To pump, to pen, or to pod?
I’ve got type 1 and I’m currently using a Medtronic Minimed Insulin pump (Paradigm model) – actually have been using a pump for most of my diabetic history, less than a year after my diagnosis to be exact.
I've noticed, because I have used it for years to manage my diabetes, that overtime it becomes less effective in the places that I use it. I typically rotate on areas around my buttocks :). Some areas that I insert it in, are actually painful, so I'll have to change it right after I put a new infusion set in...I don't like using in my abdomen area, it just feels odd… So I saw a dietitian recently and she actually was the one who introduced me to the OmniPod.
I am considering giving my pump a rest and trying out an alternative treatment…perhaps the OmniPod, perhaps an insulin Pen.
One of the biggest things of noticed is that you (me at least), get very dependent on the pump and sometimes am not as careful as I should be with my eating choices…it’s easy. So I feel like I can eat as if I don’t have diabetes and in the long run it has actually affected me. 1. I have gained weight and 2. H1C has increased.
Understandably, it is about discipline, but sometimes if you are “forced” to be more cautious because you don’t have the “tools” that make it easy you become more aware and take more initiative to be healthier with your choices etc.
Anyone have thoughts on this? To pump, to pen, or to pod? What tool has helped you have the best control over your diabetes.
To pump, to pen, or to pod?
I am not familiar at all with the Omnipod, as I believe it is only available in the US and I am in Canada...
I was using an insulin pen for many, many years (been a T1 for 35 years!) and just started with a pump a few months ago. So far, it is this option (pump) that has provided me with the best control. My last A1C was 7.7, the lowest it's been in years, and I expect it to be lower at my next visit. So far, I only use my abdomen for infusion sites, usually just below the belt line. However, for my last one, I went a little bit higher, just a few inches below my rib cage and discovered that I kind of like that area! I may venture to my thighs soon, but I can't imagine using my buttocks - just seems too awkward!
The one greatest feature that I enjoy of the pump over the pen is that correction boluses are so easy to do. With the pen, if I know I was running a little high and only needed a couple units of insulin, in most cases I would just skip it. But then, you can imagine what that did to my BGs! With the pump, it's just so easy; a couple of buttons and it's done!
I think you've started out right by asking for advice on this site, but definitely get your doctor and/or CDE's opinions on the options as well! Good luck!
Hi there joseph. First off, I'm sorry to hear you're struggling, we all go through periods like that and I totally understand. If you ever need an ear to vent to (as i am probably the queen of diabetes burnout) drop me a line. I'd be glad to listen.
Now about sites, have you ever tried your back? love handle area? I find them totally out of the way right there and it's great for absorption. Also try different infusion sets. They're all very different, you can call minimed at any time of the day and ask for samples, they'll have them to you the next morning. Here's a nice comparison of different infusion sets.
Here are some sites with insulin pump comparisons
The site gives you pros and cons of each pump. I know that the omnipod works for A TON of people (and hopefully they can speak up and give you another prespective) and for good reason, it's tubeless for one!!! That's awesome! but there are some things about it that makes me stay away. For instance you have no infusion set choices, they are one type, angled teflon. If you have issues with those sets you're out of luck. Another problem with the design is that if you get an occlusion, or a kinked cannula the whole pod (and the insulin within it) has to be tossed in the trash. Also there is no disconnect, you have that big pod on you all hours of all days no exceptions. Another problem that I have with the omnipod is the programming of Inuslin on board. Most pumps account for all insulin given in the past 4 hours to tell you how much is "on board" or working still in your system. The omnipod does NOT include insulin given for food. This is a problem for me because lets say you have a banana and your bloodsugar is 100. You bolus 2 units for that banana, then one hour later your bloodsugar is 70. You can check how much insulin is still working to decide how much of a snack to have. Your pump will say ZERO so you might think okay, 70 is fine, i'll have one cracker. When in reality you still have probably 1.5 units left still working from that banana.
Like I said EVERYONE is different, I am not saying the omnipod is bad, i'm just saying it may not work for you.
Now about Insulin Pens. In my opinion the biggest problem with insulin pens (or MDI, multiple daily injections) is that you can not customize basal rates. If your rate is at .6 in the afternoon at 1.1 at night, you are going to be high at night, or low in the afternoon no matter what you try on a Pen because you can only have one steady dose ALL 24 hours. This will confuse carb rations, correction factors, and it will be much harder to stay stable.
