Wednesday, February 1, 2012

Insulin Pump Review…our thoughts on the Omnipod

We mentioned at the end of a recent post that a trip to the endo in early January revealed that Emerson’s A1C had increased slightly since her last visit and that it wasn’t due to us allowing her to deviate from her normal diet over the holidays but rather to issues we had with her pump. We didn’t go into any detail in that particular posting because we planned to write this one – which is our review of the OmniPod.

Emerson has been podding since June 13, 2011 – so for 7 ½ months. We felt fortunate to be approved by insurance for a pump just 4 months after her T1D diagnosis, as we had heard that isn’t always the case and they actually denied the request initially. We attended an insulin pump information session put on by Riley Hospital for Children and listened to the pros and cons of many different pumps. We also did our own research but mostly found websites that simply compared the functionality of the pumps, and read blog postings from fellow bloggers and the Children with Diabetes forum. While we didn’t find any real deal-breakers with other pumps, and our pump nurse felt that we couldn’t go wrong with any of them, selecting the OmniPod wasn’t a difficult choice for us.

We loved the fact that it was tube-free and watertight. We assumed that the tubes on the other pumps would have the potential to get caught on things during play. We were sure though that the pods being watertight was a big deal to us. We live just outside of Indianapolis, so our pool activity is limited to a relatively brief timeframe. But during those few months Emerson does love to be in the water and not having to interrupt her insulin delivery while she swims is a big plus. In fact, we took her to the pool several times the first week on her pump to test it out.



This is true for baths as well. While we don’t think it is necessarily a huge risk to stop and restart insulin delivery for short durations, we like the peace of mind of knowing that basal insulin is always flowing, the convenience of not having to remove and replace the pump, and avoiding the additional manual insertions that would come with those additional applications.

That brings us to another significant benefit of the OmniPod – the automatic cannula insertion. After adhering a new pod, the insertion is accomplished by simply pushing a button – no seeing or handling needles. This is all managed through the Personal Diabetes Manager (PDM), the handheld device that wirelessly programs insulin delivery, calculates suggested insulin doses based on the settings and inputs provided, and contains the built in Freestyle blood glucose meter. We think the meter is a significant plus over those that don’t have an integrated meter as it is one less device to carry and it eliminates the potential for errors when transferring the reading from a meter to the pump. We also love that it is a Freestyle meter as the test strips require significantly less blood than other strips, meaning the lancet can be used on a much less invasive setting. In addition, the pods are relatively small and very lightweight in comparison to having to wear an entire pump, and even smaller pods are in the not too distant future according to Insulet. We have heard and read concerns by some parents about the size of the pod, but we do not feel that the pod is too big for Emerson’s small body, and she isn’t bothered by its size.

There are obviously many other features and aspects of the OmniPod that we like, but this is just an overview primarily of those things we believe are unique to this pump.

We believe the OmniPod is the best option for us and expect to be podders for a long time. But we do acknowledge that there are some negatives that, while we see them as minor, we want to explain for the benefit of others that may be preparing to make their own choice. Firstly, the smallest increment of insulin (both basal and bolus) that the pod can deliver is 0.05 units/hr (compared to some others that allow for 0.025 units/hr). We suspect this will be a non-issue for most users and would only affect those receiving very small doses. In our case it has not been a significant issue but we have experienced an occasion or two where going from one increment to the next was almost too big of a change. However, by tweaking the basal rate and the bolus formula we have always been able to manage through this fairly easily. The other drawback that we think others should be fully aware of is the periodic pod failures that do occur. When this occurs you simply contact OmniPod Customer Service, which has always been great to deal with, and they will send out a replacement pod free of charge. While we were obviously worried the first couple of times this occurred, it has become just a minor inconvenience. We do want to point out though that this isn’t always the fault of the device. The pods will fail due to technical issues but more frequently in our case, can simply work less effectively due to issues with the site and/or placement on the body. This is identifiable through suddenly elevated glucose levels that normally remain high until a pod change occurs. This is not something that OmniPod can control or predict and is obviously not a product defect. We were slow to react to this in the beginning but as consistency in Emerson’s blood glucose has increased it has become much easier to detect and mitigate. We cannot explain what specifically drives this and believe that simply being aware that this can occur and flexible enough to address it when it does is a small inconvenience in comparison to the pros of this pump. Static, from things like plastic slides or plastic school chairs can also interfere with the pod and cause it to fail, but this is an intermittent issue and something that can easily be mitigated by tucking a small piece of a dryer sheet in the pod cover or nearby clothing.

