New to Omnipod

[Loganbear]

I am about to start using the omnipod for the first
time. I’ve been using injections so this will be my first insulin pump. Any suggestions
for a first time user. Any problems with reliability with
Omnipod? Any preferences on where to place it?
I’ve been using Dexcom for almost a year now.
It took me a while to realize I could not place it on my stomach because I almost always developed a rash. Dexcom does not like sweat and if you exercise your stomach has more sweat gland than your arms. had a lot of failed startups on new sensors on my arms until I discovered it worked if I inserted under my arm. The part of my arm as Erma Bombeck put it continues to wiggle long after you finish waving goodbye. Dexcom sensor loves fat not muscle. Any opinion on omnipod? And info on making it work would be appreciated. Also what is with room temp insulin being injected into the pod. Doesn’t that require some pre planning

[Michel]

@Loganbear, welcome to FUD!

We have tons of pod users, so this is a great place to ask!

I have a crazy schedule tonight so very little input from me but I will be back hopefully tomorrow (by then everyone will have told you what you need to know I am sure…). Here goes my quick feedback:

• How do we feel: we LOVE Omnipod

• Location: we use it on the back of the arms like most people, on a 16x rotation, plus 4x lovehandles

• Reliability: on the whole very reliable, more so than Dexcom for us: we lose more sensors than pods

• Room temp insulin: we continue using pens in parallel for large injections (5U or more). So, when time comes, we use the insulin in the pen. If there isn’t enough, we break out a new cartridge and wait 5 minutes.

Will come back tomorrow. Again welcome!

[ClaudnDaye]

Happy to help with any specific questions you may have. Fire away!

[Eric]

@Loganbear

Also what is with room temp insulin being injected into the pod. Doesn’t that require some pre planning

Welcome to FUD!

You can use insulin straight from the fridge, it does not need to be room temperature. It does not seem to matter.

[ClaudnDaye]

@Loganbear

Any preferences on where to place it?

We rotate our sons PODs as follows (8 different positions to assist with keeping those areas working longer in each spot.)

The POD is on each spot for 80 hours (72 + 8 hours) - unless there is an error, which is pretty rare…but he does knock them off sometimes, being 6.

• Right leg top cannula up
• Left leg top cannula up
• Right leg side cannula up
• Left leg side cannula up
• Right leg top cannula down
• Left leg top cannula down
• Right leg side cannula down
• Left leg side cannula down

So, each leg/position sees action only once every 560 hours or so (23.3 days).

[Trying]

I used to use the back of my upper arm but about a year ago, after I switched to Loop, absorption seemed to be unreliable. I switched to my abdomen and absorption problem disappeared. I try to rotate 6x on each side, trying to keep one inch between placements of the cannula each time.

Ironically, I used to use Dexcom G5 on my abdomen (with OmniPod on my arm), but when I switched to G6 (and Loop at same time), it was no longer reliable, never lasted 10 days. So I moved it to the upper arm, and problem solved!

Could be coincidental, but I just wanted to mention it as it seems placement is important, and can be fluid!

[CatLady]

Here’s the most important thing I learned about pumping here on FUD: when in doubt, take it out!! Insulet is great about replacing pods removed early because of absorption issues. I wear my pods mostly on my legs, sometimes the back of my arms. I have given up wearing devices on my abdomen because jeans tug on them and also because my cats tend to knead on my tummy before they settle in for naps.

[Michel]

@CatLady

when in doubt, take it out!!

We have solved a few scratch-your-head problems that way.

I will also add that we have found that, occasionally, the first 6-8 hours of a new pod session show poor absorption. I think we are the only ones at FUD for whom this is true.

[Eric]

@Michel

I will also add that we have found that, occasionally, the first 6-8 hours of s new pod session show poor absorption. I think we are the only ones at FUD for whom this is true.

It’s been referenced a number of times. There are others that have this issue. Here are a few threads discussing it.

I refer to it as an “activation bolus”.

Starting Omnipod (!)

Yes, the difference in the situation I’m talking about in my example is that I can SOMETIMES not even have to put on the new POD until the morning…or at least 3 or 4 hours after the old POD has fully expired. And I tend to give more insulin with a new POD because, for us, they aren’t as effective when first applied…it takes some hours/a day for the site saturation to get dialed in. It’s a preference thing I guess, but during the night only (the only time we do this), we wouldn’t do it the othe…

Starting Omnipod (!)

I always do an “activation bolus” on a new pod. Just a small amount to get it all started.

Site/ pod changes followed by weird BG

It takes a little while for the slow basal trickle to start getting absorbed. I do what I call an “activation bolus”. If you change your pod right before a meal, you don’t need to do it. But if you change the pod and will not be bolusing for a while, take a small bit - like 0.25 or 0.50 or something - right when you start the pod. That will help get everything going. This has helped me with the same problem. Seems like it could be an issue for some people with any pump. Sounds like the same t…

Omnipod Issues / Questions

Try an activation bolus. Put it on before a meal, and then take a meal bolus. Taking a bolus right after putting it on seems to help it get started for me. Tubing pretty much kills any other pump option for me. That’s just my choice, but I can’t deal with the tubes. The pods are about like a Dexcom sensor to me, as far as comfort. If you can get used to wearing a sensor in the same spot for 7+ days, wearing a pod in the same spot for 3 days is pretty easy.

