I’ve been increasingly dissatisfied with one attribute of Omnipod 5: Slow or spotty absorption. For several months I’ve been limiting my meal bolus to 5 units, followed up by the remaining bolus as a 30 minute extended bolus. This usually works with Lyumjev but the pre-bolus timing has to be spot on, depending on the fat/protein quotient of the meal etc. The other absorption issue is the occasional pod that just does not seem to be doing its thing…the main symptom seems to be my body ignoring correction bolusses and flatlining at a high range. It usually takes me about 12-24 hours to finally give up on a bad pod/bad site.
I’ve been thinking of trying a tubed pump in order to use better infusion sets with the hope that I can avoid both of those issues. The options seem to be Medtronic 780G or Tandem Mobi. But, never having had a tubed pump, I have a few questions:
What should I do when I play hockey…is it OK to unplug the pump? (My endo says no, not OK). If I wore a pump on a waistband I doubt that I could avoid destroying it. The Omnipod 5 algorithm reliably has me at zero basal during the entire 1 1/2 to 2 hours, which is why I would not worry too much about being unthethered. Is it a big hassle to re-connect the pump and should I do it before or after I shower?
Have others switched from pods to a tubed pump and have they experienced better or more reliable insulin absorption? I am hoping that a tubed pump opens up more possible infusion sites than Omnipod 5, which has to have line of sight to the Dexcom transmitter and limited where I place the devices.
Any comparisons of the Medtronic 780G algorithm and functionality to the Tandem Mobi Control IQ will be greatly appreciated!
If your O5 has you at zero basal, unplugging a tubed pump during a game is the exact same thing.
Don’t really know why the endo says this, but it’s not really a big deal to do a quick BG check when you are on the bench, and take a very small correction dose if you need it.
If it was a tubed pump, you could have the infusion spot in an area that is easy to access when on the bench. So after you test, if you need some insulin you can quickly lift your sweater, connect your pump, take a small dose, and disconnect. That’s pretty quick.
Or do you play the entire 60 without sitting down?
The Tandem Mobi would be taped to your body, similar to the Omnipod. So if you’re not destroying pods, I suppose you wouldn’t be destroying a Mobi. Two cautions are 1: the Mobi isn’t widely available, and 2: I don’t know what happens if the Mobi is away from the controlling phone for a couple hours.
Thanks for weighing in…Her (endo) concern was mostly that a rising high would get away from me before I had a chance to reconnect and restart the pump. Delays, that sort of thing. I have had a few events of overcorrecting lows and going high 60+ minutes after games. Her husband plays so I think she understands the factors at play.
@Eric the way things go I can’t count on enough time on the bench to check BG snd temporarily reconnect to pump. The sitdown time is often in the 70-90 second range. When the games go longer than 75 minutes we always take a 5-10 minute break though so there would be an opportunity to bolus at that break. I’ve never had to yet though! Can’t think of a time when my BG was rising at the break…now I’ve jinxed it for sure.
@John58 For me, one of the hardest things to do is to respond in a measured way to heading or already being low. Everyone’s needs differ, but I’ve been slow to learn I usually only need maybe half of what I’m inclined to take to correct it all at once, then wait several minutes (10-15) to see the impact, then taking another portion. The mental aspect is easy to understand, the physical urge is hard to overcome…
My guess it would still be connected to Dexcom using either a manual basal or C-IQ, the same as the T:Slim pump. The only issue would be doing boluses which need the phone as a controller.
Yes, being conservative when treating a low is the generally accepted “best practice”. Being patient, waiting for your BG to come up, and all of that.
But with that being said, I want to add that taking more than I actually need seems to work faster.
The “more than I need” would eventually lead to high BG, so there are times when I take carbs AND insulin at the same time when I am low. Not always, just sometimes when I need my BG back up quickly, etc.
Don’t fault yourself for this. It’s actually a survival instinct. Your body knows you need food. It’s just a natural thing, like breathing.
Here are a couple of fun references for this sort of thing.
That’s true for a general bolus. But the mobi has a bolus button on the pump. I don’t know whether it’s fixed at 1u per press or whether the amount can be configured via the controller. Anyway, the pump can bolus crudely without the controller.
I feel lucky that I don’t have the “eat the refrigerator” response. When low or very low I don’t feel hunger, I just know that there’s a problem to fix, so I eat glucose tabs, counting up by 10s from my current BG 'til I reach 100.
If it is like the T:Slim Quick Bolus it there will be options either units per hit or carbs.