We hope anyone that comes across this that is looking for their first pump or is considering switching pumps finds this helpful. We believe that the availability of more thorough reviews that cover both the pros and cons of the different pump options would vastly improve the decision making process for folks. Given that, we invite and encourage others to comment on their pump of choice to give readers the ability to conduct a more in-depth comparison of alternatives. If you have questions on the OmniPod that are not addressed here feel free to let us know and we will certainly be glad to answer them for you.

22 comments:

  1. Not being able to visit my favorite little red head as often as I would like breaks my heart. That being said, thank goodness for the internet and your blog updates.

    I won't even pretend that I fully understand the daily challenges you, Jim and Em face. However, I do commend you on your well researched blogs, educating each of us on the impact of diabetes.

    I can honestly say your words (blog) have taught me and encouraged me to further research life with diabetes.

    I can only image the knowledge, comfort and inspiration you must bring to other parents and families.

    Job well done, Thank you!

    Love
    Uncle J

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  2. Great review of the Pod! We're in week 3 (I think) of podding after using the Animus Ping, and you nailed it. We've found some increments still a little too large, but it has been manageable. My biggest surprise has been how useful it is NOT to see IOB for carbs (though I get people's discomfort with this) - it has kept us from panicking over food insulin on board and has let us see when there's too much still on board from corrections. Animus munges carb & correction insulin together after an hour, which made it hard to see what's going on.
    What does Emerson think about insertion - painful, or not too bad? Our little guy still freaks out over it, b/c it's so fast, he says.
    thanks for the write-up!

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    1. In the beginning Emerson didn't love the insertions but we overcame that relatively quickly. For her I think it was the "click" that bothered her the most. A couple things helped us manage through this. First, we constantly reminded Emerson that this allowed us to eliminate the numerous manual injections. She seemed to get that pretty early on. More helpful though was seeing others that were experiencing the same thing. We showed her pictures of other podders on other blogs and we watched the video of Caleb of This is Caleb blog doing a pod change. Perhaps you could try that and see if it helps while Luke gets more used to the process and it becomes a non-event (trust us - it will get there!).

      It is of note though that there are times when the actual insertion is temporarily more painful than other times. If the cannula hits a nerve on it way in it can cause some discomfort, just as with a manual insulin injection. After getting very different reactions to the insertions from Emerson early on we asked a co-worker that is much older and has been podding for years about the level of pain. She did explain how the amount of discomfort can vary. We are guessing that the magnitude of pain is not that high though as Emerson has not acted as though she has felt any pain in months - and we don't think we have just been lucky enough to avoid all nerves for that long. In fact, Emerson will now say "I didn't feel anything" after most insertions, which probably isn't entirely true but is reassuring.

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    2. I've now heard others say that the "click" bothers their kids the most, too. Thanks for the detailed reply! Luke is reacting a lot less strongly to it now, so I'm guessing part of the adjustment is psychological, too. He's been asking about shots recently (has never done MDI), I think because he imagines it's fewer pokes. Ah, well! If he were older, I'd have him talk with your daughter! :)

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  3. Thanks for the comment on my blog! I am so amazed at how much my daughter loves the pod. Glad it's going well for you guys too!

