Insulin Pumps Aren’t for Everyone…and That’s Okay!
At the end of 2020, I decided to try an insulin pump: the Omnipod system. I was attracted to it because I liked the idea of it being tubeless and only needing to change pods every two to three days, as opposed to taking four to six shots per day with injections.
I used the The Omnipod Eros system uses pods that communicate with a personal diabetes manager (PDM) via radio waves.Omnipod Eros System. (Omnipod DASH was not covered by my insurance at the time.) The Omnipod Eros System requires you to use a receiver that you input your settings into with your Omnipod rep and your A CDES is a healthcare professional who is trained to specifically help patients with diabetes. They educate patients about diabetes management, medication, and diet.Certified Diabetes Care and Education Specialist (CDCES) based on your insulin to carb ratio, fill one pod with insulin every 48 to 72 hours based on your projected insulin usage, and then—go live your life!
I loved it at first but ultimately decided Omnipod wasn’t for me about four to six months into my insulin pump therapy journey.
Let me preface this story by saying this isn’t to scare you (or your children or loved ones) from trying Omnipod or other insulin pump options. If you are interested, you absolutely should give it a try! If you have access to options and want to try them—proceed and conquer! Different management styles work for different people—and that’s okay.
(In fact, my Beyond Type 1 colleague chooses injections over pump therapy, too!)
Here’s why insulin pumping wasn’t for me…
It Was Love at First Pod
At the start of my journey with Omnipod, I loved the hands-off management. I was getting better sleep, feeling less anxious and gaining more stability in my life in just the first three days. (Is it socially correct to say I felt a little less diabetic?) I don’t exaggerate when I say that—I was so excited. I couldn’t help but brag about Omnipod’s effectiveness, but I was just getting started and had a lot to learn.
On good days, it was easier to say that the insulin pods were better than the pens, but on days where my blood sugar levels were not going in the direction they should, I couldn’t help but feel the pods were just a different way of managing diabetes—not necessarily a better way.
When I used Omnipod in late 2020 and early 2021, I typically placed the pods on my stomach. This The location where the insulin pump attaches to the body on the skin. Most infusion sets give you the option of a plastic/teflon cannula or a steel cannula. injection site led to a lot of bruising and scar tissue I don’t get with injections. I couldn’t keep putting them in this area for these reasons, but other sites on my body didn’t absorb insulin nearly as well. So, I had few options, and most of them weren’t comfortable for me.
My New Love Betrayed Me
While using Omnipod, I also experienced a “pod failure”—which is an expected part of using any type of insulin pump. Pod failures are essentially when the infusion site—or another part of the insulin pump system—fails, and you need to replace the pod. When your insulin pump site fails, it also usually involves a sudden and rapid spike in your blood sugar levels, along with ketones, because you aren’t getting insulin delivered properly from the pump.
This happens to anyone who chooses to use a pump, and clearly, many of them are willing to forgive this experience. Experiencing a pod failure just one time was enough for me to begin to rethink my new management style. When I experienced a pod failure I had the highest blood sugar level in recent memory—387 mg/dL. Even worse, I didn’t get it down to about 165 mg/dL until five or so hours later.
I was in the 300s for several uncomfortable hours. About seven hours later, I dropped to 53 mg/dL, which caused another type of discomfort and fear. This experience was scary—I never worried about ketones with insulin injections because I always knew the insulin was successfully delivered.
Still, when the Omnipod was working, I had better stability throughout the day than with injections. Injections caused more “hills and valleys” (in terms of blood sugar levels throughout the day) than the pods in my long history with T1D.
Unfortunately, the longer I used the Omnipod, the more I also noticed how much insulin was wasted. I could never quite get enough out of a single pod to use every drop, despite where I placed it on my body. I had to have been wasting about 10 to 20 units with each pod, and that sort of waste should never happen with the cost of insulin being so high.
Omnipod gives you pennies back for the insulin wasted. Better than nothing? Sure. But still not great with insulin costs being so high and savings programs having an uncertain future.
