Navigating New Insulin Pump Sites and Nerves

This was originally published on Hugging the Cactus on September 7, 2020. I’m sharing it again today because my mom and I were recently talking about pod placements and the places where we would (and would not), hypothetically, feel comfortable wearing a pod. It got me thinking about how I’ve had to work up the courage to try new sites over the years, which inspired me to write this post to hopefully help others who feel the same way about navigating new pump sites and nerves. Read on for more…

Am I the only T1D out there who feels incredibly nervous about trying new insulin infusion sites?

I’ve been this way as long as I can remember, now that I’m thinking about it. Throughout my childhood, I stubbornly stuck to injecting in my arms, legs, and upper buttocks (tee-hee) because those were the areas I felt comfortable with. I don’t think I even considered jabbing myself in my stomach until I was in my teens, and it was only after I realized the importance of site rotation and reducing scar tissue.

So it’s kind of funny that when I went on the OmniPod just over five years ago, I only used my stomach and my lower back (just above the upper buttocks region, tee-hee) for pod placements. It was partly because my guinea pig – I mean, my mom – used those areas for her pods with success, and also because I was hesitant in the beginning to wear my pods on my arms or legs because of their increased visibility.

It went that way for a couple of year – four basic sites ’round my abdomen – when it occurred to me yet again that site rotation was also important for insulin pumpers, not just MDI-ers (multiple daily injection…ers). So I added my upper arms into the mix, and soon after, my upper thighs followed.

The little diagram (courtesy of Insulet/OmniPod) above only shows a few of the sites that people with diabetes use…over the years, we’ve gotten a lot more creative!

But lately, I’ve shied away from wearing pods on my thighs because the area isn’t overly comfortable. When I roll over in my sleep at night, my pod presses up against my leg and the resulting pressure is just enough to disrupt my sleep and make it difficult for me to find a more restful position to sleep in.

As a result, I’ve started contemplating potential new pod sites, and one of the first places I went to for advice was…Instagram! Because…duh.

The DOC (diabetes online community) on Insta is a natural resource for this sort of thing because many people tend to share photos of their sites. It’s kind of a thing. One simple scroll through my feed taught me that people can get very inventive when it comes to finding new locations to place their CGMs and insulin pump infusion sites.

I saw people wearing Dexcoms on their forearms and calves. I saw pods on backs, calves, and even the upper chest area, the latter of which I found most intriguing. For men, it seems like a very accessible spot that causes little irritation, but for women? How the heck did the T1D ladies I saw with pods on their chest deal with it?

The general consensus, it seemed, was that women wearing pods on the upper chest agreed it was a site with great absorption and minimal discomfort.

I was still skeptical, though. I was worried about how it would look if I was wearing a v-neck tank with my pod poking out of, well, my bra! Then it hit me that my pod garners questions from strangers regardless of where it’s located. Furthermore, people will (probably?) be less likely to ask about it if it’s located on my chest because, um, that’s really awkward. My eyes are up here, people!!!

Then I remembered: I could give the site a try without wasting a pod because I have a demo pack that I got from a diabetes conference awhile back! The demo pack comes with a dummy pod that looks and feels just like a regular pod, but there’s no reservoir built into it, so insulin can’t be injected into it.

So right now, as I’m writing this, I’m wearing two pods: one on my upper arm that’s actually giving me insulin, and a fake one on my chest just to see how I like it. I must admit, so far, so good! I slept comfortably with it on last night and I haven’t had any issues wearing clothing or undergarments with it. I even went for a jog with it on and got pretty sweaty, but it stayed secure/I didn’t feel it bouncing around at all (thought the adhesive got a bit too damp for my liking…it stayed on but if I wasn’t careful I totally could’ve knocked it off).

While I’m still having a hard time wrapping my head around an actual cannula piercing my skin at this location (eeeek), now that I know I can handle the pod itself living there, I’m one step closer to trying (and liking) a site that’s more intimidating to me – a win in my book.

An Onslaught of Alerts

Imagine receiving the same notification on your phone every 5 minutes…over and over again…nonstop until you actually do what it’s demanding to you.

Sounds maddening, right?

