First Pump Decision: Omnipod 5 vs Medtronic 780G

[Artur93]

Hi everyone,

This is my first post here, so please go easy on me!

I’ve recently been referred to the pump clinic due to experiencing Dawn Phenomenon (my blood sugar levels rise every morning when I wake up). During my first appointment, I was given two tasks:

1. Complete the DAFNE course related to CLP
2. Research insulin pumps and choose between the Omnipod 5 and the Medtronic 780G

I’m currently struggling with the second task. I’ve done some initial research and spotted the main differences between the two systems, and I was leaning toward the Omnipod 5. However, I recently spoke with a friend who used the Omnipod and said she only lasted a month with it. She mentioned it kept falling off and needed replacing more often than expected. Based on her experience, she strongly recommends the Medtronic 780G instead.

So, I thought I’d ask the community:

Have any of you tried both systems?
Which one do you prefer and why?

Any advice or personal insights would be hugely appreciated!

Thanks in advance

Artur

 

[Inka]

Welcome @Artur93 🙂 You’re doing the right thing doing research. Do lots. Watch YouTube videos, read reviews, write a comparison chart, circling the good things and underlining the bad things. There’s no best pump - only the best pump for you as an individual. Importantly, think about your lifestyle and imagine how each pump would fit into it. Even more importantly, don’t forget cannulas.Not every cannula suits every person or body area. Cannulas are the weak point of every pump. I always choose a pump that has a choice of cannula types and lengths - straight in, angled, Teflon, steel, etc.

I’ve been pumping 20+ years but I haven’t used either of those pumps. However, if I had to choose I’d go with the Medtronic.

 

[helli]

And just to confirm exactly as @Inka mentioned, I have never had issues with cannulas over nearly 10 years and would prefer the Omnipod although, like Inka, I have not used either.
I have used both tubed (like Medtronic) and Tubeless (like Omnipod) and prefer tubeless. The reason for this is convenience and size.
I find the tubed pumps considerably larger (in general) and, as I am petite, I have nowhere. to hide them - even under clothes, they leave a bulge - so I feel as if my diabetes is on display all the time.
The other reason is that the tubeless pump is fixed in position, out of the way. My tubed pump had to be attached to something (usually the top of my trousers or in a pump belt) which was rarely convenient for sleeping or lounging or at the gym. However, I never experienced the tube getting caught on a door knob which seems to be a fear for those who haven't tried one). As it is fixed, I am able to easily wear the tubeless pump in the shower which, being first thing in the morning, its when I experience Foot On The Floor so need more insulin.

There are disadvantages of tubeless pumps such as the pump covering a larger area of skin than a cannula. If you have sensitive skin this may be something you need to consider. And, you cannot temporarily disconnect the pump for x-rays or airport security.

Another thing to consider (which I have no experience of) is whether you are going to use the HCL feature and how this works. I believe the Medtronic learns your basal needs and uses this as the baseline pattern whereas other pumps require you to set the baseline pattern. Although the "intelligent pump" method (like the Medtronic) may sound great, it is not ideal if your basal needs change from day to day due to things like exercise or monthly hormones.

Sorry, I have probably not helped by giving you more things to consider.
Again, as Inka mentioned, there is no best pump.

Edited to add: have you tried/requested the "dummy Omnipod"? This will give you an idea what is like to have a lump permanently attached and whether the glue suits your skin. Take a look at the options for where you can attache a pump. I usually put mine below my waist. Others use their upper arm but I have too much muscle there and already have issues with tight sleeves (clothes manufacturers seems to assume that someone with my narrow waist has twigs for arms).

 

[SB2015]

Hi @Artur93

I have labelled my comments M for Medtronic bits and P for general comments on pumps.

M: I have been using the 780 in closed loop for over 5 years and it has been a game changer for me.
I have no experience of patch pumps and have always used tubed pumps. I am out off by the idea of having ‘a lump on my arm’ but I know that the pumps are a lot smaller and would probably be a lot less lumpy than I think.

M: I like being able to move the pump around according to need, preference and convenience. I have no problem with the using and simply tuck it away. I use 60 cm length which gives me enough movement to position my pump in a pocket, tucked in my bra as a third boob when wearing a dress, or in a pouch hung on the side of my bra. It is also long enough to allow me to let the pump roam free at night and not limit my Turing over.

P: There is a wide choice of cannulas with both metal and Teflon, and glue or 90. I am not sure what length needles are available. Mine are 6mm, which was longer than my pen needles but is fine. Worth trying a few which is possible either at the start or later on.

