Thursday, July 28, 2016

3 Months on OmniPod: My Thoughts So Far

3 months ago today, I took a giant leap of faith and started the OmniPod Insulin Management System. Prior to starting OmniPod, I was doing multiple daily injections (MDI) and in my 6 months since diagnosis, I had taken approximately 1080 injections. I am not scared of shots (thank goodness) and doing injections did not bother me too bad, but I was ready for a change and something a bit more convenient. For those of you who do not quite understand T1D, here is a little summary on how my day went on MDI as compared to my days on the insulin pump.

Before every meal and snack: I would test my blood sugar, count carbs for the meal or snack, calculate the amount of insulin needed to correct my blood sugar (if it was over 140), calculate how much insulin I needed to cover my carbs, add these numbers together, and take the closest amount of insulin to this number as possible. Problem was, on injections the smallest increment I could dose in is .5 unit, so many times I could not take the exact amount of insulin I needed.
2 hours post meal: I needed to test my blood sugar, if above 180 (which happened often on MDI), correct with another injection, if below 100 (which also happened often on MDI) correct with more carbs and test 15 minutes later.
Before driving or exercising: I would always test my blood sugar, if below 120, correct with carbs and wait 15 minutes to leave or start exercising.
Before bed: I had to inject the dreaded long acting insulin Lantus (it BURNS so bad). Lantus was the long acting insulin I took to help keep my blood sugar steady all night long and between meals. Also before bed I would check my blood sugar, correct if high (over 180) or eat if low (below 120 was "low" before bed on MDI).
Middle of the night: On MDI, I had such anxiety about going low in my sleep and not waking up (even with a CGM, its not always accurate). I almost always set an alarm at 2 am to wake up and test.

Before every meal or snack: The PDM (remote control for my pump) is programmed with settings tailored specifically to my needs. Before eating now, I test my blood sugar, count my carbs, and the PDM does the rest. I tell the PDM what I am eating and it will calculate how much insulin I need based on my blood sugar and carb counting. I press a few buttons, and it administers the insulin. It calculates down to the .05 unit so I am MUCH more accurate in my dosing. I can also get seconds and just dose for more if I want more food, on MDI this would require another injection.
2 hours post meal: I still test my blood sugar 2 hours after eating but now if I am slightly high after a meal, the PDM will calculate how much insulin I need for that and administer it. My blood sugars are MUCH better on the insulin pump.
Before driving or exercising: I usually prefer to be above 100 now so if I test and I am hovering close to 100 or dipping low, I will simply eat a small snack and set a lower temporary basal (steady drip of insulin I get 24/7).
Before bed: NO MORE LANTUS! I simply test my blood sugar and eat a small snack if I need to.
Middle of the night: I actually try to sleep through the night most nights now! The pump is programmed for me and I have told it what times of the day I am higher and need more basal insulin and what times of the day I am lower and need less. I have my pump set to administer slightly more insulin from 10PM-12AM and slightly less insulin from 12AM-6AM. This prevents middle of the night highs, followed by a correction, followed by a low at 2am, which was usually my pattern on MDI.

All in all, its easy to tell that pumping with OmniPod does make my life a little bit easier. BUT, it is important to read my summaries above and understand that the pump is NOT a cure. I still test my blood sugar 10-12 times per day, I still count my carbs, I still have highs, and I still have lows. The pump just helps make my life with diabetes a little less complicated and a little bit easier. Here are some pros and cons I have found while using an insulin pump and more particularly, the OmniPod.

1. LESS pokes! Obviously, on MDI, I poked myself all day. I took about 6 injections per day and tested my blood sugar 10-12 times a day, so that is 16-18 pokes per day. With the OmniPod, I only have to change my site every 2-3 days so that eliminates shots and just leaves finger pricks.
2. Better accuracy in dosing. I am super sensitive to insulin and take very small amounts. On MDI, I sometimes had to skip injection for a meal because it was not enough carbs for what .5 unit would cover but then I would go HIGH with no insulin to cover my meal. With the OmniPod, I can dose for 1 single carb if I want to, it is that precise.
3. Temporary basal settings. On MDI, I injected my basal at 10pm every night and it was done, I could not make the basal stop working if I was going low or make it work more if I was going high. With the pump, it eliminates the need for 2 separate formulas of insulin and only gives fast acting. If I am running low or getting ready to be in a situation where I always drop (exercise, heat, swimming), I can set a temporary basal so my pump will give me less basal insulin. If I am having a high day, I can simply set a temporary basal for more hourly insulin until I come back down into range.
4. Easier mealtimes. There was soooo much math involved in MDI. I had to always have a calculator and a notepad any time I ate so that I could write everything down and do the adding, subtracting, multiplication, and division. The pump takes over the math for me, now all I have to do at meals is count my carbs, test, and tell the pump. Its also nice not to have to pull out an insulin pen and needles or a syringe and a vial to draw up my insulin before eating.
5. Freedom. This is more directed towards the OmniPod in general as compared to tubed pumps but the OmniPod gives me SO much freedom. Choosing a tubeless pump was the best decision I could have made and I love not having to ever disconnect from the pump because it is stuck to me and it is totally waterproof. I have the freedom to wear what I want and not worry about where I will put my pump and tubing.
6. Easy site changes. Before I started pumping, I watched countless videos of people changing their sites for every pump imaginable. Most videos for tubed pump site changes took about 10-15 minutes. I can change my site in about a minute and 30 seconds of that is the pod priming itself.
7. Pod decorating. Okay, this is another OmniPod specific pro but I love decorating my pods! Below is a picture of all of my pods from the past 4 months. It makes diabetes SO much more fun!

1. Another attachment. I was not too excited about having something else attached to me. I already wear a Dexcom CGM so having something else attached, took some getting used to.
2. Pod failures. This is a PAIN. When a pod fails, it makes an obnoxious noise and wont stop until you tell it to. But, a pro of this compared to other pumps is that it will usually alarm before my blood sugar is sky high. I would rather find out the pod failed by an alarm than by a high BG, feeling yucky, and ketones.
3. Large PDM. The PDM is MUCH larger than the meter I used on MDI and it takes up much more space in my bag.

So, as you can tell, I obviously do not have too many dislikes for the OmniPod, it has truly made my life so much easier and I am pleased with my decision to go with this pump. If you are considering getting an insulin pump or replacing yours with a new brand, I highly recommend trying a demo kit from OmniPod. They will send you a demo pod to wear for 3 days and you can see how you like it. OmniPod customer service is the best! Once I contacted OmniPod and let them know I was ready to get started, they took it from there. My local rep, Inna, went to my doctor and got all of the appropriate paperwork signed. Within 3 weeks of contacting Inna, I had the OmniPod and I was sitting in training. I love being a "podder" and I would not have it any other way!



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