Well, that’s exactly what I experienced with my Dexcom app recently. Every 5 minutes on the dot, I got a “Calibration Alert” push notification that told me to “enter new blood glucose reading to maintain your sensor accuracy”. Doesn’t sound like too big of an ask, right? Why not just do it?

Of course I just did it – the first handful of times that it asked. But when this alert persisted to appear on my phone each day, around 24 hours after I’d calibrated my Dexcom sensor, I started to get super irritated. But I was also confused. I shouldn’t have to calibrate my Dexcom, like, ever. The G6 was designed to make it so calibrations are a thing of the past. I only ever even bother to calibrate it within the first few hours of wear if I feel that the blood sugar it’s reporting is really off, and that usually forces it to correct itself and show far more accurate readings fairly quickly.

So why was my Dexcom being so forceful with the reminders for me to calibrate?

Imagine seeing this alert pop up on your phone…every 5 minutes…for an hour…or 3. That’s a few dozen reminders too many.

I knew that my best shot at finding the answer to this question was by going to the people who are intimately familiar with the ins and outs of Dexcom devices – no, not the manufacturers themselves. I’m talking about my colleagues, of course. (One of the best parts about working at a diabetes nonprofit is that my coworkers and I collectively have 100+ years of diabetes experience under our belts and constantly ask one another for advice or wisdom regarding various diabetes scenarios.)

When I asked them if they’d ever encountered anything like this, one person explained that the CGM can get a little confused if, when after the initial two-hour warm-up period, a super high or a super low blood sugar can trigger the system to get stuck – almost like it’s unsure of what it’s reading. This tracked for me because when I started up this particular sensor, the two-hour warm-up period collided with a particularly nasty low blood sugar of 35. That blood glucose value is low enough that the system can’t even pick up the number “35” – instead, it just shows that I’m “LOW”.

So as a result of this, my sensor was likely just in need of calibrations every 24 hours just to make sure it was working properly. It’s probably in the code of the software or something to prompt users to calibrate every day until the system feels more confident about what it’s reading. That makes sense and all, but dang, is it annoying. Sure, I could’ve silenced the alarms a lot faster if I just calibrated whenever I got the first alert of the day, but my schedule didn’t always allow for that. And besides, after 4 or 5 years of using the Dexcom G6, this T1D has gotten used to no more finger pricks; because of that, it’s hard to go back to old habits.

But hey, it has wound up being another diabetes scenario that I hadn’t experienced yet and just another lesson learned, so while it may have been a bit of a nuisance it was also educational. And I’m okay with that.

Do You Know How Long OmniPods Last?

This post was originally published on Hugging the Cactus on June 3, 2020. I’m sharing it again today because I have seriously benefited from learning the “true” length of time that a single OmniPod lasts on my body. Read on to learn more…

When people notice my OmniPod insulin pump, the first question that I’m asked is “what IS that?”

After I explain that it’s my insulin pump, and it’s called a pod, the second question I’m asked is some variation of “how long does it last?”

The canned answer that I provide is something about having to change it every three days, because that’s how the OmniPod is advertised.

But I’ve used this pump for years now and never bothered to really test this three-day limit. I’ve known for a long time that my pod works a handful of hours after the expiration alarm starts chiming, but I wasn’t sure about exactly how many hours I had before a pod expired for good.

So, the other day, I decided to find out.

Have you ever made your pod last longer than 80 hours? If so…are you a wizard???

My pod expired at 10:22 A.M. Since I prefer to change my pods in the evening, I figured it was the perfect time for this little experiment, assuming that the pod really would last me for the majority of the day.

And, well, it did! At 10:22 on the dot, the pod beeped at me to notify me that it was expired. And in the six hours after that, it would alarm every hour (on the 22nd minute) to remind me, time and time again, that it was expired. In the seventh hour – beginning at 5:22 P.M. – my PDM started chirping at me on and off every 15 minutes or so. First it was because I was running out of insulin, but then it was to really get the point across that my pod was expired!

I was determined to use every last drop of insulin in the pod, though, so I bolused for my dinner around 5:45 and I was pleased to discover that I got my full dose of insulin without any issues. As I was cleaning up after dinner, that’s when the signature OmniPod BEEEEEEEEEEEEEEEEEP went off as one blaring, unceasing alarm. I checked the time: 6:22 P.M.