Replacement Omnipods: may need follow-up to get shipped

My first few months were a bit rough. Just took me a while to figure out the differences between pumps and MDI. There are some quirks, like doing a bolus after activation to get it “started” well. And watching for “day 3” problems. But I am throwing down some good numbers now. This was yesterday. Almost the whole day between 55 and 100, with one little drop after exercise when I dosed and pounded chocolate milk. Not the pod’s fault, just my aggressive post-exercise insulin and carbing You jus…

[CatLady]

That “activation bolus” is really important when changing out a pod because of absorption problems.

[John58]

Hi @Loganbear,
I started with Omnipod in January and am kicking myself for not doing it a few years sooner. It has been a great lifestyle change for me and it was not hard to get dialed in with the settings. After some trial and error I was able to make good use of all of the features (like extended bolus and temp basal) that can’t be done on MDI.

From my experience, I’ve only had two pods that did not absorb well. Both of them hurt like all get out when I installed the pod. I won’t bias you by saying where they were located…everybody seems to have different good and bad zones for the pods. There’s going to be some trial and error to find your favorite spots to place the pods and which spots to avoid…when in doubt, take it out.

Good luck with it and ask lots of questions!

[Millz]

I can also confirm that I’ve had a few Pods that really hurt from the moment they are inserted, and continued to hurt. They also had poor absorption. Once I replaced them (quickly) the new Pod was fine

[Beacher]

@Millz

and continued to hurt. They also had poor absorption.

Definite correlation in my experience, too.

@Loganbear

Any preferences on where to place it?

This is really individual. Personally I get the most even absorption from back of arms, pecs (male – still not sure how well that works for females), top of butt/hip. Mixed results from abdomen (where my Dexcom sensor is). Worst results with thighs.

Haven’t tried calves or the upper trapezius.

[Millz]

I’ve tried a number of locations over the years I’ve been Podding. Not sure why, but I find absorption is better for me when the Pod is below my waist. I prefer rotating between the outer thigh, front thigh slightly towards the inner thigh. When I need to rotate to other sites I’ll go to the back of the upper arm.

[cogdog]

Howdy, I’ve been Omnipodding since December 2019, switching from Medtronic since 2006. The lack of tubing is just marvelous.

Since I was abdomen only my arms are pretty fresh, but I’ve yet to go elsewhere. It’s helped to use alcohol pads on the area first to get a good clean spot to stick.

I’ve only had one pod that had malfunction going in. Insulet was great at replacing that one, was well as another one that did not adhere well, and they even replaced one I was responsible for knocking off when I banged it against a car door.

I don’t like that the pods last 3+days but my usage of the 200 unit capacity is like 2+days. I’m cheap even with insurance picking up 80% of the cost! I’ve been stretching my use by doing meal boluses by syringe.

All in all very happy with the pod, and I’m getting better numbers overall. This is definitely the right place for support.

[egreen76]

My first shipment shipped out today. I will have my PODs by Friday and my PDM by Monday. I’ll be on the DASH. I have some questions regarding boluses. I’ve been lurking and noticed that most everyone does their boluses by syringe instead of through their POD. That’s going to take some getting used to for me, as I’ve been delivering my boluses through my Medtronic 630G. How do you keep track with your IOB if you are bolusing with syringe? I am still trying to find my correct dosages, so am currently at 3u/HR and I’m working on doing better with my eating now that I’m really paying attention to my carb intake. However. I have had to go as high as 25u as a bolus.
I’m sure that I’ll learn more as I go along, and I’m sure my trainer will be able to help with that, but thought I’d get started asking questions so I can prepare myself…

Thanks!

[Marie]

egreen76

I do all my bolus and basal through my pod. I think a main reason some might still use a syringe for bolus is because the pod only holds 200 units of insulin. So if you use a lot of insulin then having enough in a pod might be a problem.

A couple of possible solves is having a prescription for pods every 2 days instead of three. Or using the pods for basals and doing all or some of the boluses through a MDI shot. Some people do the opposite. Save the pod for bolusing and do a basal injection. Or originally what my doctor prescribed was Humalog U 200. A double strength concentrate. I didn’t end up needing it as when I switched to a pump I ended up using less than half the amount of insulin but I stayed on it as I liked it.

PS Sometimes giving high doses on a pump doesn’t work well, you can get tunneling on any pump. So some split up the doses.

[Chris]

Like with your 670, if you suspect a POD or Site problem use the syringe to avoid a long time of running high. But I would suspect that most everyone here uses the POD for most of their dosing. The exception being some people who are susceptible to the tunnelling will use a syringe for any bolus above X units. I think the X changes person to person.

[Trying]

I agree with @Marie and @Chris. I use the pod for all insulin, basal and bolus. I only use a syringe for a correction bolus when I have a persistent high due to a bad pod. My boluses are generally <= 2U.

[egreen76]

Thank you all! I was a little confused on that when I was reading. My Dr. wrote the RX for me to change every 2 days…I think the RX for my insulin is actually written out to allow for 150U every 24 hours as needed through pump…I’ at 3u/hr currently on my 630G and I have a Dexcom G6 so I tend to check my sugar about every 2 hours or so. I’m beginning to notice though that I’m having to bolus just about every time I check my sugar, almost like the 3u/hr isn’t enough to cover my blood sugar even before/after meals. I’m on Novolog U100 Current sensitivity level is set to 21mg/dL per U with Active Insulin time at 4 hours. I am not feeling confident enough to tweak that on my own yet. I do not see an Endo. I have talked my PCP into following me and allowing me to work with my trainer and my reseaarch to dose. How can I determine my sensitivity level and active insulin time?