Libre 2 plus faults with Omnipod 5

[PhoebeC]

Hi all,

Something the Omnipod trainer didn’t tell us on Tuesday during the set up of the Omnipod 5. But Abbot did, so I’m sharing here as I didn’t know about it also I will add that I am not sure it’s true. Haven’t read it here either and you lot normally know.

After set up on Tuesday morning, by the evening my libre lost connection to the Omnipod 5 for over an hour, and I couldn’t find anything about how to reset it or scan it, their manual says with this issue to replace the libre, and my nurse had said that too.
So I took it off, put in another and the error was then “sensor not compatible” so I added a third, this one took another 24 hours to work properly, it was in and out of signal, before that and giving false lows. That was my 3rd libre in one day. Yes all libre 2 plus as I used all the others up. And one left. I was nervous that 3rd wouldn’t work but thankfully it did and at last the HCL can do its thing and I can stop finger testing as back up.

I phoned abbot to report the issues, and they are sending out replacements, he told me that if it happens again I should phone insulet / Omnipod and they can push out something to the handset which will make it connect or send out a new handset as it could be faulty.

I always find abbot pretty good customer service so if it happens again I will do as he suggested and report back.

 

[Ivostas66]

Hi Phoebe. I had a series of similar issues with my 2nd Libre - so a fortnight after moving onto the closed loop system. Scanner error and the dreaded 'searching for scanner' messages were causing me no end of issues. I used up a couple of pods over a few days and then swapped out the Libre too. Insulet sent replacement pods and Abbot sent Libre's.

After lengthy discussion we focussed upon 'line of sight'. At the orientation session we were told that the system would work perfectly as long as the pod and Libre could 'see' each other. I like to use my abdomen or lower back for the pod and upper arm for my Libre. The Insulet rep and DSN said this was fine as long as they are both on the same side of the body. However, on the phone, both Insulet and Abbot said that it is best to keep them close - allowing a couple of inch gap between the two. Other people have suggested that the sensor can read a pod on two separate areas of the body with line of sight for the first pod, but then seems to lose the ability to read at that distance after a few days/ from pod two onwards.

I have very slim upper arms, but have managed to rotate the pod around the Libre, making sure not to use the same injection site twice over the 15 day cycle. No issues with errors since then.

Hope you manage to get to the bottom of things - feel free to reach out if you want to discuss anything!

 

[PhoebeC]

Hi Phoebe. I had a series of similar issues with my 2nd Libre - so a fortnight after moving onto the closed loop system. Scanner error and the dreaded 'searching for scanner' messages were causing me no end of issues. I used up a couple of pods over a few days and then swapped out the Libre too. Insulet sent replacement pods and Abbot sent Libre's.

After lengthy discussion we focussed upon 'line of sight'. At the orientation session we were told that the system would work perfectly as long as the pod and Libre could 'see' each other. I like to use my abdomen or lower back for the pod and upper arm for my Libre. The Insulet rep and DSN said this was fine as long as they are both on the same side of the body. However, on the phone, both Insulet and Abbot said that it is best to keep them close - allowing a couple of inch gap between the two. Other people have suggested that the sensor can read a pod on two separate areas of the body with line of sight for the first pod, but then seems to lose the ability to read at that distance after a few days/ from pod two onwards.

I have very slim upper arms, but have managed to rotate the pod around the Libre, making sure not to use the same injection site twice over the 15 day cycle. No issues with errors since then.

Hope you manage to get to the bottom of things - feel free to reach out if you want to discuss anything!

Bodies don’t normally have an impact on bluetooth. I’m not majorly technical but I work for a global telecommunications, media and technology consulting firm and I know that’s not how Bluetooth usually works. So when they said this during training I thought it was odd. My husband said it will be cost cutting in the tech to bring down the cost for the NHS so they win the contract.

I’ve got the libre on my left arm and the pod on the left side of my stomach. The trainer said this was fine and I was first to put mine on our of the 5 of us, the only one moving from the dash so they kept asking me to do things first. I hope nobody else has this issue as we all used the same sites.

Thanks for the tip. I do hope I’m able to wear my pod in other locations than just my arms as that’s very restrictive. Snd like you say site rotation will be tricky. A downside of the libre which my hospital are pushing everyone to use, is that it should only go on the arm.

It is working well now, pod change later so we will see.

 

[SB2015]

Bodies don’t normally have an impact on bluetooth. I’m not majorly technical but I work for a global telecommunications, media and technology consulting firm and I know that’s not how Bluetooth usually works. So when they said this during training I thought it was odd. My husband said it will be cost cutting in the tech to bring down the cost for the NHS so they win the contract.

I’ve got the libre on my left arm and the pod on the left side of my stomach. The trainer said this was fine and I was first to put mine on our of the 5 of us, the only one moving from the dash so they kept asking me to do things first. I hope nobody else has this issue as we all used the same sites.

Thanks for the tip. I do hope I’m able to wear my pod in other locations than just my arms as that’s very restrictive. Snd like you say site rotation will be tricky. A downside of the libre which my hospital are pushing everyone to use, is that it should only go on the arm.

