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Why not Omnipod?

Discussion in 'Parents of Children with Type 1' started by Adinsmom, Apr 18, 2015.

  1. Mo1

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    We did as mentioned above. We have the TSlim (love it) and cut the cord. Thought we'd be only using Omnipod (love it) in the summer but my daughter loves the pods more than TSlim. Very glad to have both, and insurance covers both supplies . We've not had a lot of problems with the pods, not more than we had with other infusion sets.
     
  2. jenm999

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    Grrr, tried again today. The insertion was fine, he said it hurt less than he expected and off to the pond we went. His BG skyrocketed as we were doing it, probably from anxiety. Unfortunately, two hours of swimming AND two corrections later he was still over 250. Not sure what I did wrong. Back to tslim when we got home and he's back under 200 (whew). I've convinced him to try again Friday as we have an invitation to go to a pool with friends. If only he would either love the omnipod and be willing to troubleshoot, or I could figure out how the heck to deal with no basal for a few hours while swimming...
     
  3. StacyMM

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    I always hear about kids that go low when swimming and that can go without basal...mine are not those kids! My daughter does an hourly bolus of basal and she doses in advance. So if her basal is 3.5 and she's about to go swimming, she boluses 3.5. And hour later, does it again. And again. It will screw up IOB for a few hours because it's seeing the insulin as bolus and not basal but we look at the recommended bolus and add the IOB back in. She's 11, though, so in your case you would need someone to be there to oversee everything. And I keep trying to get her to just swim with the T:Slim on but she refuses. She is afraid it will ruin the pump and I can't convince her. Another option is the waterproof belt - we have one and she's worn it a few times. She'd probably wear it more often but we are losing it constantly. http://www.amazon.com/Aquapac-Waterproof-Insulin-Radio-158/dp/B0044M102M. I think it only recommends itself to people with a basal rate over 1/u per hour, so that might be an issue for you.
     
  4. jenm999

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    Usually he drops like a rock. And usually 2u of insulin will drop him like a rock too. The pod was definitely not working. He dropped the first one putting it on and we discarded; I tried to siphon out the insulin from that one for the second and thought I had done it successfully but maybe I inadvertently inserted a lot of air. Or he really was so anxious that he was still rising when I gave him those corrections and they only stabilized him. Who knows. I'll check out that belt, thanks.
     
  5. rgcainmd

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    I learned this Omnipod "trick" on tudiabetes:

    For a good number of people (my daughter included) Pods need additional "priming" after they're attached. Depending on BG at the time, whether my daughter is about to eat, amount of exercise, how the planets are aligned, etc. (you know the drill), I bolus a little extra (0.5 to 1.75 units) after changing to a new Pod to "get things going". Works like a charm every time.
     
  6. jenm999

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    Well, something was going on with him the rest of the night so it may not have been the pod after all. I got him to 110 with the tslim before dinner but then he was high despite hourly corrections and temp basal increase until about 3am. Seems OK today so far, maybe a bug?
     
  7. rgcainmd

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    I hope the problem was due to an unladen European swallow flying overhead, or an 11-toed calico cat crossing your path, or the fact that the 12th day of the month landed on a Wednesday, or... and NOT a bug because we all know how those bugs can completely mess up our kids' BG for many days afterwards despite our best efforts to get things back on track.
     
  8. jenm999

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    Fingers crossed it was the 11-toed cat. No signs of illness but still needing tons of insulin. He's 89 now so I turned off the temp rate and will put him to bed, see if he stays level. This is fun.
     
  9. jenm999

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    My little guy asked to try the omnipod again today so of course I said yes. Beautiful painless insertion on his lower back.

    This was at 2 pm and he was 113. He had eaten about 90 minutes before. He started rising about half hour after inserting the pod, and was at 160 at 3 and still going up. The pump suggested .5 as a correction, so I gave him just .25u since he still had some IOB from lunch (not sure how much because we were out, but I figured bolusing for half was safe). He went up to 180 around 3:30 and is now back down to 162. I'm not sure if the rise was a delayed reaction to lunch (usually he peaks 2 hours after eating, but was slow to eat, and had slow food: hummus, pita chips, and greek yogurt) or the new pod phenomenon you describe above, or just one of those weird things. It is unusual for him still to be so low (or not high, you know what I mean) an hour after eating so I'm betting on a delayed food rise, or maybe excitement of the new pump, who knows? Should I do anything differently?
     
  10. Cheetah-cub

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    I would give another day or two and see if there is a pattern, and then decide if you should adjust perhaps the meal IC ratio.

    My DD just turned 12, with growing, summer trip to Europe, then T1D camp, her BG has been all over the place this summer.

    I found myself changing her basal, and IC ratios all the time, but I still think her A1C will go up when we go see our endo later this week. BG going up to 180 after a meal would be pretty good to us.
     
  11. jenm999

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    Yeah, that's great for us too! I aim for <200 if at all possible but fail often. He's been in range since then so I'm hoping it was just a hiccup of a new pod. I did take the insulin out of the just-filled tslim so maybe there was a bubble or something. He loves it!
     
  12. rgcainmd

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    Glad to hear that the podding is beginning to go better. He may never want to switch back! (Don't know if that would be a good thing or a bad thing for you guys; all I know is that Omnipod is a good fit for my daughter and we really don't have anything else to compare it to as that's the only pump she's ever used.)
     
