FUDiabetes

Serious OmniPod PDM failure and pump reconsiderations

First I did not want to start a new thread since I just had “another Omnipod PDM failure :-)” Yet another Omnipod PDM failure :-) which might qualify as the worst possible. But it brings up the question of the reliability and functionality of this pump in regards to the PDM controller.

Scenario: on a 10 day vacation in Moorea, French Polynesia. Day 3 PDM error, no reset possible. $50 worth of phone-calls with support. There is no possibility to overnight a PDM to this location due to customs. Nor could support locate a PDM or supplier in that region.

Complete loss of basal line for 7 days +.

I luckily had an ample amount Humalog KwikPens with me for Bolus which made it possible to keep bg somewhat in check. According to Dexcom: the 14-day average compared to the previous 90-day average went up to 7.2% from 6.1% for the GMI, 162 CGM Average Glucose from 116 with 60 Standard Deviation from 42.

Just imagine if you have no back-up of any kind and fully rely on OmniPod for basal and bolus? How prepared are you? How prepared is the company? And it also raises the question for the preparedness in a natural disaster not only for you but this company and their device functionality?

And here is a reference to failures of an app-powered smart-phone device instead of this archaic OmniPod PDM. An almost identical case-study of how such PDM-failure could be handled.
My phone failed as well on this vacation and with that I had no access to my dexcom readings. My wife just installed the Dexcom app, different to the “follow” (just remember your log-in) and I just had to stay close to her for the readings but I had my readings. And even by myself, I could have fixed this issue with just purchasing a cheap phone somewhere.

You can get a burner phone anywhere in this world to run an app, you can get a prescription from your Doctor to be filled anywhere in this world, a bgm reader with strips. Anything you need to manage your diabetes but an OmniPod PDM. And the time period of 1 week is long enough to totally mess up your averages and too short to switch to a long-lasting instead of micro-dosing Humalog.

This archaic OmniPod PDM is almost a gamechanger if you are in the pump-market. I do love the ease of the Omnipod and the wireless nature but I am reconsidering very seriously after this incident which is almost unavoidable and doomed to happen over and over with possible more serious consequences

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I would not go on a 10 day vacation without some form of both basal and bolus insulin backup, regardless of what type of pump I was using.

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My system is simpler, MDI with Levemir basal and Humalog bolus. However, even with this simple system, I’ve learned the hard way to have backup pens on hand. The best laid plans of mice and men often go awry,

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How would you back-up with using Humalog as a basal microdrip with the Omnipod? The only way I can think around it is having a second PDM with you. Which raises the immediate question of having back-ups of back-ups and when it becomes redundant?

Having packed 10 pods for a 10 day vacation feels already overkill incase one goes bad. Also having 3 Kwikpens and 2 Humalog vials including syringes, extra Freestyle meter made me feel slightly over-prepared.

Even in a simple system if you have a single point of failure as the PDM for the entire Omnipod delivery system and there is no work around with anything readily available makes this system questionable. I should be the only single point of failure which is ok. I am used to it. Not some outdated electronic device of the late 1980’s like those OmniPod PDM’s

The backup would be a vial of basal insulin, or pens with basal insulin.

Do you not have a basal backup in your house? Levemir or Lantus or something like that? If not, you should get that.

No matter what pump you are on, you should have an alternative form of basal insulin.

Even if you are home - and any pump company can overnight you a replacement - what would you do, stay up all night injecting Humalog every hour waiting on the new pump to arrive?

This is not an OmniPod issue. Any pump can fail.

No matter what pump you are using, you should have a non-pump backup.

Not sure what PDM you are using. The first PDM came out in 2003.

If you need any suggestions, I’d be happy to make recommendations. Feel free to ask, there is a lot of info available on all of this stuff.

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Hell I wouldn’t go work an 8 hour shift without that

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In order for any long-lasting basal insulin to work properly, you would need at least 1 week to build up. I used Lantus before and there is a variety of reasons beyond this topic why I dropped it and went to Humalog as a single med vs long-lasting insulins.

