Accu Chek Combo or Omnipod?

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ElleB

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My 8 year old daughter has been on MDI since she was diagnosed type 1 in November. She has just been offered a choice of the combo, insight and omnipod.

We can't decide between the omnipod and combo. We like that the combo can give smaller doses of insulin to gain tighter control and DSN sold it has the better of the two. We like that the omnipod is tubeless and waterproof but I have read quite a bit about pods falling off.

Any advice greatly appreciated.
 
I think the sort answer is likely to be whichever you pick, you will almost certainly LOVE it. It may take some time to get used to, but essentially all pumps do the same thing and once you have learned how to get the best out of them and how to adjust them to give you the greater flexibility and precision then they return the extra effort in spades.

Both Combo and Omnipod have remotes that allow you to fully operate the pump without having to actually touch the pump part (though on Omnipod, the handset is the ONLY way of operating it, and if you misplace it you have to revert to your back-up plan right away).

Some people are really drawn to the idea of no tubes. And some people start tubeless, then move to a tubed pump. It's really personal, and not something that anyone but you can really guage I don't think.

Personally I've always preferred the much 'flatter' profile of a tubed infusion site. I was never sure quite how many comfortable places I would find for a pod that I wouldn't sit on/lean on/sleep on or whatever.

Good luck choosing!
 
She's only 8 - I should think the Omnipod will a) protrude too much wherever she sticks it whatever she wears and b) be much more likely to get bashed in her every day life.

As Mike says - the Combo - although the pump itself looks a bit bulky - the place where you stick the actual infusion set is fairly flat and therefore easy to protect. They are also pretty bomb proof, I had one for 5 years and often completely dropped it when it either came unclipped off my waistband or it fell out of a pocket when I sat down eg when going to the loo so my trousers and pocket were at half mast, so it dangled in mid air and clunked against eg the loo itself or the coffee table when I threw myself down on the settee - I've never mastered the art of being ladylike yet! and it survived absolutely fine.

The Combo remote control is also the BG meter and it's a 'souped up' version of the Accu Chek 'Expert' meter which you may already be familiar with.

I've never had an Omnipod so I dunno how robust they are in use.
 
Hi, I have been on the Omnipod for around a year now. I chose it because I liked the freedom of showering / swimming etc without taking it off and the fact it was tubeless.
So far I have had one come off - because I caught it and it pulled. I know lots of children younger than 8 use the pod and don't have any problems with sites. I wear mine on arms, tops of legs, tummy, lower back and don't have problems sleeping with it on. Quite often I forget where I have stuck it!
My kids also love pimping my pods (there is a great facebook page with loads of ideas to decorate them).
Downsides are as Mike said - if you forget your PDM, then you can't bolus (it continues to deliver your basal).
As Mike says, it's a really personal choice. All the pumps do roughly the same job, so all will help give your daughter the opportunity for better control.
One thing you can do is ask for a trial pod - they can send you one to stick on (without inserting the cannula or delivering anything) so you can see how your daughter finds wearing it.
Please feel free to ask any questions about the pod. It's the only pump I've had so can't compare - but I am very happy with it.
 
I have an Omnipod and love it! I haven't used other pumps so have nothing to compare it to, but so far it's been amazing 🙂
 
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thought this might be helpful to show how it looks on children rather than on me!
 
Subsidiary question for you - who is going to teach the school personnel the intricacies of being on a pump instead of MDI - and are they already familiar with tubed ones or pods? One of the important differences is that testing equipment needs to be instantly accessible without your child being expected to wait for a break or trek across the school to wherever it's kept, so all teachers understand instantly and don't cause delays.
 
Thanks everyone. I just want to make sure we go with the right one has it's for 4 years.

She has already worn the omnipod demo pod on her arm for a few days and it really did not bother her she said she did not know it was there. I'm just a little worried as read quite a bit about pods falling off.

DSN said you can get tighter control with the combo than omnipod as can give smaller doses. But even omnipod should give better control than MDI.

We've got clinic on tuesday so still got time to think about it. I know whichever we go with we will love it. She hates injections as is terrified of needles so will make life a bit easier for her.
 
I have used a Combo for six years now, and it would take a lot for me to change, as I can’t think of anything that annoys me about it, apart from not being able to use it with a CGM in the future.

The remote control via the handset means the pump is put away at the start of the day and just left to get on with its job. If I want to change anything on it I do that via the handset. The pump only comes out when I want to change the cartridge.

I briefly considered swapping to Insight at my last change of pump, but I had read of a number of peopl who were disappointed with their Insight and wished they could go back to the Combo.

I have never used any other pump so can’t comment on them. I think you will enjoy what ever you choose, and it certainly improved my control, dropping my HbA1 c by 10.

