If you are like many insulin dependent type 1 diabetics out there who strives for optimal excellence in diabetes control, chances are you either have an insulin pump already, or you have given consideration to going on an insulin pump. Here is a look at the OmniPod insulin pump.
When I got my first insulin pump slightly over 10 years ago, I started off with a MiniMed 501 pump. While it certainly did most everything it promised to do, there were many things I didn’t like about diabetes management on this pump. The biggest factor for me was all of the tubing and feeling like I was “connected” to something. I found it nearly impossible to wear with a dress because I had such a small frame that there was no way of placing it discreetly under a dress. I always had a giant bulge somewhere under my clothes. My chest size has never been large enough to hide a pump in my bra like the product claims say you can. Additionally, it was uncomfortable to try to sleep with and when I would tuck it under my pillow at night, I would often wake up because I had tangled myself up in the tubing. It was also cumbersome to have to manually calculate how much insulin to take and when, etc. and was challenging trying to swim or take a long bath because I had to detach my pump, but be careful to re-attach it and check my blood sugar every 20-30 minutes to ensure my blood sugar did not go too high.
I am, and always have been, an extremely busy person. At that time I was a wife and mother, I worked full time, and I also went to school. It wasn’t that I didn’t want to maintain good control of my diabetes, it was more that because of how busy I was, diabetes management often went by the wayside. I would forget to check my blood sugar or would forget to bolus for meals, and my diet was certainly lacking as well. So, after the warranty on my MiniMed pump expired and it malfunctioned, and I didn’t have the money right away to replace it, I went back to manual injections. Three years later after a trip to the ER for diabetic ketoacidocis (DKA) and an A1c of 10.7%, I realized that I had to do something before I wound up unintentionally killing myself. I knew I needed to go back on an insulin pump, but I hated the restrictiveness I felt with my previous pump. After doing a ton of online research and asking around, I finally decided on the OmniPod insulin pump.
The OmniPod has taken care of many of the issues that I previously had with my MiniMed 501, but it also has some drawbacks too. Here are a few of the advantages.
1. No Strings Attached. This is the slogan of the OmniPod and it means exactly what it implies. There is no tubing to deal with. Instead of tubing and having to find a place to secure the pump on your person, OmniPod offers a pod with a reservoir that holds 200 units of insulin. If you take a hard boiled egg and cut it in half length-wise, this is a pretty close illustration of the size of the pods. You control all aspects of insulin delivery with a “remote” called a Personal Diabetes Manager or PDM. The pods are active for three days and communicate with the PDM to deliver the appropriate basal rates at the appropriate times. When you eat a meal, you tell the PDM how many carbs you are about to eat and it delivers the appropriate bolus of insulin to cover your meal.
2. It is idiot proof. As I previously mentioned, diabetes management was always difficult for me due to my busy lifestyle. Forgotten boluses, skipped meals and failure to test my blood sugar was all a way of life for me, often because I would simply forget to do what I needed to do until I felt bad and had to “chase” a high. Then, I ran the risk of not calculating the appropriate correction and would often then wind up going too low, or wouldn’t take enough insulin to cover the high.
With the Omnipod, all the guess work is eliminated. With the help of your doctor, you determine what the appropriate basal rates are and what your target glucose range should be. You program this information into your PDM along with your insulin:carb ratios – which can be programmed to be different from meal to meal, and you set your correction factor (for example, 1 unit of insulin lowers your glucose level by 50 points). You can also program the PDM to calculate reverse corrections if your blood sugar is below your target when you test before a meal. When you eat, you simply check your blood sugar and tell your PDM how many carbs you plan to consume in your meal and the PDM calculates everything for you, including increasing or decreasing your dose based upon your blood sugar reading and thus reducing the risk of math errors which may result in an incorrect insulin dose. You do retain the power to override what the PDM suggests for a bolus, however. And if you are unsure about the amount of carbs contained in a food item, the PDM has an extensive self contained library which you can use to look up your food item and see how many carbs are in one serving.
And that brings me to my next advantage…
3. Built in glucose meter. There is no need to carry around a glucose meter and your PDM. The PDM has a built in Freestyle glucose meter so you only have one device to carry around.
4. Lots of alerts and reminders! This was a huge selling point for me. With the OmniPod, you can program reminders just in case you forget. For example, if I do not bolus for breakfast between the hours of 6:30 am and 10:30 am, my PDM will beep to remind me of my missed bolus. If I have skipped breakfast and no bolus was necessary, then I simply press the button “OK” to let it know I’ve seen and heard the alarm. If I ignore or do not hear the alarm, it will beep periodically to get my attention and to remind me. I have reminders set up for all three meals. Additionally, you can program the PDM to remind you to check your blood sugar. The PDM will then use the same method of beeping until you respond to the alarm. You also get alerts and reminders when your pod will soon expire or if your reservoir is low (you get to set when it should alert you).
5. Awesome safety feature. You can program your PDM to sound an alarm if you have not manipulated the device for a specified period of time, and if you ignore or do not hear this particular alarm, after about an hour, it will disable your pod and cease to deliver your basal rate. This is an excellent feature, especially if you live alone or are prone to overnight hypoglycemic unawareness. This is a safety net of sorts so that if you black out, the PDM will shut itself off, and (hopefully) once it shuts off it will cause your blood sugar to raise enough so that you regain consciousness and can get yourself the help you need. And no need to worry about not hearing this alarm. With each reminder beep, the sound on the PDM gets progressively louder. Additionally, the pod also beeps. And if that doesn’t get your attention and the PDM needs to shut itself off, then both your pod and your PDM will then sound off an extremely annoying high-pitched solid beep that will not stop until after you have pressed the appropriate keys on the PDM to silence the alarm.