It is working well now, pod change later so we will see.

Hi Phoebe I am using a different HCl system, which is still connected by Bluetooth. I wear my sensor on my arm and find that I need to keep my pump positioned on the same side of my body. Sometimes at night as my pump roams free it ends up on the opposite side and if I then squish it as well it does have a stop and start complaining. I know your pods are in a fixed position but the line of ‘sight’ thing seems to apply to other systems.

 

[nonethewiser]

Only ever used libre when not looping, but this line of sight issue hasn't occurred with Dexcom G6 up to now after using device for last 18 months, it's a shame your having these issues @PhoebeC as libre is a good reliable device from past experiences.

 

[Richard F]

If lost connection I replace the pod and report.
My Libre 2+ is back of arm, I've given up using my abdomen. Arm provides 2 sites (above and below sensor) side of back and top of buttock are my other 2 favoured places. By the time I've used all these spots, Its time to swap arms and give the sites a rest for a couple of weeks.

It takes a bit of trial and error.

 

[PhoebeC]

If lost connection I replace the pod and report.
My Libre 2+ is back of arm, I've given up using my abdomen. Arm provides 2 sites (above and below sensor) side of back and top of buttock are my other 2 favoured places. By the time I've used all these spots, Its time to swap arms and give the sites a rest for a couple of weeks.

It takes a bit of trial and error.

Thanks @Richard F this is good advice.

And trail and error is the tag line for diabetes in general.

 

[PhoebeC]

Only ever used libre when not looping, but this line of sight issue hasn't occurred with Dexcom G6 up to now after using device for last 18 months, it's a shame your having these issues @PhoebeC as libre is a good reliable device from past experiences.

Yes, I have always been happy with the libre. It has worked for me well. I have had a few not work as they should. A bent needle going in, one that didn't stick and then only a few that gave odd readings or fell off early. Less than 10 in nearly 5 years I think it good going. I haven't needed to stick them on early to get good results, they seem to work for me well.
Compared to the pod quality, at least over 25 faulty pods in 21 months, and some screamers and very badly timed issues like on the beach, or when we are stuck on the motorway.

I have gone with on the arm for this new pod. Will see how this goes, I sleep on my right side, so I don't think I could use my right arm like this, I don't mind my libre on it, and occasional use my right arm for my pump, but my little arms are tiny. There's always something with diabetes.

Spoke with my DSN before, he is happy with my data, and so am I actually. We have made some small changes to the settings, overall I am happy with the HCL set up, just not the faulty tech. Monday is my last pump dafne, it's been good timing and has given me confidence I don't think I was lacking anyway, but it's reinforced my knowledge so I feel in control as much as possible with this little machine in control.

 

[Ivostas66]

I seem to be able to use my lower back with my first pod, but then have to move to my arm for the remainder of the Libre's life as they struggle to read at that distance. Insulet said that it is best to keep them very close - they also reminded me that you can wear the pod in the same place, but flipping it (canula at the top, then canula at the bottom) gives quite a bit of distance between injection sites.

 

[Richard F]

I seem to be able to use my lower back with my first pod, but then have to move to my arm for the remainder of the Libre's life as they struggle to read at that distance. Insulet said that it is best to keep them very close - they also reminded me that you can wear the pod in the same place, but flipping it (canula at the top, then canula at the bottom) gives quite a bit of distance between injection sites.

Interesting. When I fit a new Libre I tend to put the 1st pod adjacent. My thoughts are to reduce variables (distance) in-case of comms error.
I hadn't considered libre battery depletion.

 

[PattiEvans]

I have always got on well with Libres and I have used them from when they were first released - periodically at first due to having to self fund and then all the time on prescription. I went onto Omnipod 5 and Libre 2+ HCL at the end of June and have had no problems with connection until my last pod which seemed flaky from the time I put it on. Gave up with it on day 9 and Abbott have replaced it. I'm not too happy with the limited rotation places. I can use my lower back but I find it uncomfortable and occasionally painful. I use my side, above my belt but below my bra, which gives me 3 or 4 sites to move it to. All of which work well. I also use my arm but that's limited due to my arm being skinny and not very long!

they also reminded me that you can wear the pod in the same place, but flipping it (canula at the top, then canula at the bottom) gives quite a bit of distance between injection sites.

I was told to always ensure the cannula end was pointing slightly downwards to keep any bubbles away from it.

Anyway, that aside I'm not very impressed with the HCL programme on the Omnipod 5. I seem to spend an awful lot of time in the 7s and 8s these days, whereas previously I would be in 5s and 6s. Am awaiting an Hba1c so will see what transpires. However at a recent DSN appointment I was just 1% better TIR compared with when I was managing it myself on Libre 2 and Omnipod dash. Also when I was managing it myself I had had 0 time low whereas these days I am having more hypos than I like as I don't hear the pathetic alarms on the PDM.

I am probably one of the few not terribly happy with this particular system!