So there was my answer. An OmniPod can last precisely 80 hours after you initially activate it for the first time (or in other words, 8 hours after you receive the first expiration message)…as long as it still has insulin in it. It’s definitely something good to know for sure now, because in the future, it might come in handy and help me avoid wasting precious insulin.

Ask Yourself These 6 Questions Before Trying New Diabetes Technology

This blog post was originally published on Hugging the Cactus on May 13, 2020. I’m sharing it again today because I think it’s super important to weigh the answers to these questions before deciding to try new diabetes technology. This is coming from someone who waited 17 years before she tried her first insulin pump, and even though it has had an enormously positive influence on my life and sometimes I wish I’d tried it sooner, I’m ultimately glad that I waited that long! Read on for more details…

So you want to try your first continuous glucose monitor. Or maybe you’re ready to leave behind multiple daily injections and switch to insulin pump therapy. Whichever diabetes device you’re looking to start using, there are some questions you’ll probably want to have answers to before decide that now’s the time to introduce new diabetes technology into your daily routine.

The following is a compilation of the questions that I thought long and hard about (literally for years) and that I wish I’d thought long and hard about before I made the transition to the OmniPod insulin pump.

1. Am I ready for it? It took me 17 years before I decided that I was ready to try an insulin pump. 17 freakin’ years!!! I spent most of that time being too afraid of introducing such a drastic change to a routine I’d had down pat for such a long period of my life. There are times when I wish I’d gone onto my insulin pump sooner, but ultimately, I’m glad that I wasn’t swayed by my family or doctors to go on it before I truly felt ready. By the time I started using my OmniPod, I had the maturity, responsibility, and emotional intelligence that I felt that I needed for an insulin pump.

2. Will I be able to afford it? Obviously, this isn’t a question that I wondered about when I was younger, but it’s one of the first things that comes to mind as an adult on her own health care plan. We all know that diabetes supplies are expensive, and it seems that the more technologically advanced something is, the more money that has to be forked over in order to obtain it. This isn’t right or fair, but it’s a simple truth and an important one to think about before choosing one pump or continuous glucose monitor over another.

3. Why do I want to start using it? I wanted to start using my OmniPod because my mom experienced great success when she started using it. And I decided to get a Dexcom CGM because I fell in love with the technology after undergoing a trial period with my endocrinologist. In both situations, I felt very much in control of my decision to start using these devices and I didn’t really listen to anyone else’s opinions. But I am very aware of the fact that social media and real-life friendships with other people with diabetes can often sway people in different directions. After all, if I saw a post on Instagram from a dia-influencer who was singing the praises of a Tandem T:slim pump, then I might seriously start thinking about switching to it (this has actually happened to me). But the bottom line is to think about the why – will this device enhance quality of life for me? Will diabetes be easier to manage with it? Will it help me achieve my A1c and/or blood sugar goals? Do I need to add something new to my routine because I’m feeling burnt out by doing things the same way all the time? Knowing why I wanted to use an OmniPod or a Dexcom CGM made me feel that much better during the whole process of learning how to use them – I felt like I had clear goals that would help me navigate the integration of these new technologies into my daily routine.

Did you know that Insulet/OmniPod has demo pods that you can wear? They don’t hold insulin or deploy a cannula, but they can give you a good sense of what it’s like to wear a pod on a daily basis!

4. Will I be comfortable wearing it 24/7? This is a big one! Pods, pumps, and CGMs are very visible, and it can be jarring to go from being “naked” to having bumps and lumps underneath clothes that can get caught on doorknobs, chairs, and the like. Personally, the benefits of my OmniPod and Dexcom outweigh something like this which is a bit superficial, but that doesn’t mean it’s not something to think about. But it’s also worth thinking about comfort and what is least painful when it comes to insulin delivery, so that’s why this is an important question to ask.

