Omni pod or T-slim Basal IQ

Hi, I’m 29 and getting my first pump! I’ve had a long journey and it’s taken me years to get here to get my diabetes under control. So now I’m able to get a pump and I have a high deductible so I’d like to choose the best. I’m really torn between the Omni pod and the dexcom. I love the tubeless aspect but also love Tslims basal IQ aspect. Thoughts? If you’ve had both or either ? Any regrets? Hard time with either staying on or inserted?

It varies. Personally, I recently switched from Medtronic 670g to t:slim x2 with Control IQ. I wasn’t interested in having a pump until it could react to my CGM readings. The pump fine-tuning my insulin flow every 5 minutes has improved my A1C from the low 7s to about 6.4.

I’ve found that I much prefer the t:slim to the 670g. The Dexcom sensor (as my doctor promised me) is significantly more accurate and reliable than Medtronic’s Guardian 3 sensor, and Tandem takes full advantage of that. Instead of having to prick my fingers 3 times a day (and sometimes more), I can technically get away with not doing it at all. (I still check daily, just to make sure, and anytime my symptoms or expectations don’t match the readings.) The t:slim will automatically adjust to increase or decrease the basal (background) rate, automatically factor in my CGM reading into any bolus (larger dosage for meals) calculations, and will even automatically give me an additional correction bolus once per hour if basal adjustment isn’t enough. That’s been an improvement over the 670g’s much more cautious approach.

I haven’t looked too closely at the Omnipod, and I don’t have any experience using it. I don’t think it works directly with a CGM? You can wear a Dexcom with it and use those readings to help guide your dosage choices, but you don’t get the automatic fine-tuning.

The Omnipod’s main advantage, as far as I’m aware, is that you don’t have tubing. The pump is directly affixed to your body. So there’s less showing and nothing to get tangled. Personally, I prefer having the tubing, so I can move the pump around, look at its screen, and have only a coin-sized cannula taped to my body. But you may be more comfortable not having exposed tubing, not needing to temporarily disconnect the pump when you shower*, and just using the app to do everything.

*The t:slim is waterproof, but there’s no good place to keep it when you don’t have a belt or pocket. But there’s no risk to being disconnected for a while. You only get a tiny amount of insulin every 5 minutes, and the pump can make up for that when you reconnect.

I have occasionally had a cannula pop loose. Sometimes because I got the tubing tangled on a cabinet knob. Sometimes because I dropped the pump. Sometimes because I messed up when I inserted it. T:slim does have the XC cannula, which has a bit of extra adhesive to prevent that. But I always keep an extra infusion set or two on me, just in case. Doesn’t take long to insert and get running again.

I don’t know how common it is for the Omnipod to be jostled loose. I expect it’s taped on fairly securely.

Is there a reason you’re looking at Basal IQ rather than Control IQ? What other factors are you considering?

1 Like

I love my TSLIM with CIQ - can’t give you a comparison as I’ve never used the pods, but add I understand it Omnipod will be coming out with something similar in the coming months. I’m sure pod users can give you info on that our you could talk with a rep.
Some people have skin sensitivity to infusion sets or pods - i suggest you try a sample pod to check for and rules out skin irritation. If you go with a tubed pump ask your rep if you can try samples of the infusion sets before you choose so you can see if a particular insertion angle or set type (soft cannula vs steel needle) works better for you.
Congratulations!

1 Like

I meant the control IQ. My biggest problem with tandem is the tubing. I’m not used to wearing anything but the dexcom so I’m just concerned. Do they give you extra inserts? Like more than one a day in case it becomes detached ?

Typically, you change the cannula and tubing about every 3 days. They do send extras in case there’s an accident and you need to replace it early. As I said, it’s happened to me. But it’s been rare, and almost always a matter of my own carelessness in forgetting to tuck the tubing back in, fumbling when I pick up the pump to bolus, not waiting sufficiently for the rubbing alcohol to dry before insertion, etc. The extra adhesive on the Autosoft XC helps.

I haven’t found it too much of a problem in general. The cannula is smaller and less intrusive than a Dexcom. You can choose your tubing length, but I find mine to be long enough to let me comfortably hold the pump to bolus without being so long it’s wasteful or liable to tangle. It’s made of a firm plastic, so it’s not prone to damage, tangling, etc anyway.

The one thing to be aware of is airport security. I don’t know how much you travel during non-pandemic times, but it has been a hassle for me when I have. You’re not supposed to take a pump through the body scanner. The machine produces very little radiation, but the manufacturer’s instructions for both pumps I’ve had say it can interfere with operations and not to risk it. You can go through a metal detector just fine, but if they tell you to go through the body scanner you have to decline and get a manual patdown instead, which can take a while. (I believe the same applies to the Dexcom.)

1 Like

Now that we have the Omnipod being tubeless is a must for some people.
The infusion sets (tubing & cartridges) fir other pumps - come in sets of 10, and your doctor may write your prescription to cover a 3 month supply
They will tell you have often to change - typically every 3 or 4 days (some people change every 2 days because of scar tissue). Future orders will be timed to arrive before you finish what you have.