P: When I first switched from MDI to a pump it made a massive difference. Giving me more flexibility in exercising and reducing night time hypos. It required quite a bit of work adjusting the initial settings to get it to do what you want it to do. This was in the days before sensors were available, which was the next big game changer.

M: I am using the 780 in closed loop with Simplera Sync sensor (previously using Guardian 4). It takes a bit of work at the start to get the pump doing it what you want it, but it gives you a lot more flexibility (as do any of the pumps) to match your basal to your needs hour by hour.

P: The looping has eliminated night hypos and deals well with the dawn phenomenon for me. The looping also deals with a lot of thinking about D that I used to do. For me this was the biggest bonus, as I had a tendency to micromanage my D. In general I wake to my chosen target with a lovely flat line over night, and i am usually in the 80s / 90s for my TIR. I think that it is well worth choosing a pump that offers the option of looping.

M: Excellent ongoing training available through webinars, which I have found very informative. The telephone support for me has also been very good, and ordering has been fine apart from the odd glitch, which has always been sorted quickly. Any sensors that fail are readily replaced by phoning or ordering online.

Happy to answer any questions that you have about the 780

 

[rebrascora]

Hi and welcome.

Good luck with your pump choice. As others have said it will depend on your priorities and lifestyle.

I am curious if your levels rise when you wake up, whether you have tried injecting some bolus insulin to cover that rise as soon as you wake up. I do this... I keep my insulin pens under my pillow and I inject an extra 1.5-2 units of fast acting insulin plus my breakfast bolus and any correction before I get out of bed and that stops my levels from rising. I inject my basal insulin at the same time and both injections are always done before I even sit up in bed because as soon as I am vertical, my liver starts releasing extra glucose. If I didn't do this my levels would rise by about 6mmols in the 45 mins after getting up, but this gives me a near flat line on my graph and in fact I generally wait until my levels are in the 5s before I eat breakfast so often this means a slight decline on my graph. It gives me about 30-45 mins to get a coffee and prepare my breakfast and get washed and dressed.

I just mention it so that you could perhaps experiment with it whilst you wait for your pump situation to come to fruition if you haven't already.

 

[Thebearcametoo]

When it came time to change my kid’s pump we had various options. One suggestion was to try the omnipod for a few months and because each pod is stand alone you don’t have to be tied into the contract (this all needs setting up with their rep but they were very open to it) so that may be an option for you. In the end we continued with another tslim.

 

[PattiEvans]

Hello

You are faced with the same decision that I was some 4 years ago (except my choice was Omnipod Dash model rather than the 5).

Like yourself I did a lot of research, but with the added advantage of being able to see in person and talk to other T1s on the Medtronic. At the time I was using another tubed pump. I will set out my reasons for choosing the Omnipod and qualify them by saying that many may not apply to you as a chap.

The pump I was using was quite a lot more compact than the Medtronic (the now defunct 640G) plus it had a handset which controlled it. Whereas you had to control the medtronic directly which meant removing it from your clothing to do so. As Lady that was awkward if wearing a dress, whereas a chap can keep it in a pocket. The idea of a "stick on" version of a pump which could be concealed anywhere on the body and controlled by a handset was infinitely more appealing.

I did not need anything near 200u per 3 days - insulin consumption on a pump is less than that on injections. So for that and no doubt other reasons at the time I chose the Omnipod. I was quite happy with the control with the Dash, but by the end of 3 years I had learned that in fact sites were limited by some placings where I tended to accidentally pull it off, or were too awkward to access,plus the issue of rotation. Though doubtless it was an advantage to be able to swim and shower wearing it. It is down to what will suit you best.

I'd more or less come to the conclusion by the end of 3 years that at my next choice I may revert to a tubed pump. Then, out of the blue I was offered the opportunity to switch to the Omnipod 5 with Hybrid Closed Loop technology. I jumped at it. Unfortunately I found it disappointing. It in no way matched the control I could achieve manually on a pump. I won't say too much more on that subject, some people get
on with it. I do hear good things said of the Medtronic Closed Loop though. Myself I am now on a different tubed pump and HCL and very happy. I wish you luck with your choice.

I wish you luck with your choice.

 

[PhoebeC]

Never used both, I have only used the Omnipod dash and now O5. I don't think the quality is that good, they are cheaply made, so is the PDM device. It is about 1-2 a month for me that don't stay stuck, or the cannula comes out, but also they do replace the faults, and its not even "most" and it easy to spot. I had one that I put on and in about 3 hours it just fell off.