5. Do I know anyone else using it who can provide feedback from a patient’s perspective? I’ve talked about this before, but I’m not sure when, if ever, I would have seriously considered using the OmniPod if my mother hadn’t tried it first. The fact that we both have diabetes has probably made us a little closer and strengthened our bond, so if there’s anyone’s opinion that I’m going to trust when it comes to something like this, then it’s hers. I can actually remember her first few weeks on the OmniPod – in which she learned a lot of valuable lessons – and how pleased she was with it once a few months with it elapsed. She taught me the ins and outs of the OmniPod when started to use it, and I’d argue that her advice was more helpful than that of my diabetes educator. So I’d advocate gathering opinions from family and friends (if either is applicable) or the diabetes online community before going on a new diabetes device, in addition to the research component below…

6. Have I done enough research on it? …Like any smart shopper, it’s crucial to really consider all options and research them thoroughly, especially when it comes to the top contender. I definitely did not complete sufficient research before going onto the OmniPod or Dexcom; rather, I trusted that they were just right for me. If I were to switch to something else tomorrow, though, you can bet that’d I’d spend a lot of time scouring the web for every last bit of information on the device so I could make the most informed decision possible.

New diabetes technology can be both scary and exciting. But more than anything else, it can really make life with diabetes much more carefree, and I’m glad that in this day and age there are so many options available to people with diabetes that continue to be technologically impressive

Do You Know What It Means to “Sensor Soak” Your CGM?

This post was originally published on Hugging the Cactus on September 27, 2019. I’m sharing it again today because I still find the concept of “sensor soaking” to be fascinating, though I haven’t been brave enough to try it yet. Not sure what sensor soaking is? Read on to find out…

I saw an Instagram story a few weeks back that intrigued me.

In it, a friend of mine was talking about how she “soaks” her CGM sensors. Instantly, I was confused: What the heck did she mean by that? Soaks them in what, hot water or some other liquid?

Contrary to the connotation of the word “soaking”, this does not mean you’ll be submerging your CGM in any sort of liquid.

Within seconds, her definition of “soaking” became much clearer. “Soaking” a CGM sensor means inserting a fresh sensor hours before you intend to activate it. Rather than giving your sensor just two hours to warm-up, you’re giving it 4-6 hours so it can supposedly provide much more accurate readings immediately after the warm-up period has ended.

I was interested in this practice because I’ve definitely experienced sensors that were off for several hours post-insertion/warm-up. Sometimes, it even takes a full day for a sensor to start reporting accurate numbers, and I wouldn’t exactly call that efficient.

While I haven’t had the guts to actually try sensor soaking yet – I’d like to sometime in the near future – I’ve been doing some research on it so I’m fully prepared to try it whenever I’d like. Here are some questions I had about the process, and the answers I’ve found to them:

Q: Doesn’t this mean that you’re wearing two sensors at once?
A: Yes. But it’s only for a short window of time, until the old sensor expires and it’s time to activate the new one; in other words, for the full soaking period.

Q: How long should I let a new sensor soak?
A: According to what I’ve found online, it seems that 4 to 6 hours is the sweet spot for soaking. It’s basically doubling or tripling the built-in warm-up period that all sensors must go through, so I can see how this might contribute to improving immediate accuracy.

Q: How do I protect the new sensor if it doesn’t have a transmitter snapped in it for several hours?
A: The reason why I haven’t tried soaking yet is because I was worried about wearing a sensor that didn’t have a transmitter snapped in it. But I found some photos online of people who wore transmitter-less sensors with stretchy, self-adhesive wrap tape to protect the nook in which transmitters rest for the soaking period. It’s smart to protect that space, because in theory, it could be vulnerable to catching on clothing or other surfaces. Plus, tape like that is really easy to remove without damaging the sensor in the process.

Q: What changes about the sensor activation process when it’s finally time to start the new soaked sensor?
A: My research leads me to believe that nothing really changes at the end of the soaking period/when it’s time to activate the soaked sensor. All that will be needed is the sensor code so it can be properly activated within the receiver/Dexcom app. So the most important thing you can do at the very start of the soaking period is hold onto your sensor code/store it somewhere safe so you’ll be able to enter it at the end.

Q: So…why would anyone bother trying this again?
A: My understanding is that it all relates back to making sure a fresh sensor is as accurate as possible once it’s activated. I can’t tell you how many times I’ve put on a new sensor, only to discover a few hours after it has warmed up that it’s off by 40 or 50 points – and that just doesn’t cut it. So I don’t think there’s any harm in me giving sensor soaking a shot one of these days. I just have to remember to do it, and have the patience to wear three devices at once (my pod, the soon-to-expire sensor, and the new soaking sensor).