Maybe this Relationship with Omnipod Wasn’t Working…
While I was experiencing issues with Omnipod, I worked with my CDCES to ensure I was using the correct insulin-to-carb ratio and basal rates—I was. I wanted to make sure I was doing everything in my power to have a smooth experience.
Another distressing part of this situation is that it was explained to me by my CDCES that when you try an insulin pump, it’s nearly impossible to switch to another pump for a few years (three to five, depending on your insurance). I was unsure if this was relevant to my state or a nationwide rule, but I was disheartened to hear it, nonetheless.
I found this limitation to be a bit absurd with how fast technology upgrades and your diabetes management needs change. You’d think it wouldn’t matter, and we could try anything we like, but that just isn’t the case.
Later, I found out these rules are in place for most health insurance providers across the U.S. as pumps typically fall under a three to four-year warranty. If you run into an issue with your pump, it is sent to the manufacturer and replaced (sometimes with a loaner, and your pump is fixed and returned and sometimes with a refurbished pump altogether). If you just want an upgrade or a totally different product, you will probably have to wait it out or pay out of pocket for the hardware.
Since insulin pumps typically fall under the durable medical equipment (DME) category for most insurance providers, the ability to switch your pump is limited. They are a large financial outlier for the insurance company and individual, sometimes costing up to $7,000 USD out of pocket.
Though some trial programs exist, in my time, I have found that the total pump experience typically only comes once you purchase the product. Pumps and disposable pump supplies are generally unaffordable for most people with diabetes to pay 100 percent out of pocket.
Omnipod was also more expensive than buying insulin pens and needles with my insurance at the time, and since it wasn’t better but different, this financial factor further pushed me to reconsider.
The Straw that Broke Pump Therapy’s Back
The more I used the pods, the more anxious I felt about them falling off at night or as I was doing any strenuous activity. I was plagued by paranoia that I’d accidentally inject myself with 150 units instead of filling the pod with the units, as I had been so routine about injecting myself directly every day of my life since I was 10 years old.
I move quickly and automatedly in my life with type 1 diabetes (T1D), so I could see myself doing this. Perhaps that thought scared me more than anything.
I recall when I accidentally injected myself with 15 to 20 units of insulin when my blood sugar was already in my goal range. I survived that accidental experience, but I knew if I made the same mistake while filling a pod with 150 to 200 units of rapid-acting, all at once, my chances of survival would be slim. I wasn’t willing to live with that fear towards the end of my insulin pump therapy journey.
Ask Yourself: Do the Pros of My Management Style Outweigh the Cons?
You will have good and bad days with any T1D management style that you choose. You have to consider which problems you’d rather deal with at the end of the day. You have to ask yourself: What problems can I manage best? That’s really what it comes down to.
Insulin injections and pumps each have their downfalls.
I experienced terrific days and horrible days with pods and injections. Good or bad management is not exclusive to either. After my first pod failure, I experienced two other significant issues, which finally pushed me to revert to injections.
Many people love using the Omnipod to manage their T1D. At the start of Omnipod, I was having a lot of good days that I shared about, and I do not want to give a false or unrealistic recount as I look back. The good days were just as real as the bad ones.
What I Learned About Diabetes From My Omnipod Experience
You’ll never know unless you try, and despite these issues I experienced, I’m still glad I tried something new as it was the reset I needed to rethink the way I approach injections. Pods taught me to be more patient with my insulin injections and that it’s okay to give more injections of smaller amounts of insulin throughout the day if it helps me stay stable and feel well. Pods helped me think more like a CDCES when I re-approached my life with insulin injections.
Pods might not have been suitable for me in the end, but they happened at a time I needed a wake-up call. They helped me shift how I think about my day-to-day management, and I will always be grateful for the experience and proud that I recognized what does and doesn’t work for me.
I also learned I don’t have to be ashamed that I’m not on a pump —despite the pressure I once felt to use one by my peers. The right way to manage your diabetes is up to you and your care team to decide. You don’t owe anyone else answers about the method you choose!
All said and done, it really comes down to figuring out which method of insulin delivery helps you live your happiest and most rewarding life with diabetes!
