Why no try

Type 1 and LADA
21

I live in the sub zero winter Colorado mountains, but used to spend 1 week a month in the much nastier Thief River Falls, MN. (Perks if having a pilot in the family, I often get to go too when work takes him out of town.). I never had an issue with the tubing on my T:slim freezing. I’ve always felt like if I’m comfortable outside in my clothes/winter woolies, then so is my pump. I don’t quite understand the risk of exposed tubing, though. All my tubing is against my skin, under clothes. There is zero chance of it being exposed unless all my clothes somehow fall off or I get soaking wet, in which case my tubing is probably the least of my concerns.

No. That was never fixed with Medtronic pumps. It is a persisting problem with that old-school syringe-style pump mechanism where you are directly in line with the reservoir of insulin and just put pressure at one end to push the insulin out the other. Medtronic pumps are currently the only ones being sold in the US with this problem. Both Omnipod and Tandem have circumvented this issue with new pump designs that keep you entirely isolated from the stored volume of insulin. Unfortunately, some of the most desirable traits of the Medtronic pumps (being able to see your insulin, fast tubing fill, and easy reservoir fill) go hand in hand with the “leaky” pump style. Medtronic and Tandem entered into a patent sharing agreement a few years ago. I believe Tandem adopted their reservoir/pump mechanism for the Mobi in said agreement, and likely Medtronic got the patents protecting the remote upgrade pathway, something previously unheard if in medical devices. . I have no way of knowing for sure, but I highly suspect the Mobi will also be susceptible to the leaky capillary action problem. Keep in mind, though, this is only a problem for those who are incredibly sensitive to insulin. It’s a microscopic amount of insulin we’re talking about. Most of those papers reporting the capillary action were essentially propaganda for Omnipod, and then later reiterated as propaganda for Tandem when they came along. I don’t think the average diabetic would ever notice, but likewise, I wouldn’t recommend a Medtronic OR Mobi for small children, MODY diabetics, or anyone else similarly sensitive. Essentially, if your insulin requirements have you worrying about the minimum delivery specifications of the pumps on the market, then you’re at risk of being affected, otherwise, worry not.

As for O5, I did consider it. Briefly. Given my chronic inflammation issue, I really need to change my basal profile often. The higher my inflammation, the more insulin resistant I am, but on a good day, I need DRASTICALLY less insulin. Any system in which I can’t inform the baseline won’t work for me. Also, after a trial of dash pods, I know my insulin absorption sucks with the Pods and they fail me often. The algorithm doesn’t matter a lick if it’s not reliably delivering insulin.

4 Likes
22

Here’s the most recent follow up on the manual BG machine study. It’s from 2018. They were in discussions with the caucus at the start of covid. https://www.diabetestechnology.org/surveillanceprogram/Aug27-2018-Diabetes-Caucus-Letter.pdf

I wrote to DTS to inquire if follow up studies are planned.

This seems like where they are currently at: https://www.diabetestechnology.org/VOL-7-4-MTG1-KLONOFF%20FINAL.pdf

It would be great to hear some user feedback on that. I’ll make a separate post.

23

I won’t even try it. My Dexcom is often reading 40 mg/dl higher than the finger stick. If I relied on it, I would become hypoglycemic. Furthermore, the Omnipod 5 uses a much larger PDM and no software for the iPhone.

John

24

I get it. That’s something that I wish could be investigated further, but until we get some final word on machine accuracy and stuff, it gets hard to move forward. I can’t imagine these 100 point differences between sensor and manual stick are great for evaluating the efficacy of the closed loop pump…especially when its doing these super precise postprandial corrections delivered during periods of rapid change. :grimacing: Some of these lingering problems require resolution. It drives me nuts!

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25

Accuracy is relative. Dexcom can state that their sensors accurately measure interstitial glucose. However, interstitial glucose may not be the same as blood glucose at any given time.

John

26

You might want to experiment with sensor placement. My arms work better tan anywhere

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27

I, too, and extremely sensitive to insulin, but I will have to say that I think the OmniPod 5 has somewhat helped. You can set the parameters to react to your sensitivity, just like with other pumps, and you can “fine tune” that adjustment more than I have noticed with previous pumps. It certainly helped me in the evenings. It does a great job in Automatic Mode with preventing both highs and lows, allowing me to sleep through the night.

With me, exercise always causes problems, and I am NOT terribly thrilled with the Activity mode. It is supposed to keep you at around 150, but it does nothing if you already are lower than that when you start the activity – except to totally suspend all insulin – and it cannot do anything else to prevent lows. I usually end up dropping low after my daily walks, but that is the same as I reacted to earlier pumps, so I just make accommodations to head off those lows before they become dangerous.

Personally, my numbers have improved. After four months on the OmniPod 5, I am in range 83% of the time, and my last A1c was 6.4. I am too sensitive to insulin to ever hope for a 5.4 A1c since I would have to do nothing all day but micromanage everything I eat or do. That, to me, is not living.

My largest concern remains with the not-overly-reliable G6. I think that the sensors have declined in reliability within the last two years, to the point that I can never get more than 8 days of trusted readings. I changed to a new sensor again this morning, one day early this time.

The OmniPod 5 is worth giving a try, but you do have a lot on your plate right now. Changing to the OM5 does take some time and attention to your readings, so if you do not have the time to give it your full attention, you may want to wait until your life settles down a bit.