Have you tried soaking? If so, please drop a comment and let me know your thoughts on it – and be sure to tell me if I missed any key steps in my research!

“Doesn’t Your Pump Do All the Work for You?”

The answer to the above question is a big, fat, resounding…

NO.

I’ve written blog posts in the past about questions I’m frequently asked about life with diabetes, but shockingly, I neglected to include this one…which is so surprising because it’s probably among the more frustrating questions.

Don’t get me wrong: Diabetes technology has come a loooooong way, particularly in the last couple of decades. There are options when it comes to insulin pumps and pens alike (that is, if the choices are covered by insurance…that’s another story for a different post). There are tubed, tubeless, touchscreen, CGM-integrated, and waterproof pumps out there. There’s even a couple with intelligent software that can kick in and predict low or high blood sugars. And there are smarter insulin pens available that far surpass the ones I used just 7ish years ago…some can track insulin intake and are bluetooth-enabled.

It sounds like our pumps should be equipped to do all the work for us…but the simple truth is that they can’t.

Our diabetes devices are far from perfect.

_Doesn't Your Pump Do All the Work for You__
No…these two pieces of plastic simply CANNOT do all the work for me. They actually rely on me quite heavily.

Failures happen.

Batteries drain.

Error messages pop up.

When it comes to dealing with diabetes, technology certainly helps us, but sometimes things can go so awry with it that it almost makes life even more frustrating.

Certainly, the reward outweighs the risk; after all, I don’t believe that many people would continue to use pumps, CGMs, etc. if they didn’t work for them the vast majority of the time. I know that I wouldn’t.

But there’s too many variables happening independently of these devices doing their jobs that it essentially guarantees imperfection.

Stress, miscalculated carbs, medication dose/timing/interactions, too much/too little sleep, expired insulin, temperature, exercise, menstruation, alcohol consumption, family and social pressures…these are JUST A FEW of the things that are known to impact blood sugar levels. Just a few!!! I can barely keep track of those factors, let alone how they each affect me…and to expect a machine to know how to do that is placing a little too much faith into something comprised of wires and chips.

My point is that I really wish that people living without diabetes didn’t make assumptions that our lives are easy because of these devices. They are easier, most of the time. But there’s that other portion of time in which a lot of spare mental energy is used on maintaining that technology and making sure it functions the way it should, which is far from easy.

The short answer to the question-as-a-title of this blog post is no, I (we) do all the work for my (our) insulin pump(s)…they’re smart and capable, but only with the input of the people handling them.

The Best Time to Do a Pod Change

Whether you’re new to using an insulin pump or a seasoned pro, you might be wondering if there’s a time of day that’s most ideal to do a pod/site change.

And I’m here to tell you…there isn’t a one-size-fits-all answer. (Sorry!)

Like many aspects of life with diabetes, the best time to do a pod change will be different for everyone.

However, I do feel pretty strongly about what works best for me, and I can explain why it does. Maybe that will help you or a T1D in your life decide what makes the most sense for your individual situation!

The best time to do a pod or an insulin pump site change will probably vary for most people with diabetes, just like so many other things.

In my opinion, the best time to change my pod is within the 3-hour window after I’ve eaten dinner. Since I typically eat at about 5:30/6 o’clock, this means that I like to change my pod no later than 9 o’clock at night (but preferably sometime around 8).

Here are the reasons why:

  • I can take my dinnertime bolus using a pod that I know for certain is acting the way it should.
  • That timeframe is early enough for me to verify that my new pod is acting the way it should before I go to bed.
  • Usually, I don’t eat much in the evenings after dinner, so even if my new pod isn’t working right, it’s not too big of a deal because it’s not like I’ll be bolusing for mealtime carbohydrates.
  • When I change my pod at other times of the day, it interrupts other aspects of my daily flow (e.g., my wake-up time or my work schedule).
  • There’s something to be said for ending my day with a fresh pod and incorporating the pod change into my bedtime wind-down routine.

