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Anyone switch to Omnipod and end up with a higher A1c?

Discussion in 'Parents of Children with Type 1' started by mmgirls, Jan 4, 2014.

  1. Junosmom

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    Thank you for the clarification. Yes, I will restate it and try to remember to word it correctly in the future. Both the PDM and the CGM show that they are within control parameters. Both give very different numbers.

    I do understand that the CGM is calibrated to a meter, of course, but which one do I trust? My son was very astute and said to use the PDM (which reads low) because if it is actually higher (the Nano reading) and we trust that, but he is in fact much lower, it would make him go very low. However, we've always used Nano without experiencing many low symptoms.

    If, however, the Nano is correct, then using the PDM readings will mean thinking we have numbers in range (80 to 120) when in fact the number could be much higher (160s). This would, over time, affect A1C. I have to call Omnipod today anyway about strips, so I'll ask them what they think.
     
  2. hawkeyegirl

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    LOL, Insulet will say that the PDM is just fine as a meter. What else can they say?

    I've read enough reports of the PDM reading low from people who I trust on here that I would not use it if we were to start using our Pod system. Which sucks, because that is then one more thing you/your child has to schlep around.
     
  3. Junosmom

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    This morning, we used it and the numbers were close, 107 versus 116. I called the CDE and she said that she has heard/seen that the PDM meter will correspond well when the numbers are within range, but not if out of range (I'm assuming of target BG). Her recommendation was that if I had been comfortable with the Nano to continue using it. I deduced that many patients do that. Son really wanted to use the PDM, and yes, because it is one less thing to bring along, but he said okay reluctantly.


    I also called Omnipod number on the back of the PDM as advised by CVS pharmacist to ask about strips. (He'd indicated they might even send some to me free of charge because of a recall. Nope.) The representative was not friendly at all and bluntly said, "You need to call Abbott, you are calling the wrong company." I asked if they had a phone number (of a company that is part of a device that they sell!) and she said no she didn't, she'd Google it for me. Thanks, I know how to Google. It seems that the rest of my difficulty with getting Freestyle strips is all paperwork, insurance haggling, etc that can be overcome, but I think I might just stick with Nano for right now since I have a bunch of strips anyway. We'll see how that goes before pursuing the strips for the PDM.
     
  4. swellman

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    It's honestly not a big deal - the Verio IQ fits neatly in the PDM case with virtually no added weight. It's no worse than carrying extra multiclix barrels. I would say the biggest inconvenience is that it makes it a 2 step process and, hell, half the time or more we're talking about how to bolus and the PDM times out and we have to enter the BG again anyway. For me, it the fact that the data contained in the PDM is biased unless you enter all BG measurements regardless of insulin administration - which we do not.
     
  5. DavidN

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    It's difficult to ignore the number of parents claiming the PDM understates BG, but again yesterday our A1C came back spot on with the G4. Maybe it works for some and not for others ...
     
  6. Junosmom

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    If I understood her correctly, the Omnipod representative herself admitted that some PDM meters have been a problem and were not working properly. If I suspected this, I could prove it at my own expenses and they would then replace it. It is entirely possible that it works for some and not others because of the device itself, isn't it? I was told to do what works for us and makes us the most comfortable, but you are right, it is hard to ignore that they seem to have a problem. It does validate my experience somewhat. :)
     
  7. Melissata

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    I don't see anyone else stating that they do this. Instead of comparing an average on any meter or CGM, why not just note the bg at the time of the blood draw and compare the two? I do this almost every blood draw, and have never had it be more than a few points off. Since it is a big deal to me for my daughter to have to enter a number into the pump, it does concern me that people are saying the PDM is not accurate. In fact I didn't get her last tests mailed to me, so I don't have the bg at the time of the test. I will be sure to get it next month when I go, because I am not certain that we have tested this new PDM.

    Has anyone else actually compared the new PDM to a blood draw? It doesn't make sense to me to compare it to a different meter. That is why I always thought it was stupid to make her test with the office meter when there. Who says it is always accurate? This office has stopped doing that now, and has her use her own meter.
     
  8. DavidN

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    I'm not sure what you're trying to say here. It's confusing.

    We go to the ped endo office. They check my son's BG with our PDM then they check again with the office meter. The two readings are always very close. I always thought this was part of the drill for everyone. And if it is part of the drill for everyone, there are lots of people sticking with the PDM. That combined with the fact that our A1C matches our CGM avg allays a bit of my concern over the accuracy of the PDM.
     
  9. ecs1516

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    The other office in our area(Ped End) does not compare against their office meter. I am glad that our office does.
     