I do understand what you mean about the pump giving you freedom, it's a tough thing, self control. I'm still struggling with that myself. The reason I stay on the pump and keep working toward more self, and bloodsugar, control is that I know it will pay off in the end. We just have to keep on fighting.
Lastly, again this is your decision, I'm just here giving my opinion :)
I used pens (humalog) and lantus for about six years and switched over to the Omnipod this past November. After using the Omnipod, I can say I'll never go back to injections.
On the whole, I really like the Omnipod and would recommend it to others. The pod itself isn't that big. I rarely know I'm even wearing it. This might be different for girls since they wear tighter fitting clothing than guys. I really like the PDA device, mainly because it contains a glucometer, so you don't have to carry one with you all the time. It doesn't really look like a medical device either, which is pretty nice too.
There are a few drawbacks though, which Joanie mentioned above. A pod lasts three days and will expire in exactly that amount of time. The pod holds 200 units of insulin, so if you take a large amount of insulin the pod may expire in less than 3 days. Some times you will receive a faulty pod and have to throw it away. You can, however, still save the insulin that's inside the expired pod by using one of the syringes they provide you. I can say that if you ever have a faulty pod, Omnipod is extremely diligent in replacing that pod and shipping you a new one at no cost. The replenishment order could use a little help on the whole, but so far I've enjoyed using the Omnipod...much better than injections.
Thanks for that Perry!
I was hoping to get a positive review for the OmniPod. I hate leaving things one sided :)
Very insightful! thanks a million!
Oh another thing on your last paragraph about having the tools to 'slack' on control. I think that when we're burnt out we're going to slack one way or another. Making it HARDER to control your bloodsugar by cutting out tools will only make things worse, they won't force you to take better care, they will only frustrate you and make the burnout worse
I realize this thread is over a year old but came upon it on a google search. I'm currently experiencing exactly what you talked about. I'm newly diagnosed as Type 1 and got the Minimed pump very fast. I used injections (humalog/lantus) for the first month after diagnosis and was pretty successful with my control. It was too early to know what the A1C difference was because the only one I had to go on was the one at diagnosis. I read about how the pump can really tighten your control so pushed my Dr. to prescribe it as soon as possible. I've only been using it a week and a day but have noticed my control fall off since. I too have questioned the discipline with the pump as I'm more apt to have an unrestrictive diet with it. I also question if it's working properly as I've just had a recent high that I can't make sense of. I'm going to have follow-up with the pump trainer and hopefully get some of the kinks worked out. If you don't mind me asking, what ever happened to your situation? Did you stay with Minimed or move on/back to Omnipod or pens?
I tried the pump recently after 16years on MDI...didn't work for me. My A1C was better(7.4), but I was having no less than 3 lows a week(though, I often had multiples in one day) and my highs were more extreme as well. My target was hit sometimes, but usually quickly turned into a high(i'm talking 20+) or a low(below 3). That was only one of many problems I had with the pump. My bloodsugars had no pattern to them, like some people's so even changing my hourly basal rates would result in extreme highs or lows. There wasn't really a "middle ground" for my blood sugars or my basal rates while I was on the pump.
I went back to MDI and while I still don't have the best control(my last A1C was 8.6 or something) I feel MUCH better than when I had the pump and I know I can get my A1C down to 7.4 without the lows, as I have before.
I've tried the pen once, but I ended up giving myself a double dose by mistake somehow and haven't tried since.
I love, love, love my pump. I use the same model as you and it works great for my lifestyle. I like to wear it on my stomach, love handles, and my bum.
The Omnipod is also an insulin pump so if you're mostly happy with the mechanism of control of your paradigm, but would perfer a cordless, waterproof system I'd say give it a shot.
If you're interested in the Omnipod, I recommend ordering a free demo-pod from their website so you can see if you like the size/feel of it:
You just have to find the method of management that works best with your life. All methods can achieve remarkable control, its just variable on the user and what fits their lifestyle.
I love my pump, but I use MM like you. The Omnipod has its pros and cons, but as others have said, it isn't that different a method of controlling diabetes than any other pump. If I were in your position, I would try using the pen or MDI to try to "limit" myself more, as weird as that sounds. However, if your basal rates vary greatly throughout the day, that may not be the right option for you.
Talk to your endo and see if he/she has any suggestions, but you know your body/lifestyle best - no one can decide which option will fit in best with your lifestyle while also helping you with your A1Cs, etc. except you!