My Year with Omnipod: A Bitter-Sweet Journey

It’s been just over a year since I permanently switched to the Omnipod, and my experience has been a blend of highs and lows. Despite a slight increase in my A1C from 5.7% to 6%, in part due to increased carbohydrate consumption, I appreciate the benefits of the Omnipod’s tubeless design. Not having to deal with tubes and the convenience of the Omnipod’s form factor have made managing my diabetes a bit less intrusive.

However, the transition hasn’t been without challenges. The Omnipod system requires immediate activation upon insertion, which can cause insulin resistance due to the initial trauma of insertion. Its design also means that you experience any issues with insulin resistance or site trauma and need to change a pump early, it can be a costly endeavour. This resistance is difficult to manage, especially around meal times when precise insulin delivery is crucial.

Another problem I encountered was tunnelling, where insulin leaks out from the cannula site. This not only affects insulin delivery but can also cause irritation. The excipient nicotinamide in the insulin formulation has also caused some site reactions for me so I mix insulin with a 50-50 ratio with Humalog. Please note this is off label.

Tips and Tricks I’ve Learned

Despite these challenges, I’ve discovered several strategies to improve my experience with the Omnipod:

1. Adjusting Insulin Profiles:
   • When installing a new pump, I set my profile to 120% to counteract any initial insulin resistance.
   • I try to install the pump a few hours before or after a meal to avoid the insulin resistance coinciding with a meal.
   • If I miscalculate the timing and need to change a pump around meal times, a short 5-10 minute walk on the treadmill helps improve insulin absorption.
2. Securing the Cannula:
   • Using Opsite Flexifix under the pump has been a game-changer. It keeps the cannula in place and reduces the need to replace the pump after activities like running.
   • For additional security, I use Smith+Nephew Primaflex Plus or Fixomull stretch over the pump. I use an old pump or the over-tape provided by Dexcom as a template to cut pieces as needed.

These tips have significantly improved my experience with the Omnipod, making blood sugar management more consistent and reducing the frequency of pump replacements due to physical activity.

Interesting Facts and Supporting Information

• A1C and Diabetes Management: An A1C level of 6% is considered good diabetes control. According to the American Diabetes Association, an A1C below 7% is recommended for most adults with diabetes .
• Insulin Absorption: The angle and method of insulin delivery can impact absorption. Studies have shown that the angle of insertion can affect how well insulin is absorbed, with certain angles potentially causing more issues like tunneling .
• Use of Adhesives: Using adhesives like Opsite Flexifix can help secure insulin pumps, reducing the risk of dislodgement and improving insulin delivery reliability .

In conclusion, while my journey with the Omnipod has had its ups and downs, the freedom from tubes and the ability to manage my diabetes with less visible technology are significant benefits. With the right strategies, I’ve been able to mitigate some of the challenges and maintain effective blood sugar control.

---