I always take spares if a certain distance or time away from home, and not just 1. All my posts are on here so have a search and you will find them.

I wanted a patch pump, it works well for me and my needs. Loads better than MDI, and the HCL is better (not drastically) than manual pump. I actually sleep like a normal, none diabetic person for the first time in my life. So I will stay on O5 and not go back to Dash for this reason.

Loads of info on this site have a look at others posts.

 

[Artur93]

Welcome @Artur93 🙂 You’re doing the right thing doing research. Do lots. Watch YouTube videos, read reviews, write a comparison chart, circling the good things and underlining the bad things. There’s no best pump - only the best pump for you as an individual. Importantly, think about your lifestyle and imagine how each pump would fit into it. Even more importantly, don’t forget cannulas.Not every cannula suits every person or body area. Cannulas are the weak point of every pump. I always choose a pump that has a choice of cannula types and lengths - straight in, angled, Teflon, steel, etc.

I’ve been pumping 20+ years but I haven’t used either of those pumps. However, if I had to choose I’d go with the Medtronic.

Thank you so much! That’s really helpful advice, especially about the cannulas — I hadn’t thought about how important they are. I’ve added that to my research list now.

 

[Artur93]

And just to confirm exactly as @Inka mentioned, I have never had issues with cannulas over nearly 10 years and would prefer the Omnipod although, like Inka, I have not used either.
I have used both tubed (like Medtronic) and Tubeless (like Omnipod) and prefer tubeless. The reason for this is convenience and size.
I find the tubed pumps considerably larger (in general) and, as I am petite, I have nowhere. to hide them - even under clothes, they leave a bulge - so I feel as if my diabetes is on display all the time.
The other reason is that the tubeless pump is fixed in position, out of the way. My tubed pump had to be attached to something (usually the top of my trousers or in a pump belt) which was rarely convenient for sleeping or lounging or at the gym. However, I never experienced the tube getting caught on a door knob which seems to be a fear for those who haven't tried one). As it is fixed, I am able to easily wear the tubeless pump in the shower which, being first thing in the morning, its when I experience Foot On The Floor so need more insulin.

There are disadvantages of tubeless pumps such as the pump covering a larger area of skin than a cannula. If you have sensitive skin this may be something you need to consider. And, you cannot temporarily disconnect the pump for x-rays or airport security.

Another thing to consider (which I have no experience of) is whether you are going to use the HCL feature and how this works. I believe the Medtronic learns your basal needs and uses this as the baseline pattern whereas other pumps require you to set the baseline pattern. Although the "intelligent pump" method (like the Medtronic) may sound great, it is not ideal if your basal needs change from day to day due to things like exercise or monthly hormones.

Sorry, I have probably not helped by giving you more things to consider.
Again, as Inka mentioned, there is no best pump.

Edited to add: have you tried/requested the "dummy Omnipod"? This will give you an idea what is like to have a lump permanently attached and whether the glue suits your skin. Take a look at the options for where you can attache a pump. I usually put mine below my waist. Others use their upper arm but I have too much muscle there and already have issues with tight sleeves (clothes manufacturers seems to assume that someone with my narrow waist has twigs for arms).

Thanks for sharing your experience — really helpful! My main concern with the Omnipod is the insulin capacity, and I worry about a pod failing and being left without a pump. As suggested, I’ve already ordered a demo pod to see how it feels — great tip!

 

[Artur93]

Hi @Artur93

I have labelled my comments M for Medtronic bits and P for general comments on pumps.

M: I have been using the 780 in closed loop for over 5 years and it has been a game changer for me.
I have no experience of patch pumps and have always used tubed pumps. I am out off by the idea of having ‘a lump on my arm’ but I know that the pumps are a lot smaller and would probably be a lot less lumpy than I think.

M: I like being able to move the pump around according to need, preference and convenience. I have no problem with the using and simply tuck it away. I use 60 cm length which gives me enough movement to position my pump in a pocket, tucked in my bra as a third boob when wearing a dress, or in a pouch hung on the side of my bra. It is also long enough to allow me to let the pump roam free at night and not limit my Turing over.

P: There is a wide choice of cannulas with both metal and Teflon, and glue or 90. I am not sure what length needles are available. Mine are 6mm, which was longer than my pen needles but is fine. Worth trying a few which is possible either at the start or later on.

