Hello! This is my first post and I'd like to thank everyone for this discussion list. It is just what I need to help my husband with his new OmniPod. Jamie (Type 1 insulin dependent since age 6) started on the OmniPod two months ago after much gentle persuasion from me. He refused tubes so the OP was the only option for him. He basically likes it but is really disappointed at wasting so much insulin. He loads the minimum 90 units but uses only 60-70 units every 3 days. Is there a way to unload the residual insulin and re-use it? His Insulet contact said there was no way to avoid wasting loaded insulin. Jamie tried inserting a syringe into the loading port but came up empty.
Also, he often has a high BG for at least 12 hours after changing pods. My sister, who has been using the OP for the past year and a half, often experiences the same post-pod change highs. Jamie has yet to ask his Insulet contact about this. My sister's contact had no advice unfortunately. My sister is still on the old version but Jamie started with the new smaller version. Any ideas?
Thanks again for the opportunity to ask questions!
The post-change high is a known issue with the old pods - I injected 1IU on a pod change to mitigate it. It is reported that the issue is fixed with the new pods and there is a significant change to the mechanics of the silicone needle cap that suggest Insulet were trying to address that issue. There's no consensus yet about whether the problem is fixed.
I don't pull the unused insulin; my insurance currently pays for all my insulin (this may change!) However I've seen one other report that suggests getting the insulin out of the *new* pods may be more difficult. You could try treating it like a vial - inject air *first* - but this might not work because the mechanism is designed to accept incoming fluid but not eject it until the pump operates.
I'm sure someone will find a way to get the insulin out - there are enough motivated people on this group - but it might take a little time.
My 4 y/o daughter only uses about 45 units every three days so I try to pull out the remaining insulin but am not very successful with the new pods. I might get 1/3 of what's left. The syringe needles are much shorter with the new pods, which might have something to do with it. I hold the pod up with the flat side down and put the needle in this way.
She also experiences post pod-change highs, sometimes for as long as 12 hours. Did it on the old pods too. So frustrating and I haven't figured out how to combat it. I usually do a temp basal of +25% for a couple of hours, but not always successful.
Before pod change, if I get the chance, I inject one or two units, change, then inject at least another two with the new pod. I am just ready to go onto the new pods on my next change, within 2 days so we'll see. I would think if you opened a pod, I use pliers, you could easily get to the reservoir and pull out whatever insulin is there. Never tired since I was able to remove insulin thru the regular port...sometimes, not always.Fortunately I get plenty from insurance and don't have to worry about using every last drop.
This is all with the old pods as i have received new ones but using up my supplies of old first. In regards to post pod change highs which I experienced until I read on this site is to change my pod and then bolus, no to using current bg and no to eat now and then I started my bolus with .40 u and then adjusted each pod change time until I figured out what worked for me (between .50 & .65 depending on what time of day I change my pod)
I’ve only tried once to get insulin out of a pod that went bad and had a hard time getting much out. I do let my pod go the max time (72 hrs plus the 8 hrs until it really expires with a continues beep). That way you will use some more insulin
I’ve noticed the time of day impacts my post pod change highs. If I change early in the morning (basically fasting for 12 hrs besides my morning coffee) I only bolus 1 unit with my old pod and .5-1 unit with new pod. Result is no highs and sometimes I’ll go low. If I change after dinner I do not typically need to bolus with new pod and my BS stays steady throughout the night. It is after lunch changes that never work. No amount of pre or post pod change boluses offset the highs. I only learned this by trial and error. I also do the hard expire (72+8) to maximize my insulin usage.
Thanks Aimee. I will share your thoughts with Jamie. Much appreciated! Wonder why my sister's Insulet contact didn't know anything about these post-pod change highs? Will be interesting to see what Jamie's contact says. Surely the company knows about this.
Thanks for the detailed reply lamavisca. Really helps. I suspect Jamie might have a hard time going 72+8 since he cannot easily leave his work station during the day to address pod changes, etc. Plus his PDM is not close by at work...everything stays in his locker since he works in a contaminated area. And he has a long commute to work. But we will talk about trying that.