 

[PhoebeC]

A few days in and know it is still learning. But I gave it all the details of my previous set up amounts, I haven't change the setting amounts for the move across, on Dash in the day I was very steady most of the time, nice flat line, rare hypos, I did have some new issues recently with overnight which I had been slowly working on and fixing.

But yesterday and today so far huge spikes after meals then crashing down between. Overnight which was my issues on the Dash seem to already be much better, so fine lets hope that stays. But this up and down is making me feel ill actually and drained, so we will see.

@PattiEvans I have always got on very well with the Libre's, never had any major issues really, only 1-3 in total. Very happy with the quality, and how it works for me. The arm only issue now isn't ideal, but before it was fine.

I do find your experience interesting @PattiEvans. And this is my concern that TIR won't be better, and the hypo issue.

We moved me to pump due to my menstrual cycle, my requirements are the same apart from ovulation and period days. On the Dash I had background programs for each stage in my cycle and normal for most of the time. I have been told that this Omnipod5 will work better for me. But I am not sure on this point how it will know this in the automatic setting, I can't tell it about my cycle, and only in manual mode would it let me change say to my period setting. If it uses 2-3 weeks data and my cycle is 28-30 days it won't know, will it?

Both the rep and the DSN team said it will be able to handle it, but I am not confident in their answer. And that is the main reason for me upgrading. I liked the Omnipod dash and Libre 2 set up, loved actually.

 

[PattiEvans]

Hi Phoebe

Like you I have big spikes after meals, but the system doesn't seem to act as aggressively on them as I would like it to. For example, last night I spiked up to 13.6 and didn't drop into range at all. Was 12.6 on waking. I had a meal consisting of a salmon fillet (only ate half of it) a small portion of lentil, aubergine and pepper stew and a quarter of a Sharon fruit. OK the Sharon fruit was so ripe it was like eating marmalade, but 60g carb and the recommended dose should have dealt with it and after 3 hours there should have been some decent corrections. I didn't notice as I had gone to bed by then.

Fortunately I am long past menopause so don't have to worry about the issues you have - I dread to think! You have my sympathies.

 

[Richard F]

When using a manual basal I used to work around 50/50 Bolus/Basal. Since using HCL I've increased my bolus and now operate around 60/40 bolus basal, seems to work for me.
My evening insulin/carb ratio is much higher too. During the day I'm around 1/10 evenings 1/6.
If I allow my BG to get high, getting it down again can be a challenge.

(who knew mince pies were so high in carbs )

 

[PhoebeC]

(who knew mince pies were so high in carbs )

@Richard F I did ha! But also I love them, so by sight and weight I can carb count those well. All these years of experience

We will see what happens. I am giving it a few weeks. So close to Christmas also doesn't feel like the best time to start anyone on HCL, who eats or does anything "normal" these few weeks. We don't. Buffet / piccy teas are already a thing.

 

[Richard F]

Christmas seems a tricky time to start.

As an aside talking to the diabetic team earlier they think we'll be able to use a phone app rather than the provided handset. I'd like to be able to hook it up to a smart watch for monitoring BG too.

Why oh why doesn't BG appear on the handset 'lock screen' instead of the time to make monitoring easier?

 

[PattiEvans]

Like you I have big spikes after meals, but the system doesn't seem to act as aggressively on them as I would like it to. For example, last night I spiked up to 13.6 and didn't drop into range at all. Was 12.6 on waking.

Apparently the reason for that was that I had knocked the cannula out and rather than giving me a bolus, the insulin was just leaking out. Only discovered the next day when I went to change the pod and the backing was soaking!

 

[PattiEvans]

Why oh why doesn't BG appear on the handset 'lock screen' instead of the time to make monitoring easier?

I agree wholeheartedly. I think the programming of the PDM was done in a hurry with no attention paid to what the user really wants/needs.

 

[PhoebeC]

Yeah I had my libre on my watch and lock screen of my phone via gluroo (or similar) and that was so handy. My phone has since died so actually having the PDM is a blessing in some ways. But I do wish it was on my watch too.

I think dexcom can also work via phone at the same time as the PDM, but PDM must be set up first. I managed to get the libre on the phone too, but like the libre 1, no alarms or on the lock screen. Sure someone will find a way to do this, if they haven't already.

 

[Proud to be erratic]

As an aside talking to the diabetic team earlier they think we'll be able to use a phone app rather than the provided handset. I'd like to be able to hook it up to a smart watch for monitoring BG too.

I believe Apple watches can connect directly to the sensor, but I could be wrong for Libre. They do for Dexcom G6 or G7. But Libre can route through android phones to various smart watches, using a number of different apps.

Why oh why doesn't BG appear on the handset 'lock screen' instead of the time to make monitoring easier?

I also agree - WHY OH WHY. It's classic about something provided with scant consideration of the user. Since Abbott have upgraded Libre at least twice and ducked the opportunity to provide just a simple and blatantly obvious user benefit says everything really. The original Libre wasn't a true CGM since users had to scan to get readings, but that was changed with upgrades making Libre a true CGM.