Of course, I’ve had to change my pod at less-than-ideal times (I recently did a 6 A.M. pod change because I was deliberately wearing my pod for the maximum 80 hours and it was not my favorite way to start my day). Pods fail or get knocked off and I’ve learned to roll with the punches by having back-ups at all times.

But since I know my best time for a pod change, it’s really nice when I can stick with it…because any reliable aspect of life with diabetes is one that makes it ever-so-slightly more tolerable.

Throwback to My First Day With the OmniPod

Life is incredibly busy lately; as a result, I don’t have as much time as I’d like to write brand-new blog posts! But I thought this would be a fun throwback to publish today: the post I wrote for ASweetLife.org on January 21, 2015. It’s all about how I got started with my first (and only) insulin pump, the OmniPod. I’ve written so much about it here in the last few years and it recently occurred to me that I’ve never gone into much detail on how my first day with it went. Fortunately, I rediscovered this post, which does a great job at capturing all the emotions I experienced that day. Read on for more…

Today marks a new beginning for me. After seventeen years of taking insulin shots, I’ve made the move to a higher form of technology: the insulin pump! My pump of choice? The OmniPod, which appealed to me mainly because it is tubeless and my mother also uses it.

As the day went on, I experienced an array of emotions. I woke up feeling pumped (ha-ha, diabetic humor) because I realized I would be taking my last shot via insulin pen for the time being at breakfast. It was pretty anti-climatic, but a major moment for me nonetheless.

Some anxiety started settling in around midday. This was partly due to the fact I knew my visit with my diabetes educator would last roughly three hours in duration. I wasn’t exactly thrilled about having to spend a good chunk of my day off at the doctor’s office. I also had a few lingering questions. When would I take my first bolus? When would I be able to eat my next meal? Would it hurt when I inserted a new pod? I was driving myself nuts with my ceaseless stream of questions.

When it came time for me to actually leave for my appointment, I felt as ready as ever. I decided it would be best to just go with the flow and be patient as I listened to everything my diabetes educator needed to say to me.

Turns out there are no cutesy cartoons of insulin pumps out there (go figure)…but this woman looks like she COULD be playing with a new pump (a huge, futuristic one, that is).

Much to my relief, the three hours flew by more rapidly than I thought they would. In that span of time, I learned not only the basics of my pump, but the finer points that I may not have necessarily understood or picked up on my own. And I was reassured when upon inserting my first pod, I learned that it’s painless – my Dexcom causes more of an unpleasant pinch than the OmniPod system.

By the time I left the office, I had three more follow-up appointments scheduled and a fully active pump stuck on my belly. I didn’t give it much more thought until dinnertime, where I tested (more diabetic humor!) its abilities. I was impressed with how simple the entire insulin delivery process was, and I liked that my PDM would beep periodically to inform me of the status of my bolus.

Post-dinner, though, brought some frustration. As I write, I am still higher than I would like to be. It could be due to anything, which makes it especially irritating. Maybe I miscalculated my carb intake, or maybe my basal rate or insulin-to-carb ratio needs tweaking. For now, all I can do is accept the fact that the beginning of this new regimen will bring lots of trial-and-error with it and monitor my blood sugars carefully – it means waking up a couple times during the night, but I know I just have to do it.

I am not looking forward to this start-up period, but I am hopeful for what it will bring and what I can learn from it. I do look forward to sharing my experiences along the way, so stay tuned for my next post about my transition!

5 Things I Hate About Pod Failures

I’ve had a slew of pod failures – three in the last two weeks.

What gives? I’m not exactly sure yet, but I’m hoping to get to the bottom of it. I sent my most recent failed pod to OmniPod/Insulet for analysis, and my suspicions are telling me that I have a bad batch of pods in my arsenal.

While I wait to hear back, I decided to write a blog post listing the five things I hate the most about pod failures as a form of catharsis…

1 – How suddenly and randomly they occur. Pods don’t give an eff as to whether or not they fail at an inconvenient time. In the middle of a conference call? Fails can happen. Sleeping? Fails can happen. On a date? Fails can happen. Just sitting there minding your own damn business? Yes, still, fails can happen. The unpredictability of pod failures makes them doubly obnoxious and loathsome.