Whatever you choose it takes some work at the start but it is definitely worth it.
 
trophywench said:
Subsidiary question for you - who is going to teach the school personnel the intricacies of being on a pump instead of MDI - and are they already familiar with tubed ones or pods? One of the important differences is that testing equipment needs to be instantly accessible without your child being expected to wait for a break or trek across the school to wherever it's kept, so all teachers understand instantly and don't cause delays.
Click to expand...

DSN will go into school to do training. At the minute her medical bag is kept in the medical room and she is allowed to leave class whenever she wants to test or someone will bring it to her if she feels unwell.

When she goes onto a pump I'm hoping she will wear a bumbag at school so she will always have her equipment with her.

I do find school a worry though as she is the first and only type 1 they have there and they don't always get it. There has been times she hasn't been given all the carbs she'd had insulin for. They also counted 99 for a bun instead of 9.9 giving her 3 hypos but luckily she felt them all before she dropped really low but they didn't realise what had happened until I told them.
 
Good God! (the 99 I mean)

Ask the D Nurse to insist they do a refresher course on exactly why nobody on insulin can afford people to make those sort of mistakes! (or make them themselves of course but the mistakes we make carb counting aren't usually anywhere near that exaggerated cos we'd know 'that can't be right surely?')
 
ElleB said:
DSN will go into school to do training. At the minute her medical bag is kept in the medical room and she is allowed to leave class whenever she wants to test or someone will bring it to her if she feels unwell.

When she goes onto a pump I'm hoping she will wear a bumbag at school so she will always have her equipment with her.

I do find school a worry though as she is the first and only type 1 they have there and they don't always get it. There has been times she hasn't been given all the carbs she'd had insulin for. They also counted 99 for a bun instead of 9.9 giving her 3 hypos but luckily she felt them all before she dropped really low but they didn't realise what had happened until I told them.
Click to expand...

It would make a lot more sense, whether in MDI or a pump for her to have her emergency stuff (test kit and hypo treatment) in the classroom, rather than waiting for someone to bring it to her. You can’t ask a hypo to wait.

In one primary school I visited, the child had a small back pack with her all the time with JB and test kit in. In her test kit, she had a card which she just put on the table if she was hypo. It said
I am having a hypo. Leave me to deal with it. I will join in again soon.

For lunches the school sent a menu home for the following week and the child chose her lunches. The carbs were worked out by the kitchen staff (who were excellent) and the meal presented on each day with the carb count. It is the first school I went into where when I was given lunch I was also told my carb count.

In another school, the child took a packed lunch with the carb count clearly written. The form tutor then sat with the child whilst she did her BG and entered the carbs, and delivered insulin.

There are a lot of models for Support in schools. It is well worth getting your DSN to go in again, and enquire whether your local office has speakers who specialise in working with schools can go in and work with her class to raise awareness. This is my main focus for my volunteering.
 
Also

There is now a thread on this forum Diabetes in schools.
There are hosts on there who have moved across from the Children’s Support line
and have a lot of experience in helping with issues relating to schools.

It is in its infancy but if you have specific questions about school, posting in that thread might help others as they see the responses you get to any questions.
 
My daughter has had Combo pumps ever since she was diagnosed at age 6, and we've had no problems. Whichever one you choose it will be fine!

Regarding school staff though that's extremely variable. Make sure you have a good care plan set up and that all the necessary staff know where it is and understand why it's so important to get things right! Nobody at primary school would ever carb count for me, I think they were too afraid of getting it wrong, so I always had to send her with a post-it note with that day's count on and then the staff would just help her to do the bolus (just to make sure she got the number the right way round). The teacher she had in year 3 was a bit afraid of it all and left her to do things herself more than I would have liked, but she managed well and had to learn sometime! I did get kitchen staff to help me work out carb counts for things like rice and potatoes, and eventually we got the full nutritional breakdown from the council, only after the headmaster had a go at them though!

Now she's at secondary school we pre-select what she will eat and they make sure she gets what she's chosen, we got some help with carbs but apart from that we're making educated guesses and keeping an eye on blood sugars!
 
SB2015 said:
Also

There is now a thread on this forum Diabetes in schools.
There are hosts on there who have moved across from the Children’s Support line
and have a lot of experience in helping with issues relating to schools.

It is in its infancy but if you have specific questions about school, posting in that thread might help others as they see the responses you get to any questions.
Click to expand...

You'll find the Diabetes in Schools board here: https://forum.diabetes.org.uk/boards/forums/diabetes-in-school.38/
 
I've had the Omnipod for a year and I absolutely love it! I don't notice it all during the day/night and I've only had one fall off (after a long day swimming at the beach and sweating in the sun).

I've never forgotten my PDM, it just sort of becomes attached to you just like you would carry your blood glucose monitor/pens etc. I also have a cool pink case for it and have given it the name 'Podington Bear' 🙂

Personally I didn't like tubing and having to unattach things for swimming/showering but of course it's all relative and a personal choice. All pumps come with their pros and cons. Omnipod works for me as I feel like it gives me freedom without feeling attached to anything. Hope that helps!
 
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