Thanks tebbemae. That is something we will keep track of. Jamie began changing in the morning but when he had a pod failure he ended up on a change at bedtime routine.
Special thanks to all who replied. Your help is so appreciated! The only reason Jamie is on the OP is because I pushed for it in an effort to address his low BGs. He's had D for 47 years and is now at the point where he sometimes doesn't realize he is low. We've had some scary moments and my hope and prayer is that the OP will keep him safe.
One of the great things about using a pump is that you can eventually get the problem with low BG unawareness to go away. I had this problem before, but fixed it with a new MDI method, but pumping does the same thing. Basically he's hitting too low at night and his body is getting used to the low BG and doesn't react to it any more. After a couple months or so of not bottoming out the body will adjust back and you'll get the low BG feelings back at least a little bit. It's a great thing! :) (yes, that was a bit sarcastic...)
Thanks Scott. Sarcasm noted and appreciated. :-) Jamie did have most of his lows in the AM but others at any time of day. I would thrill for him to get those feelings back!
Couldn't one use the pump to remove the insulin? Instead of switching pumps initially, just stop it, sanitize the cannula area, pump and discard a couple units to minimize contamination, and then just bolus it all out? Seems a bit crazy though. I think I'd rather beg my doctors for free samples when I visit.
Not crazy if you are the frugal sort. Or if you hate to waste anything. Or if you pay a portion for your insulin. All describe my husband. :-) But that's a great idea Scott. And probably a lot easier than using a syringe in the loading port which doesn't seem to be all that successful anyway.
Not so sure I would advise attempting this, unless you have no desire to use the record keeping abilities of the PDM. Your numbers would look really screwed up every 3 days.
As to getting the insulin out of the partially used pod, it can be a bit of a pain. Typically, I just place the old pod, face down, just like you do when you fill it, but I raise the injection side about the thickness of my pocket comb (which is what I use). This tilts the original fill point downwards.
Then just attempt to pull as much as I can, I don't worry about air bubbles etc, as I can usually get more insulin out by taking a bit of air in at this stage. Once I have what I feel is going to be all from that used pod, I just tap the air up the syringe as normal, and blow it out as normal. I use roughly 12-20 units or so per day, min fill is .8 cc or 80 units. I always fill to 100 or 1 full cc, so I always have extra left in the pod. I typically get 25-30 units or .25cc -.30cc back out when I drain it. Which means I am not losing more than about .15 per pod change, typically a lot less than that.
Ahhh...that's where me not being the OP user gets in the way. Thanks so much John! I had wondered to Jamie if tipping the pod might work. We will try your recipe. I am feeling optimistic! I really want this to work for Jamie and so far this is the only drawback for him.
You guys rock. :-)
One more question...do you put the retrieved insulin back in the original vial or fill the new pod by just adding however much more you need to get to your loading dose into the retrieval syringe and then loading the new pod?
I don't like to put the old/used insulin back into the vial with the new, so what I do is:
Draw back the syringe and insert air into the vial Draw out as much insulin as I can from old pod and tap out the air bubbles
Insert syringe into vial and fill to minimum with new insulin, but I am careful not to push the plunger back up to expel bubbles so as not to mix old insulin into vial
If there are a lot of bubbles or one large one at the top, I'll draw insulin just past the min line and expel the bubbles by pushing up on the syringe.
I used to try drawing out old insulin with the pod facing up (like during fill and prime) but then someone suggested inserting the syringe from below (hold the pod up with flat side down and insert syringe).
Others have mentioned opening the pod up to get to the reservoir, but I've heard this is much more difficult to do with the new pods than it was with the old (I haven't tried yet, so can't speak to experience).
You are in the right place to ask questions! I have learned so much from so many people. TuDiabetes is my go-to forum when I have questions!
Yeah, I might end up doing it myself this time around. It's my first pod and I put in the full 200 units. It took about 24 hours for the remaining Levemir to get out of my system, and then I'm using a lot less insulin with it. I estimated high figuring I'd toss some, but then I'm using much less than I expected.