We used both, and Omnipod is the better choice for us. I really wanted the closed loop system, but we just couldn’t make the Tandem work for our daughter. No matter which infusion set we used, she just constantly had problems (blocked, kinked, came out, wasn’t in right, nothing we can tell is wrong but she’s clearly not getting insulin and the issue resolved with a site change, whatever). After a lot of work with a lot of people and every kind of infusion set they sell, we never were able to get good results, so we went back to Omnipod, which thankfully works great for us.

And supposedly Omnipod will talk to Dexcom soon — they’re waiting on FDA approval of Omnipod 5 (aka “Horizon”). They’ve been saying it would be available by June, but of course it’s not real until it’s real.

1 Like

Hi @savekittys , welcome back!

First off, you are not comparing similar devices, either performance expectations or comparable costs - investment and continuing.

The OmniPod is a "throwaway - use once for a maximum of three days and discard. The Tandem / Dexcom System [both requirements for Basal IQ [BIQ] requires an initial investment [list price of the Tandem t-Slim x2 is currently $7,000] plus the on-going cost of cartridges and infusion-sets. The Dexcom G6, common for work with the Tandem and Omni, has ongoing cost for transmitters and sensors.

The above isn’t intended to discourage you, but you brought in the cost factor. Do keep in mind that a pump is not a miracle cure - it takes considerable work.

If you are able to change to the Tandem with Dexcom system, I strongly suggest that you begin with Control IQ [CIQ], the only currently approves iAIDs [integrated/interoperative Automated Insulin Delivery system] - this system is significantly superior to the intermediate BIQ.

1 Like

Ah, thanks for the reminder, Dennis! By all means, have the reps for each company run your benefits and tell you what it will cost. Omnipod may even be available through your pharmacy, rather than through DME — specifically have them check both! — because if pharmacy is an option, that can be an incredible cost difference.

I’ve used both the X2 and the Omnipod dash in the past year. It’s a very personal decision and no pump is perfect, so it’s a matter of finding the one that works best for you. For me, I quickly got tired of the Tandem - they force you to use their insets and those insets cause all kinds of infections and other problems for me (again, my personal take but that are very poorly designed compared to other insets, like the Quick-set, on the market). The software on the Tandem also leaves a lot to be desired - it’s a small thing, but when you open up the temp basal setting option, it defaults to 100%. The only temp basal rate that you would never pick, because of course if you wanted 100% you’d just leave the regular rate in place. Again, it’s a small thing, but there are a lot of them and for me it just became more trouble than it’s worth.

The Omnipod is not perfect but it comes closer to my expectation that, whatever the pump is that you’re using, using it should make your life better. If it doesn’t, it’s the wrong pump for you. What’s annoying about the Omnipod? The call their customers “Podders,” which is demeaning and gross. There is no way to know exactly how much insulin is in the pump until it goes below 50 units, which makes it hard to plan. The pod is easy to stick on and forget (although it would definitely be nice if they would make the thing smaller - it’s been the same size for years), but the downside is that you have to use the separate device to do bonuses, temp rates, everything. They are working to get approval to have the app on your phone control the pod, hopefully in addition to their dedicated device, but for now you have to have the device , and the device is ALWAYS in the other room. I try to see it as good exercise.

Omnipod is working to get closed loop approval with both the Libre and Dexcom CGMs, but with all the pandemic delays I agree with the person who said it’ll be real when it’s real.

Again, it’s a personal thing. I found the Tandem to be so annoying I dumped it less than 6 months after getting it, but it has legions of fans. The Omnipod has strong support too and with some good engineering the coming version of it will fix some of the current hassles. Although they still aren’t making the darn pods smaller. :grinning_face_with_smiling_eyes:

Agreed that there’s no perfect pump, and that what matters is your own personal preferences and experiences. I think it’s valuable to hear from people with different experiences so we can make more informed decisions. So thanks for sharing.

You do have to use approved infusion sets because you need to be sure that it will connect properly to the cartridge. For the record, Tandem doesn’t make the infusion sets. They contract that out to the exact same company contracted to make infusion sets for Medtronic. Which is why the Tandem Autosoft 90 is the exact same infusion set as the Medtronic Mio, just with a different connector at the end of the tube. That one’s my choice because I like that it’s all in one self-contained pod that I can easily carry around with me in case I need to replace my cannula when I’m away from home. But they do have a few options available.

I agree the Tandem UI could use some improvement. I don’t like that there’s no way to completely mute key presses, either. Every time I touch the screen, the pump has to either beep or vibrate. Also, if I don’t hit the buttons exactly right, the screen turns itself off after 3 misses in a row. Both are designed to ensure that the touches it’s sensing aren’t accidental (my hand or something bumping against the screen when the pump is on my belt, for example) but it can be frustrating.

On the other hand, when I need to disconnect (to take a shower or whatever), the “STOP INSULIN” button is right at the top of the first menu. On my Medtronic pump, I had to go down to the bottom of the first menu to open a sub menu to get to the thing that would let me pause delivery. Really, the whole Tandem menu system is better organized than the Medtronic, I find. Don’t know how it compares to Omnipod.

I do hope both can get approval for app control. A bigger screen with better touch sensitivity could simplify everything.

Dexcom CGM and Tandem pumps aren’t problem free. Forums are filled with pump and CGM issues. From someone who has been a T1 since 1956, pumper since 1997 and CGM user since 2010, Medtronic has been great for me. Currently using the 670g pump with guardian 3 sensors and will update to the 780 later this year. Like most things, when used as instructed, technology is great!