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  4. Thank you for visiting my blog and directing me here to your pod review! We're still definitely leaning in this direction, I just hope that the increment differences don't become a problem (maybe it won't be - same with the IOB - as we don't have any reference point from another pump with these things to begin with). She's on pretty aggressive humalog doses for breakfast and lunch but not for dinner, and her lantus is only 2 units, so I'm not sure how that would relate to a pump situation. I guess these are things we'll find out through training and with the reps when they come to the house. I'm glad to see another positive review of the pod though! Thank you for sharing your experience with it.

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  5. Great review of the pod! We are only about a month or so into it...and while Adam LOVES it...I'm still on the fence. Since he loves it so much, I don't think we'll go back to the Ping, but I have to admit I miss those little basal increments too! And we just have the darndest time keeping those pods on him. We haven't had a pod "fail" yet, but plenty have failed due to the cannula coming out - that is my biggest issue right now. Perhaps Adam is just so active no pump can stay on him! Who knows...but I'll keep trying because he loves the pods. :)

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    1. Glad to hear Adam loves being a podder. We understand your concerns though as you need to have peace of mind with these things. A couple thoughts come to mind. Emerson gives her pods quite a workout at m practice twice a week and when she treats our house like her personal gym on a daily basis. We don't doubt that Adam is giving the pods a workout but may have something that will help. As we mentioned in our "Favorite Things" post we use a product called Skin Tac, which is a liquid adhesive for applying things to skin. You wouldn't believe how much this helps with security and stability, and how it holds up under rigorous activity.

      My other thought was around the actual insertion. I do not know what Adam's body type is but Emerson is very lean and it is difficult to find much fat to "pinch up" on her pod sites. We think this can sometimes cause a less than ideal cannula insertion - but is not something that can be avoided obviously. Also, if Adam gets tense when it comes time for the insertion to occur that may also be affecting the cannula's abilty to go in correctly. We experienced this in the past and now always remind Emerson of the importance of staying relaxed. Not sure if Adam is getting a bit tense as he anticipates the insertion but it could be having an impact.

      Hope this is helpful!

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  6. Hello there! I was just searching "omnipod reviews" and came across your blog - My 6 year old son has type 1 and we're seriously considering the pod for all the reasons you listed. We've been trying demo pods and while the adhesive sticks, we're finding that the pod pulls away from the adhesive. Do you think it's because there is nothing inserted? Or would you have any suggestions on how to correct this? Oh, and fun fact - we're from Kokomo, IN and went to Riley last Friday for Jack's pump consult with Jill. It's a small d-world :) aedouble@yahoo.com

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    1. Hi there. From time to time, Emerson has a pod pull away from the adhesive but we can usually tape it with Hypafix tape and save it. If she wears the pod on her arm, we use a Bands4Life band and it helps keep the pod secure.

      We also have goodluck with using Skin Tac. It doesn't keep it from pulling away but it does help it stick!

      I have several little tips and tricks that I have learned along the way that I would be happy to share with you. I will email you my contact information and you can call or email anytime.

      P.S. Maybe we can even meet up sometime when you are in the area...we live close to Riley!

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  7. Thanks for your candid and personal review. My 11 year old was diagnosed 3 months ago and we attended pump night this week with her leaning toward the Omnipod. This helps to know that it is working for you. Mary Beth Osborne Durham, NC

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    1. Good luck with your selection! If you have ant questions on the Omnipod, please feel free to message me.

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  8. IN YOUR REVIEW, YOU MENTIONED ABOUT GETTING IMSURANCE APPROVALS. I ALSO, AM HAVE PROBLEMS GETTING INSURNACE APPROVALS. COULD YOU PLESE PROVIDE A FEW POINTERS ON GETTING THE APPROVALS. MY INSURANCE COMPANY IS FOLLOWING THE MEDICAD/MEDICARE GUIDE LINES.
    I AM 60 YRS OLD, HAVE BEEN A DIABETIC SINCE I WAS 10 AND MY DOCTOR IS ENCOURAGING ME TO GO TO A PUMP. I HAVE BEEN RELUCKENT, UNTIL NOW. THANK YOU

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    1. Hi David. Insulet was a huge help in getting us approved for the Omnipod. We were initially denied by Anthem, but Insulet scheduled a peer review between an Anthem rep and my daughter's endo and we were approved after that meeting. If you have selected a pump, you should work with that company...I hear that they all have great customer service reps.

