Switching to Omnipod 5 after 43 years MDI Help and advice welcome please

[Broomey]

Mix of emotions but looking forward to the transition
Currently using levemir and Fiasp
Only had to wait 18m since agreeing to the switch. but a year after getting nhs funding approval
So many questions for actual users rather than salespeople or consultants
Any advice and guidance welcome
Specifically
-how does the reordering process work -I have concerns I will run out of pods before the next 3 month batch arrives - I think I will need to change the pod after 2 1/2 days rather than at the end of day 3?
- is Fiasp compatible
-generally I have been told the number of units falls using Omnipod - Is that your experience
- do you know if there is any correlation between number of Levemir units versus units of Fiasp though the pod ie if I currently use 35 units of levemir through mdi does that equate to 35 units of pumped Fiasp

Really keen to know peoples views

Thanks

 

[Tdm]

Not a pumper, just wated to say congrats on the pump!

 

[Natalie123]

I don't use the omnipod 5 but I do use Fiasp in the Ypsomed pump. I can't answer all your questions but these are my thoughts and what my research before I chose my pump (6 months ago) told me:
1. If you need to change more often than the standard timing you will need to ask your diabetes team to set you up so that you are given enough supplies to last you for the whole period if it is an automated reordering system. For my pump I have to make an order every 3 months, if I go over my yearly allowance, my hospital team have to contact the pump company to authorise more supplies.
2. It looks like the omnipod 5 is not licensed for use with Fiasp (interestingly the Omnipod Dash is). This doesn't necessarily mean that you won't be able to use Fiasp if your hospital team are willing to try it off licence but you would need to discuss this with them.
3. The amount of insulin I needed fell significantly when I switched from MDI to a pump but I don't know if that is a common occurrence.
4. Your diabetes team should set up the pump with you so I would allow them to use their expertise to guide you. Obviously you will be able to give your input, but when I got my first pump, the settings were mainly decided by my diabetes team with my input, for example I knew I had bad dawn phenomenon and suggested more insulin in the morning to cover this, they then chose a basal profile that took this into account. If I remember correctly there is a correlation between the amount of levemir to the total basal rate you will need on a pump but it may be significantly reduced to begin with.

I hope you get on well with your new pump, I was much happier when I switched to a pump.

 

[helli]

I have been pumping for about 8 years but not with OmniPod (my clinci say it is too expensive) so I cannot answer all your questions but
-generally I have been told the number of units falls using Omnipod - Is that your experience
- yes, this is commonly the case. I think my TDD was reduced by about 15%.
- do you know if there is any correlation between number of Levemir units versus units of Fiasp though the pod ie if I currently use 35 units of levemir through mdi does that equate to 35 units of pumped Fiasp
- all insulin needs are reduced. Not just bolus. But for me, my basal needs were also reduced by about 15%. However, you may find some variation as the option to set your basal for different times of the day means you won't have to use bolus to deal with DP, this will be done by your basal and, if you are needing to "feed your insulin" because, for example you need less during exercise, you can reduce your basal.

 

[Natalie123]

I have been pumping for about 8 years but not with OmniPod (my clinci say it is too expensive) so I cannot answer all your questions but
-generally I have been told the number of units falls using Omnipod - Is that your experience
- yes, this is commonly the case. I think my TDD was reduced by about 15%.
- do you know if there is any correlation between number of Levemir units versus units of Fiasp though the pod ie if I currently use 35 units of levemir through mdi does that equate to 35 units of pumped Fiasp
- all insulin needs are reduced. Not just bolus. But for me, my basal needs were also reduced by about 15%. However, you may find some variation as the option to set your basal for different times of the day means you won't have to use bolus to deal with DP, this will be done by your basal and, if you are needing to "feed your insulin" because, for example you need less during exercise, you can reduce your basal.

Interesting! My pump basal rate was about 50% of my basal when injecting, maybe even less, I was really surprised. My bolus amount dropped slightly but not as significantly. And good point about reducing the basal rate during exercise, that was a big positive of the pump for me.

 

[Bloden]

I switched from the Dash to the Omnipod 5 (hybrid closed loop) in January.

I was told I was only "allowed" to use Novorapid or Humalog in the O5, but it really depends on your consultant. Mine sticks to the guidelines so I use Novorapid.

My TDD hasn't changed significantly on the Omnipod 5. My basal needs are more or less the same as when I was on MDI.