Good luck with your choices, and I hope that all goes well with your husband’s recovery.

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28

That’s a rockin’ good result.

1 Like
29

Thanks. I am happy with the results, especially since I have tried to manage diabetes for the past almost 57 years. No pump is perfect, and much has to do with individual metabolism, knowledge, experience, and effort. I will continue to learn, to grow, and to be content with myself and my control.

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30

Plus with having to transition to Medicare next Fall, I don’t know the coverage I will have. So yes, waiting is best but thank you for the info. This sensitivity is hard to deal with.

31

Oooops, just realized I should have calculated the % difference of the sensor against the manual stick (I did it the reverse) yesterday. Here’s the actual percent differences between the 2 readings. This makes it better.
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32

I’ve been on Omnipod 5 for 3.5 months after using the old Eros system for years and years. I also don’t understand the reticence to try it. I confess, auto mode pretty much sucks, though I’m still trying to give it a chance to get its act together. I said I would give it six months, and if it doesn’t get better that it is now, I will go back to manual. (It’s just now getting so my overnights aren’t a complete dumpster fire…my CDE told me it takes MONTHS to really learn a person and I needed to stick it out before I made a final judgement.)

But it’s quite easy to use it in manual, and the PDM is light years better than the old one, which I loathed. It will be even better once they get the iPhone app done and I can have one less device! That part alone would sell it to me.

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33

I’m at 7 months using Om 5 and (bad news…) am going to give Tandem control IQ a try instead. There have been so many episodes of bolus and bolus, temp basal, etc which seem to make no difference because of cannula trouble or infusion site problems. Limiting the possible pod sites to maintain connection with Dexcom has also become a bigger issue for me than it started out as. The whole thing of starting pods that have to be replaced before the 3 days is sort of burning me out. Which is why I want to give Tandem a try.

2 Likes
34

If you have site issues I suggest you use the angled infusion sets that you can put in manually(varisoft)some like the steel, but I don’t. I can’t use Omni pod because they only have that 90 degree tubing that just never works right and comes out and you can’t tell it’s out till you take it off

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35

In case this is helpful to this community:
Loop and Learn: Loop vs. Omnipod 5 Panel Discussion
Sunday, 8 January 2023
5pm PT/8pm ET/1am GMT

Zoom: https://us02web.zoom.us/j/85706683220
YouTube: https://www.YouTube.com/@LOOPandLEARN

Join us for an informative discussion with experienced Loopers and O5 users about their experiences with Omnipod 5 and how it compares to Loop.

YES, this event will be recorded and available on https://www.YouTube/@LOOPandLEARN

Topics will include:

  • Comparison to/switching from Loop
  • General O5 tips
  • Understanding how the algorithm works/learns and
  • How to best approach managing T1D with O5

Learn from our panel:

  • Jon Fawcett (LoopFollow & SugarPixel, teenage daughter switched from Loop to O5)
  • Matthew Kitchin, daughter also switched from Loop to O5)
  • Britni Schipper, CDE, 6-year-old son switched to O5
  • Tina Hammer, LnL moderator, 12-year-old son tried O5 & switched back to Loop

For more information:

7 Likes
36

Not sure about OmniPod before the 5, but with the 5 the cannula resides at more like a 45-degree angle. From Omnipod:

" With the touch of a button, the Pod’s automated insertion system automatically inserts the soft cannula below the skin to a depth of 6.5 mm and at an angle of less than 50 degrees to the skin."

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37

It’s a good pump, @John58. Wishing you luck. Please keep us informed as to how it goes and compares to the OP5.

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38

Thank you, I’m still deciding. I’m getting nervous about the 5 year commitment and want to make sure I would be eligible to upgrade to Tandems patch pump when it is released.

Thats true for all the Omnipods. I think the problem is the cannula is subject to movement or jiggling no matter how hard we try to attach the pods with extra tape etc.

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39

We’re still a long way off from that yet. It’s still in development phase, and it takes years to do all the testing after that. We won’t see the patch pump for at least 4-5 years

If you’re considering the upcoming Mobi (not quite a patch pump, but a solid, nearly-there hybrid), they’ve already announced that it’ll be $999 to upgrade an in-warranty pump to the Mobi. There hasn’t been any mention of free upgrades for new X2 owners yet, but historically those kinds of offers are made closer to release if sales/renewals are stalled in anticipation.

It’s a little weird. You’re basically renting the Mobi for the remainder of your warranty. (They do the same thing now for people wanting to switch from Medtronic). They disable your t:slim, but you physically keep it. Really not sure how that works. Do they just instruct you to power it off and hope you don’t know how to turn it back on? Is there actually a kill command? Is the pump left exactly as it is and fully functional, but they remove the serial number from their system so there’s no support for it??? They send you the new pump, while your old t:slim collects dust. Then at the end of the warranty period, you have to send the Mobi back to them, and they revive your old t:slim, but it’s now out-of-warranty, so lacks any support.

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40

That’s good info, thanks! I’ve already had one sales call with a Tandem rep who will be checking on coverage and copays for Tandems Control IQ pump. I’ll be sure to check with the salespeople about this Mobi upgrade deal and how it will work with Medicare.

1 Like