The issue with the OmniPod is its single point of failure with the PDM. I want to almost guarantee you that this PDM was some Atari controller or Nintendo Gameboy in a previous life before resurrected by Insulet in 2003. Note the sarcasm about the state of insulin delivery systems in the year 2020.
There is no good reason for Insulet to continue this PDM system instead of using an app on any smartphone. iPhones are not even hackable by the FBI if that is a concern that someone hacks into your medication delivery system to kill you. Develop the app with encryption and ID technology separate from the one of your smartphone. Pod and controller have to be in short distance anyhow. With that you have easy interchangeability and eliminate this single point of failure. Show me one place on this planet where you cannot buy/borrow/have access to a smartphone and load the app within 24 hours therefore eliminating this issue?

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Don’t quite agree with that… yes several days can be necessary in order for some basals to completely stabilize but they’d be providing meaningful basal coverage within 1-3 hours

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If you think OmniPod does not want to have control of their pods through an app, you’re crazy. It’s Numero Uno on every OmniPod users wishlist. The problem with bringing it to market is the FDA. Both OmniPod Horizon and Tidepool’s OmniPod loop algorithm will both be using an app on a smartphone and ditching the PDM. iOS for Tidepool and Android for OmniPod’s in house loop.

Tandem will be launching the first iteration of their app with control-iq. This version will be read only for pump info, will upload all CGM and pump information to Tandem’s servers just like Dexcom’s clarity. Late 2020, when the t:Sport launches, the smartphone app will fully control the pump functions.

These things take time, and a lot of money to appease the ever skeptical FDA.

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I absolutely disagree with that statement. Lantus for example has a steady release in the sc level for 24 hours, meaning the loss of a certain amount to begin with and a slow down as well. Any long lasting insulin and the release in someones body would create those little peaks of delivery every 24 hours. In order to make this an almost indiscernible flatline of insulin delivery you would need to be on it for at least 7 days. There simply is no long-lasting insulin that can guarantee you a delivery of basal units into such details as the Omnipod down to 0.05 every 5 minutes

That may be true… but that’s a far cry from “they don’t work properly for at least a week”

But if you feel safer not carrying a basal insulin as a backup in case of pump failures, I guess there’s nothing I could say to convince you otherwise

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I was indeed referring to the FDA and their concerns over a smartphone app to deliver insulin which is utterly ludicrous over that single failure system now. But it is 2020 now and we are still using it instead of an app. Insulet is happily pushing DASH and again a PDM to control the pod. Horizon is build on Dash. PDM = single point of failure not easily replaced. If you have any link beyond late 2018 that shows any indication or further news of development of smartphones controlling the pump functions, it would be greatly appreciated.

Google it dude, I’m not your secretary. Both OmniPod and Tidepool have publicly spoken about these plans.

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We use our iphone app… But we’ve taken the loop plunge. Couldn’t be happier about the transition. So much more flexibility.

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This is the equivalent of “in order to stop the bleeding you can use ducttape or you can cauterize a wound”. Either way, you have about as good an outcome after 7 days of switching to a longlasting and getting off it again and deal with the rash or burn of those 2 methods in coming hypos because of residual long lasting instead of trying to control bg with Humalog alone

And guess what I did and why I asked if there is any news past Nov 2018? I did not find any. As a reminder this is over one (1) year ago that it was announced. https://www.mobihealthnews.com/content/samsung-galaxy-smartphones-control-insulet’s-tubeless-insulin-pump

I am looking into that one in about 30 seconds

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This is what I kept missing, excellent somewhat recent info in one place. Thank you.

That makes no sense to me at all. Basal insulins like Lantus, tresiba, basaglar, and levemir are essentially 100% effective within a few hours… a few days to settle out to perfection sure… but if you’d rather wake up or stop what you’re doing every 1-2 hours to inject bolus to get it to behave something like a basal (although realistically not at all like one)… guess that’s your choice… I’d have simply taken a shot of Lantus or levemir and got on with my vacation

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