  13. jenm999

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    I'm ambivalent about pumps at this point. Whatever makes him happy is fine with me. There are things I love (and things that annoy me) about both devices. The only thing I worry about is losing the PDM but we haven't lost a Dexcom yet so there's hope!

    And, above, when I laid out his BGs after putting on the pump, I was not concerned about his BG numbers per se, I was only concerned that he maybe was not getting the full basal amount up front because of the dramatic rise right after we put on the pump. I do think though that maybe it was a delayed food rise because he grazed for some time and came back in range nicely.
     
  14. T1mama

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    Can someone explain to me how you get both a pod and a pump? We are just about ready to start looking into switching from MDI and I'd like to know all our options.

    Thanks!
     
  15. Christopher

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    What is your rationale for wanting both?

    Others more knowledgeable hopefully will chime in but the company that makes the Omnipod has a program called Cut The Cord. It is for people who already have a pump and gives them a discount to encourage them to switch. I am not sure exactly how this would work if you don't have a pump yet. I guess you could order the tubed pump and then "change your mind" and do the Cut The Cord program. Not sure how your insurance would feel about that.

    I had originally considered this because I was concerned about the problems I had read that people had with the Pods. I figured I would try the Pods and if they were just horrible then I would have the tubed pump. Other people use the tubed pump at certain times of the year but then during the summer months they use the Pod because it is waterproof.

    Danielle did saline trials of both a tubed pump and the Omnipod. She really did not like the tubed pump and really liked the Omnipod. In the end it didn't make sense for me to pay for both pumps if I knew she wasn't going to use the tubed one. We have been using the Omnipod for about 3 weeks so far and (Knock On Wood) they have been working great. I am having a bit of a learning curve with pumping in general but that would have happened with a tubed one too. The one thing I really like about the Omnipod is being able to dose her remotely. So if she needs a correction at night I just need to program the PDM ahead of time, step into her room to get the PDM close enough to the Pod and push a button.

    I would also recommend getting a CGM if possible. It really makes a difference in helping to determine the pump settings, especially the basal insulin.

    Good luck with your decision!
     
    Last edited: Sep 1, 2015
  16. MomofSweetOne

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    My daughter has a Medtronic pump, and two years ago we cut-the-cord to also give her the option to have it for waterparks, kayaking, etc. after having waterproof pouches not work out for her. She wore it more than the Medtronic last winter until May, but she's worn the Medtronic this summer. We like having both for a back-up to avoid the Lantus/Humalog basal differences in event of a pump failure - which we've had with both systems. When we got the pod, Cut-the-Cord was $200 OOP for the pdm and they submit the pod bill to insurance. Our primary insurance refused to cover the pods since they'd approved the Medtronic, but we're able to get them through our prescription company. It's not like she wears both sets at the same time!

    We like having it, but we both agree we wouldn't choose it as her solo pump. In fact, she's hoping to switch to T-slim within the month. T-slim seems to have the best features of each pump for us, minus the remote. It wasn't on the market four years ago, or I'm sure we would have chosen it then.
     
  17. jenm999

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    This is exactly what we did, and like T1mama planned it out before we even had a pump. I knew a week's trial would not give me a complete picture and if my son didn't like the Omnipod we were stuck for four years, but that if he didn't like the tslim we could always try to Omnipod. Personally I was attracted to the Omnipod but skittish about all the problems I'd read about (for the record, not a single failure yet).

    We are fortunate to have insurance that covers pumps and supplies as DME at 100% so I got him the tslim first and added the Omnipod once summer arrived to try out a waterproof pump (and have a back-up pump in the process). Yes, I suppose I'm taking advantage of my insurance company, but they have approved both consumables interchangeably, and I do pay higher copayments for the Omnipod compatible strips.

    I'd be curious to see the out of pocket costs for a month of pods vs. a month of cartridges and insets.

    We also change our pods/sites every 48 hours per our doctor's recommendation and our insurance covers that.

    Ultimately it's in the insurance company's best interest for my son to have good control and keep him out of the hospital. One trip to the ER or an overnight for DKA is much more expensive than pump supplies. Not to mention the cost of treating complications down the road. I don't think they feel anything; it's a numbers game.
     
  18. T1mama

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    Thanks for the responses! I wasn't sure what "cut the cord" was. I wouldn't want to purposely take advantage of insurance, although I really wouldn't feel too bad if i did. They have made us jump through hoops to get approved for the necessary # of test strips we need a month!

    My son has had Dexcom for cgm since June (about 6 weeks after diagnosis). We are thinking that he will prefer the Omnipod but like jenm99 said, we dont' want to get stuck for years if he ends up not liking it.
     
  19. Christopher

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    I had the same concern. But just so the OP is aware, most pump companies (I know for sure t:slim and Omnipod) have like a 45 day period once you purchase the pump that you can return it if it is not working out for your child. Just another thing to consider.
     
  20. jenm999

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    Just coming in after a month of podding to say we LOVE the omnipod! I can't believe how much easier it is than the tubed pump. It's just less fussy to fill, insert, and so much less bulky for my little man.

    I see how people can be skittish with all the info online about recalls and screaming pods but it's been totally problem free for us and much less stressful than the tslim. I wonder if Insulet will ever live that down.

    Anyway, VERY HAPPY here and encourage anyone on the fence to give it a try. Not sure if they are still doing a cut the cord program, but that's a good option to have your cake and eat it too, if your insurance will allow it.
     

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