Will you be using the O5 with the Libre 2+ or the Dexcom G6 or G7?

I use the O5 pump in Manual mode as it suits me better. Lots of people are happy with Automated mode.

 

[Broomey]

Really helpful comments
Thanks everyone
Keep em coming please
Bolden -I will be using LS2+

 

[Broomey]

What happens in the hour switchover when a new Libre sensor is added?? There will be no feed to the Omnipod so how much insulin is being pumped in that hour??

 

[Bloden]

The Omnipod goes into Limited mode while the sensor 'warms up'. This is from the O5 handbook: in Limited mode "the system constantly compares the Automated Adaptive Basal Rate with the Manual Basal Programme and uses whichever is lower".

So, it compares its own basal rates to the basal rates you put into the Controller at pump set-up.

I hope that's clear!

 

[SB2015]

I am not using the Omnipod system but I am using a HCL and will answer as best I can

My orders are set up by the hospital and sent automatically. If I need any extras the DSn sends confirmation that this is okay to Medtronic. No problems so far.

At training for my first pump the DSN used my previous data to help me work out my settings. This was before Libre was available so based on finger prick data. From a basic profile I then adjusted my basal rates and carb ratios over time to suit my individual needs
When I got my latest pump they had access to sensor data and again checked that they were happy with the settings that I put in. They will work with you at your training.

When my sensor is in warm up mode my pump reverts to the manual settings that I have put in. Once it is ready to use it flips back to looping.

 

[helli]

Hey @Broomey
A couple of additional thoughts
- while we are sharing our experiences, these often differ from clinic to clinic (and person to person). Hopefully, you will have a training session on your pump when you get it which should answer your questions, Even where we have answered on the forum, I recommend asking gain during your training in case things are different.
- you mentioned that you will have HCL with Libre 2+. There has been some discussion about this set up on the forum. Unfortunately, some people's experience has not been great but, we are all different. You may want to take a look at some of the threads like this one https://forum.diabetes.org.uk/board...g-with-omnipod-5-and-libre-2-dexcom-6.117318/

 

[PhoebeC]

Hi @Broomey,

I moved over to the Omnipod dash after 17 years MDI. I'd never looked or even been interested in pumps for 16 years of that time, so understand how you feel. it is a big set. I did go to the Dash before over to full HCL with the Omnipod 5 so I had some adjustments to the different set up. From the first week my control/life was vastly improved and in ways I never imagined.

I am under Tameside diabetes clinic.

- reordering pods- set up by the DSN - they just arrive every 3 months, any faults you must report to Insulet (Omnipod) via phone and they send replacements. Quick at sending replacements. Its not via prescriptions, if I need more or was running low I need to contact the DSN team, as it is via them.

-Why do you think every 2 1/2 days rather than at the end of day 3? I have most pods lasting the extra 8 hours after expiry in most cases, its 3 days plus 8 hours. I use less insulin now. They hold 200units, will you need more than that?
I am not even using 150 units now in the 3 days. This one expires at lunch I have over 50 units left and my total insulin per day is about 30-35 units so I won't change it until the last point possible now.

- is Fiasp compatible - Insulet do not approve the usage of Fiasp. I use it with the okay from my DSN team, and a number of other T1s who got set up the same day as me think 4/6 people used it. I know other users online.

- number of units falls using Omnipod - yes, as it is better control than MDI for me. But I never really thought about my total daily insulin until I move over, I think I was on 20ish and now its 14-17ish.

- number of Levemir units versus units of Fiasp though the pod - units work about the same I believe, however your team will help you with this. On set up day I was told to have a very small amount (less than half) of my background. You will work out on setup day (if not before) all the settings for the pump. I feel like fast acting in small amounts is more effective than the background insulin.

Now I am 6 months in, and my CGM is working (libre 2 plus didn't) I can say I am happy to stay on it, it has taken 4 months to decide this.
From MDI to Omnipod dash was lifechanging for me, for the better. I cannot say if this is just move from MDI to pump.

With the O5 I had teething issues, waiting on my bloods (taken last week) to confirm that I have better results. It is mixed half the month its great, around my cycle it doesn't know what's going on, and it can't work out rugby training or matches, but this is about the same as the Dash or MDI. It is not perfect, do not expect that. But it depends on you, your lifestyle and current diabetes gremlins. Loads of information on the Omnipod site, Youtube and here. Have you given the sample pod a go? That was useful.