P: When I first switched from MDI to a pump it made a massive difference. Giving me more flexibility in exercising and reducing night time hypos. It required quite a bit of work adjusting the initial settings to get it to do what you want it to do. This was in the days before sensors were available, which was the next big game changer.

M: I am using the 780 in closed loop with Simplera Sync sensor (previously using Guardian 4). It takes a bit of work at the start to get the pump doing it what you want it, but it gives you a lot more flexibility (as do any of the pumps) to match your basal to your needs hour by hour.

P: The looping has eliminated night hypos and deals well with the dawn phenomenon for me. The looping also deals with a lot of thinking about D that I used to do. For me this was the biggest bonus, as I had a tendency to micromanage my D. In general I wake to my chosen target with a lovely flat line over night, and i am usually in the 80s / 90s for my TIR. I think that it is well worth choosing a pump that offers the option of looping.

M: Excellent ongoing training available through webinars, which I have found very informative. The telephone support for me has also been very good, and ordering has been fine apart from the odd glitch, which has always been sorted quickly. Any sensors that fail are readily replaced by phoning or ordering online.

Happy to answer any questions that you have about the 780

Thanks so much for sharing your experience — really helpful to hear from someone using the 780 long-term! I know this might sound like a silly question, but how do you sleep with the pump? Do you keep it under your pillow, attach it to your pyjamas, or maybe leave it on a bedside table?

Also, have you ever had issues with the tubing while sleeping — like accidentally ripping it out or it disconnecting during the night? Just trying to get a realistic picture of what to expect!

 

[Artur93]

Hi and welcome.

Good luck with your pump choice. As others have said it will depend on your priorities and lifestyle.

I am curious if your levels rise when you wake up, whether you have tried injecting some bolus insulin to cover that rise as soon as you wake up. I do this... I keep my insulin pens under my pillow and I inject an extra 1.5-2 units of fast acting insulin plus my breakfast bolus and any correction before I get out of bed and that stops my levels from rising. I inject my basal insulin at the same time and both injections are always done before I even sit up in bed because as soon as I am vertical, my liver starts releasing extra glucose. If I didn't do this my levels would rise by about 6mmols in the 45 mins after getting up, but this gives me a near flat line on my graph and in fact I generally wait until my levels are in the 5s before I eat breakfast so often this means a slight decline on my graph. It gives me about 30-45 mins to get a coffee and prepare my breakfast and get washed and dressed.

I just mention it so that you could perhaps experiment with it whilst you wait for your pump situation to come to fruition if you haven't already.

In my case, my blood sugar starts rising just before I wake up and it’s really rapid — I can go from 8 mmol to 20 mmol in about half an hour. I do treat it with insulin as soon as I wake up, but by then it’s already around 20. It doesn’t seem to matter what time I wake up — it’s more like the act of waking up itself triggers the spike.

 

[helli]

Thanks for sharing your experience — really helpful! My main concern with the Omnipod is the insulin capacity, and I worry about a pod failing and being left without a pump. As suggested, I’ve already ordered a demo pod to see how it feels — great tip!

Any pump could fail but you will see this if you are using a CGM as your BG rises.
Different people have different approaches. You could carry a spare pump/patch with you when you go out. In this case, it is useful to consider how much stuff you need to carry - in my experience, tubeless pumps have less stuff to carry.
Or you could just carry a small vial and a syringe for "top ups" if you are out for a short period of time.

Also, have you ever had issues with the tubing while sleeping — like accidentally ripping it out or it disconnecting during the night? Just trying to get a realistic picture of what to expect!

As I mentioned, I have tried both tubed and tubeless. The advice I was given with tubeless was to leave it to "do it's thing" and the chance of it getting ripped out is incredibly low. In my experience, this is true - I never ripped out my pump neither in bed or when my pump became unclipped climbing and doing flying trapeze (yes, I know these are extreme examples but they are the only times it happens in 4 years). However, if my pump was no "tethered down" it would somehow find its way under my hip which does not have much padding. As I do not wear pjs, I found the easiest thing to do was use a pump belt (the HidIn ones were by far the best) wrapped around my thigh.
I move around to much in my sleep to leave a pump (which is attached to me) on the bedside table).
Remember, if it was easy and common-place to rip out a cannula from a tubed pump (or dislodge a tubeless one), they wouldn't exist.