  10. Junosmom

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    I'm very, very new to pumping and CGM, so please bear with me :) (As in this week!) I called Omnipod, and rep said the only way to verify a meter was to check it against a blood draw - lab work. Now, my question, is the "office meter" one like they use in the hospital - that is - it is supposed to be more accurate than our personal meters (or so I heard while in the hospital with him). At the hospital, they were not allowed to use his meter for the records, but had to use a bigger, supposedly more accurate meter.

    I have compared the meters only to see if they agree, and mine do not. That doesn't mean that yours doesn't, they could. Am I correct in understanding that the CGM is calibrated to your meter, which is why every 12 hours we enter a reading? So if the G4 is calibrated to a meter, it would agree with that meter. Change meters, they might not agree and you'd have to recalibrate? The G4, then, is only as good as the meter you use, as I am understanding it.

    I just ordered the book, Pumping Insulin by Walsh, and hope to learn more soon. We've had a rough patch here in the last 24 hours after a fairly good start.

    When next we have an appointment and they draw blood, I will ask the result and also use our meter. At least I'd have some data.
     
  11. MomofSweetOne

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    Is your child now running high once the Lantus is out of his system? My daughter ran high the 2nd day, was miserable and dizzy. We weren't supposed to call in until the 4th day, but by the morning of the 3rd, I couldn't stand it any longer. Our CDE changed her basals, and within 4 hours, she was in range and feeling fine. I wish I had called earlier than I did. Don't wait to call your CDE for help if you're seeing problems. Things really can be completely different in a few hours.
     
  12. danismom79

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    Our office has never checked our meter and compared with theirs. All they do is the A1c.
     
  13. StacyMM

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    We've never had our meters compared with an office meter. And we onlyhave a blood draw once a year - they do a finger prick a1c test each visit but that's it.
     
  14. KatieSue

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    Our Endo has never checked our meter either.
     
  15. Megnyc

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    I don't have the more recent ones but this was in August:
    Blood Draw (fasting): 83
    PDM: 64
    Onetouch Verio IQ (meter 1): 87
    Onetouch Verio IQ (meter 2): 84

    It is possible I was using the recalled freestyle strips. I don't have the strip containers left to check. My endo does not have me compare my meter to the office meter. We do all A1Cs by blood draw because I have to get weekly blood work to check my blood counts anyway so it is not a big deal to add it on.

    My last A1C was equivalent to an average blood sugar of 105. My Dexcom average for the past 90 days is 107 and my 90 day meter average (487 tests on onetouch verio) is 106. Since my PDM is very consistently 20-30% lower than my onetouch meter (which correlates near perfectly with my A1C) I am comfortable saying that I believe the PDM reads too low for me.
     
    Last edited: Jan 13, 2014
  16. Junosmom

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    Yes, he was running high after dinner, and not coming back down like he used to. CDE called me this morning, looked at our numbers, and suggested a higher basal from 8 p.m. - 12 a.m. Going to try it tonight. (She called me last Friday morning, but everything was fine then :) ) So, this is maybe due to Lantus gone?
     
  17. Melissata

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    Thanks Meg, I will be checking into this more fully. I looked up my records from the blood draw in July, but I neglected to have her test at the time of the test. I did have her test at the one in November, but I didn't get the actual copy of the test, they just called with the A1c results. I am going to call for them to mail that out to me, and I remember for sure what her bg tested that day on the PDM. It was 65 and they were all freaking out in the lab, one girl ran for juice. They obviously don't see that often in an adult practice with mostly type 2's. I can't imagine that her PDM was reading low that day, because she had no symptoms. She will have another lab draw on Feb 5, so I will be pretty sure between those two tests on how well her PDM is testing for her. I had forgotten that most ped endo's do the finger stick A1c's, so it is harder to know for sure. There have been times when the lab has not tested the actual glucose with the blood draw, you have to make sure the doc puts it on the orders, just in case anyone has yearly labs coming up that want to test their meter or PDM. It really is the only sure way to know.
     
  18. NeurosurgeryNP

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    I use the OP as a tubing break pump with the Cut the Cord Promotion. I use One Touch and find that the Freestyle consistently reads lower. Although NOT APPROVED, I use Code 18 with the Freestyle strips and it matched on par with my OT readings. My OT readings reflect my A1C.
     
  19. Melissata

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    I remember that being discussed before, but hadn't thought of trying it until now. I did request and receive her actual labwork. The Omnipod PDM read 62 and the lab result was 75. Not a huge difference, but I wouldn't have had her treat a 75.

    As far as the testing against an office meter, it just doesn't make sense to me why they assume that their meter is more accurate. I know of two docs that stopped doing that, which leads me to believe that they realize it too.
     
  20. DavidN

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    The hospital and doctors office has lots of medical equipment on hand that is superior to what we carry at home. Not sure why a BG meter would be any different. But maybe it's not. I guess a comparison equals some information which IMO is better than no information.
     

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