Quick Bolus Button
Tandem’s Quick Bolus button can be programmed to enter either units of insulin (in 0.5, 1, 2 or 5-unit increments) or grams of carbohydrate (in 2, 5, 10, or 15 gram increments) without needing to look at the screen, or even take your pump out of your pocket. And with your choice of audible or vibrating confirmations, no one needs to know if you’re checking for your keys or bolusing for a snack.
I really wish some things with the omnipod were different, But for me i will never go back to tubed pumps, though i find the new tandem with the 5” tubs interesting. I have 4 dogs that sleep with me, am single and live alone, they are all cuttle bugs and i have to wear over patches on my Dexcom to keep them from tearing them off. Weed to have fits with my bogs getting tangled i my tubing before.
But for most part have found soluti9ns to most the issues with the omnipod.
That sounds like the recommendation from my endo, C-IQ actively working while my phone is out of range (because I would not disconnect pump).The little Mobi pump would not need to be within BT range of the iphone app in order to keep working in C-IQ, correct? If that is the case I can probably make that work. But will wait for Mobi to become available and see how Medicare handles coverage.
Here is a marketing brochure from MedT that covers some details I had not bern aware of, compares the 3 pumps. Might be necessary to zoom in to read it.
I have not had a 780 but I did use a 670 for a few years. The limiter of the 670 was not the algorithm, and I would expect it has improved since then. The limiter of the 670 was the cgm sensor and getting booted from auto-mode for any number of reasons. It was just too much hassle to use the 670 in closed loop.
Agreed, that is often the way things go during daylight hours but not always in the evenings. I’ve noticed that in the evening a glucose gel (15g) will sometimes seem to have zero effect in the middle of a skate…because the workout is still craving more fuel just to stay on a (low) flatline. Those events are where I’ll sometimes total up to 50 grams of fast carbs which will (sometimes) kick in hugely about an hour later. They kick in too quickly for Omnipods algorithm to keep up and I believe that is because I am just coming off a few hours of zero basal before the carbs kick in, IOB is at zero.
@John58 This has been my experience as well. When running in the early evening I drop faster and sometimes respond to glucose slower. I’ve got the prefueling mostly dialed in for known distances, but with unpredictable exertion it would be extremely difficult.
I’ve been on the OmniPod5 for several months. I had problems with them staying attached while I was at work. I changed 3 in a week because where I sweat at work welding for a living they were JUNK!!! I finally gave up on em and switched back to the Tandem Tslim. I use the steal needle type, if I need to take it off then I can reapply it. My advice is don’t use the OmniPod 5s. It doesn’t take much to knock these things off then you’re screwed.
Well as luck would have it your post showed up soon after I ripped a pod off showering after a skate. That hasn’t happened often but is a PITA when it does. For a couple years I elected not to shower after games just to avoid the problem but eventually I decided it was worth the risk. Since I’ve never had a tubed pump I don’t have a good feel for why a tandem infusion set would be better able to not get ripped off compared to Omnipod? And what do you do with the end of the tube while you shower, is there a plug or a cap to keep water out of it?
While in the shower you just unhook it from the pump. It comes with everything you need with instructions to tell you what to do with it. Like I said, I use the steel needle type which I can reattach if it comes loose from my body. They make them where it has the same type infusion set like the OmniPod, but I prefer the steel needle type. Trust me, I’ve never had one come unattached unless I wanted it to. If you’d like I can send you all the information for Tandem to get in touch with you. Best pump I’ve ever used.
Thanks! this is helpful as I have been on Tandem X2 but did not like the fact that I cannot wear it while lap swimming and the nuisance of the pump tube! However, as I am testing the OmniPod 5 on my body over the last two months, I am unhappy with their algorithm which continually minimizes basal doses and makes it nearly impossible for me to control the Dawn Effect or higher carb meals! It does very well to control lows at night, but my daily highs are raising my HgA1c values! I am sticking with the OmniPod 5 to see if the basal doses increase after the “learning” it does after each Pod change because I have always loved the “elegance” of their simple system! I am staying on Auto mode because the Reps tell me that is necessary to help the OmniPod learn from my history. Occasionally I go back to my tightly controlled manual baseline.
I’m going to go ahead and start the switch over to Tandem which will get me eligible for a discounted upgrade to Mobi within a year I hope. Wish me luck, I have to figure out if Medicare will cover all this. Never thought I’d go for a tubed pump but everything I’ve heard about the Tandem is telling me it will work better for me than Omnipod 5.
Not always, just sometimes when I need my BG back up quickly, etc.