6. No need to keep the PDM on your person at all times. Unlike other pumps that have tubing, it is not necessary to stay “attached” 24/7. The pod stays on your body, however there is no need for any sort of belt clip or holster to keep the PDM at your fingertips. Your pod will continue to give your basal rates even if it is not in close proximity to the PDM, including changing basal rates at the times you have programmed. The PDM comes with an attractive carrying case that is small, yet has enough room to store test strips, lancets, a bottle of insulin, spare syringe (always a good idea to have with you in an emergency), and extra batteries. However, in order to bolus for meals, it is necessary to have the PDM with you and within close proximity to the pod in order for it to communicate the appropriate information and deliver the bolus.
7. Price. Compared to other insulin pumps, the OmniPod is extremely affordable. The cost before insurance pays (or without insurance if you don’t have any or it doesn’t pay for insulin pumps) is $199.99, but Insulet (the manufacturer of OmniPod) often runs specials where you can get the pump at an even lower price.
8. Its Waterproof. Unlike most other pumps, if you wish to swim or soak in the bathtub, you need to disconnect from your pump and keep a close eye on the clock to make sure you have not been disconnected so long that your blood sugar begins to creep up. The pods are waterproof for up to 30 minutes, so you can continue to receive your basal insulin while swimming or soaking in a bubble bath or taking a long shower. The PDM, however, is NOT waterproof, so be sure to keep the PDM away from moisture.
9. Pain free. Activating a new pod is about as pain free as you can get. You will hear three clicks and then the pod will insert the flexible catheter into your skin. It is extremely fast and feels like only a slight pinch.
The advantages of this pump are fantastic. However, the pump does not come without disadvantages as well. Here is my list of disadvantages.
1. Not always discreet. If you wish to wear something form fitting, you will still need to deal with the dreaded “bump”. OmniPod does offer several recommended sites for placing your pod to reduce it’s visibility such as the lower back or thighs, but for some people, this is still not good enough.
2. It is not klutz-proof. While the adhesive on the pods is strong, if you are prone to bumping into things or if you forget you are wearing a pod, it is relatively easy to rip the pod off. This is painful and it is not possible to re-attach the pod if this happens. If a pod is ripped off, you are forced to disable that pod and fill and activate a new pod. You will be surprised at how easy it is to rip off a pod. I never realized how often I bump up against door jams, which can tear pods off my arms. Additionally, if you place a pod on your thigh, it is essential you not forget that it is there when you use the bathroom because pulling your pants up without being careful of the pod will also easily rip it off.
3. Pods are expensive. While the pump is incredibly inexpensive, the pods are not. Before insurance pays their portion, the cost of a box of 10 pods is roughly $380. My insurance is pretty good and pays 80%, but my out of pocket expense is still $76 each month. Unless you require high levels of insulin, each pod should last around 3 days and so you shouldn’t need more than one box of pods each month, however it can still be costly.
4. Frequent malfunctions. I have had issues with both the pods and the PDM malfunctioning. The biggest issue I have had with the PDM is that it goes through spells where it will reboot with the slightest bump, even a bump from touching my finger to a test strip when checking my blood sugar. With the pods, while they do not malfunction often, it does happen which can cause you to have to replace your pod more frequently than every 3 days, especially if you get a bad box. Insulet is great about sending out a replacement PDM quickly and they will also replace defective pods, but it is a hassle and if your PDM completely malfunctions before the replacement arrives, you will be stuck with traditional injections until your replacement arrives which can cause control to go into a tailspin. The customer service department at Insulet has told me that they recommend using only Energizer Max batteries for the PDM. They have claimed that this should eliminate the rebooting issue I have had with the PDM, however even with being loyal to Energizer Max and not using any other brand, I still have had issues with this.
5. No way to extend pod life. If you’re a diabetic on a budget, chances are you have been guilty of reusing syringes or of extending the time between insulin pump site changes, or of reusing pump supplies. With the way the OmniPod is designed, there is no way to “cheat” and extend the life of the pod. Every three days, you must change your site. Your PDM will alarm to alert you when your pod is nearing expiration. Once your pod has gone 8 hours past the expiration time, the pod will deactivate itself. There is no way of “un-programming” this on your PDM. Additionally there is no way of reusing your pod. The adhesive begins to wear out at about the same time the pod is due to expire, and the pod will only “stick” you once to insert the flexible catheter into your skin. If the cannula is inserted incorrectly, you must discard that pod and try again with a fresh pod.
6. Can be easy to lose PDM. Because you are not attached to your PDM, if you are not careful, it can easily be misplaced, forgotten or lost and this is something that is not covered under the warranty. Insulet recommends insuring your PDM through your homeowner’s insurance to protect you against loss, theft, or damage. So, while this is a pump that would likely have a great appeal to teenagers due to how discreet it can be, don’t waste your money unless your teenager is extremely responsible. Unlike losing a cell phone, it is not possible to “call” your PDM to locate it.
For me, the advantages far outweigh the disadvantages. I like the freedom the OmniPod affords me and I like that I can wear the pods under my clothes and others can rarely see it. This reduces the number of times I have to answer “What’s that?” questions to those who might see a pump clipped to my belt, or offhand comments to those who mistake the pump for a pager, telling me that no one uses pagers anymore.
I am not ashamed of my diabetes, but I am so much more than just a diabetic and I prefer for others to get to know the other facets of my life first. I like to be the one in control of what I can and cannot eat and don’t like to feel like I am always setting people straight about when it is okay for me to have things such as candy or cake, and I like to avoid the lectures that well-meaning folks like to give when they think they know how to control this disease better than I do. OmniPod gives me all of this, while also offering me the best diabetes control I think I have ever had since my initial diagnosis.
Source: www.myomnipod.com
