day miss my Cozmo. I still with I could trade back even after the couple of years on MM. When my time to upgrade comes MM will be at the end of the shopping list.I am not saying I will not buy it, only that I am going to try and find a pump that I dont want to live without.

19

Slightly off topic…but not really. I went with Animas Ping because of lowest basal and bolus on the market. Great for fine tuning if you are sensitive to insulin. They will also integrate with Dex in time. I now have a Dex. I agree with comments about additional gadgets to keep up with . Not so bad when you are a female and a purse is the norm.

What is holding up integration with Dex and these pump companies? I am beyond ready!!

20

Hey Matt~ I’m an educator and would definitely make sure to take into consideration, “ease of calibration” of the MM CGM. I work with folks that use both MM pump with and without RT sensor and also Omnipod and also Animas pumps and Dexcom sensors as well. The only con I can find with the Dexcom is that it’s not ‘paired’ with a pump yet, but I’ll bet that it’s not too far down the line… it’ll most likely be available in Europe as the Vibe before the US, but hopefully it’s not too far off. There really are some big differences in how insulin is delivered (volume versus time delivery) with MM, Animas, Omnipod and Roche and there’s more to think about as you’ve already seen with some responses! I always recommend talking with the sales reps for each company (both pumps and sensors) becuase it’s really their job to ‘sell’ their products and they know them best!
Good luck with decisions, they are big ones and I don’t think should be made rashly…sounds like you are not bring rash which is smart!