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  9. Thinking about getting Omnipod for my active 12 year old. Thanks for your candid replies. This is a big decision for him.

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  10. Hello , my name is Chris and I am a 39 yr old male with T1 and I wear the pod. This is my first pump and have been wearing it for abour 6 months now. I like the pod but i an having difficulty with it staying attached to me, I sweat a lot!!!! I need help bc I am getting very frustrated and thinking about changing to another pump even though I would prefer not to. On top of the frustration I really don't like wasting insulin and if I loose too much insulin I have to pay full price for insulin till its time for a new prescription. Please help!!

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    1. Hi Chris. Have you tried Skin Tac? We use the liquid form and apply it to the skin before applying the pod. My daughter's pods almost always stick for the full three days (if we have to change it early it is for other reasons). We also use Bands 4 Life bands when she wears the pod on her arm. They also have thigh and stomach band but we haven't tried those yet.

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  11. Hi, I have been diabetic for 22 years using needles. I have recently decided to get a pump. After seeing several different pumps and not knowing a thing about them, I was leaning towards the omnipod due to the fact that it has no tube and is waterproof. I have been searching the internet to see if there are any others with the same features. No luck. Would you know of any? I don't want the hassle of tubing and I swim a lot. At this point I think I want the omnipod. Thanks for all your info. Wanda

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    1. Hi Wanda. Omnipod is your only tubeless option at this time. There are probably others in development but I do not have any information. My five year old daughter wears the Omnipod and she has no trouble keeping it on with swimming. We do use Skin Tac to help the pod adhere so it usually sticks the full three days (however, she will occasionally knock on loose). Good luck with your decision. If you have any questions about the Omnipod, please feel free to shoot me an email. Redheadliving@gmail.com

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  12. Hi-

    I also am considering the omnipod. I was just diagnosed last June but my doctor is talking to me a lot about going on a pump. Do you use a Continual Glucose Mointor like Dexcom? The hesitation I have is having two different things attached to my body. Thanks!

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    1. Hi Sunni. We love having our daughter on a pump. She has been wearing the Omnipod pump for a year and a half, and she started wearing the Decxom G4 continuous glucose monitor about a month ago. So far, we have not had any issues with her wearing both except she doesn't have much real estate so we have to trade between arms, back and bottom. If you pull up our December 21st post, you can see a picture of her wearing a pod and CGM sensor on each arm.

      If you have any questions, please send me a message andi will see if I can help!

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  13. I'm a 55 year old T1D since 1969. My, how the tech has advanced! Have been on the Medtronic Minimed pump for about 10 years and started the Dexcom G$ CGM last month. That thing is slick....and painless! They are working on an iPhone interface for the bluetooth receiver. My endodontist, Hemant Kapadia in Clear Lake, TX, wears the Omnipod and he has suggested it to me. I'm tired of the tubing and belt clip. Many firms as working on the closed-loop system, but FDA requries an auto-suspend AND Glucagon options that must be autonomously programmed into the system. This wll be a great advance, but the Dexcom G4 still CGM still swerves up to 100 points off actual. (That's only when rising and falling FAST). The best thing about it is the trend arrows. They really help you anticipate WHERE your blood sugars are going. All of this...before the stem cell fix becomes available. They are working on tricking one's own gut stem cells into producing islet cells that don't require immunosuppresants. That'll be the ticket in 3 - 5 years! - Scott McNeill

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