 

[Inka]

Thanks so much for sharing your experience — really helpful to hear from someone using the 780 long-term! I know this might sound like a silly question, but how do you sleep with the pump? Do you keep it under your pillow, attach it to your pyjamas, or maybe leave it on a bedside table?

Also, have you ever had issues with the tubing while sleeping — like accidentally ripping it out or it disconnecting during the night? Just trying to get a realistic picture of what to expect!

I’ve always used a tubed pump. So, over 20 years the number of times I’ve pulled out a cannula at night or got tangled in the tubing is quite literally zero - and I speak as a very clumsy person! My pump sits in a pump belt round my waist. It’s super-soft and I don’t even know I’m wearing it. I often pat myself to make sure I have my pump on! When I was pregnant, I just used to put the pump beside me and that was fine too. It’s not an issue 🙂

 

[PhoebeC]

Any pump could fail but you will see this if you are using a CGM as your BG rises.
Different people have different approaches. You could carry a spare pump/patch with you when you go out. In this case, it is useful to consider how much stuff you need to carry - in my experience, tubeless pumps have less stuff to carry.
Or you could just carry a small vial and a syringe for "top ups" if you are out for a short period of time.

As I mentioned, I have tried both tubed and tubeless. The advice I was given with tubeless was to leave it to "do it's thing" and the chance of it getting ripped out is incredibly low. In my experience, this is true - I never ripped out my pump neither in bed or when my pump became unclipped climbing and doing flying trapeze (yes, I know these are extreme examples but they are the only times it happens in 4 years).
Remember, if it was easy and common-place to rip out a cannula from a tubed pump (or dislodge a tubeless one), they wouldn't exist.

Yes, I carry a very small case which has my blood glucose monitor stuff, 2 pods and a little bottle of insulin. Its the Omnipod case actually, like a pencil case / makeup bag. Goes in even my smallest bag, and sometimes I have a small bumbag for on the side of the pitch for rugby, with a few jelly babies, glucose monitor, 1 pod and the tiny insulin.

I have never had a pod knocked off and I play full contact rugby 2 - 3 times a week. I have had 1 peel off during training since march 2023, but it was very loose on stick before I left for training, it was muddy and very damp so it had no chance, user error that one. I should have changed it before I went to training.

I have had one of the Dash pumps, and one O5 just stop working/fault and start loud beeping (known as a screamer) but since 2023 I don't think that is awful. And MDI had issues too, I dropped pens, had one of the dials just give up and not turn, broken insulin inside the pens, insulin go off, power go etc. there's always issues with any treatment but personally the wins of a pump and the Omnipod versions for me outweigh any hardware/tech issues.

 

[nonethewiser]

Only ever wanted a tubeless pump so never considered any others tbh, as Omnipod was only one around back then so Omnipod it was.

Since initial pump switch to Dash then to O5 integrated with Dexcom G6, rarely get any pods come unstuck & can't remember last time had to report one, providing I clean site with alcohol wipe or surgical spirit first find each pod sticks like glue.

Best bet is to way up pros & cons of each pump & consider how each one would suit your lifestyle & convenience.

 

[SB2015]

Thanks so much for sharing your experience — really helpful to hear from someone using the 780 long-term! I know this might sound like a silly question, but how do you sleep with the pump? Do you keep it under your pillow, attach it to your pyjamas, or maybe leave it on a bedside table?

Also, have you ever had issues with the tubing while sleeping — like accidentally ripping it out or it disconnecting during the night? Just trying to get a realistic picture of what to expect!

With the 60 cm tubing I find that that is long enough for me to let it roam free. If I do put it in a pocket during the night I inevitably get woken when I roll onto it in the night as it hurts. Letting it roam has not caused a problem.i am often not sure where my cannula is situated as that does not cause any discomfort once in (I get the odd ouch if I hit a nerve) and I can lie on it without a problem

The Louer lock on the connections is very secure so does not become disconnected. If the pump falls out of the bed it will give a gentle tug on the cannula but again not enough to pull it out. It takes quite an effort to pull it out.

I did catch the tubing on a lever door handle and walked on, which did extract the cannula. For a few changes I put tape over the cannula (but not over the connector on the tubing. I soon reverted to no tape.

I found that it is these practical questions that I wanted answering when I moved to a pump. Keep the questions coming, and there is no such thing as a silly question.

 

[Thebearcametoo]

In 4+ years of using a pump my kid has had cannula issues twice overnight with ripping the cannula out once and the tubing coming out of the cannula once. He just lets the pump roam free.