2 – That wretched, unrelenting BEEEEEEEEEEEEEEEEEEEEEEP. Crying babies, barking dogs, ambulance sirens – I’d much prefer any of those other sounds over the high-pitched scream of a failed pod. I get why it’s necessary – how else are you supposed to know that a pod is no longer functioning – but it makes my ears want to bleed. Plus, you’ve got no choice but to silence the pod by sticking a paperclip/toothpick/other equally skinny object into that teensy-weensy crevice in the corner of the device! Let’s be real here, who has a paperclip just…available like that at all times in the event of a pod failure? It’s no wonder I chose to silence my most recent screeching pod by taking a hammer to it (note to anyone else who chooses to use this method: DON’T DO IT INDOORS, go outside and smash it on the pavement or in your garage…and maybe wear something to protect your eyes, just in case).

I smashed this screaming pod with a hammer and let me tell you, it felt great to release my frustration that way!

3 – The perfectly good insulin that gets wasted. When I deal with a pod failure, I can sometimes salvage the remaining insulin left within by inserting the syringe from the brand-new replacement pod into the insulin reservoir and sucking it out (literally the opposite of adding insulin into the reservoir for a routine pod change). But it isn’t always possible to rescue the insulin due to time constraints, amount left, and so forth. So it’s extra painful to just toss the failed pod away knowing there’s insulin left inside it that I just won’t be able to use.

4 – You don’t always find out why it happened in the first place. I am a naturally inquisitive person who is always asking “why”. So when a pod fails, I want to know what went wrong. Unfortunately for me, I don’t always get an answer. OmniPod/Insulet customer service representatives might be able to tell me why based on the reference code I provide them when a pod fails – when that reference code is found in their database, the answer might be that static electricity caused it to fail, or that when the pod was performing its routine and automatic safety checks, the pod itself determined it could no longer be used. But there have been plenty of other times that my reference code didn’t signify anything, leaving me permanently clueless as to what happened to make the pod fail. SO FRUSTRATING!

5 – You have to call customer support in order to get a replacement. As someone who has customer support experience, I dread these sort of calls. It’s just a giant pain in the neck to have to go through everything about your experience with a failed pod, such as how long I was wearing it for, what brand of insulin I use, where the pod was located, the lot, sequence, and reference code numbers…the list of questions go on and on. The silver lining here is that I’ve almost always had a very positive experience when calling OmniPod/Insulet to report a pod failure. My issue is usually documented in 10 minutes or less, and I’ve never had a problem getting a replacement, which shows is indicative of superior customer service.

But…is it so much to ask for the dang thing to simply work the way it’s supposed to 100% of the time?!

Is the Livongo Blood Sugar Meter Accurate?

It occurred to me the other day that even though I wrote a couple of blog posts and even made a video about it, I still haven’t addressed one major component of my new Livongo blood sugar meter: its accuracy.

How does it stack up to my Verio meter? More importantly, do I think it’s accurate?

Well…the answer isn’t cut-and-dry because I think it can be accurate…as long as my blood sugar isn’t above 200.

How did I arrive at this conclusion?

I conducted a little experiment.

Bear in mind here, I’m no expert in experimental design, so I established a simple setup for this. During the period of approximately two weeks, whenever I checked my blood sugar, I used the same drop of blood on test strips for two different meters: my Livongo and my Verio.

And the results were interesting, to say the least.

Whenever I was about 80-180, my results from the Livongo meter and the Verio meter were within about 10 points from one another. One instance, I was 86 on the Livongo and 92 on the Verio. Another time, I was 105 on the Verio and 113 on the Livongo. The meters never reported the exact same number at any point during my experiment, but I was happy whenever they showed similar results.

Things got dicey, though, any time I entered the hyperglycemic range.

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That 163 and 165 show how at times, the two meters were in agreement with one another…but then there’s that 231 and 262. Those are just a little too different for my liking.

It was weird and I can’t explain it, but the Livongo would report that I was anywhere from 20-50 points higher than what was on my Verio at a given point in time when my levels were 200+. This really surprised me, because I’d suspected that my Verio skewed a little higher compared to most other meters, so I never thought that the Livongo would prove me wrong about that. At times, it was truly maddening: On one occasion, the Livongo said I was 251 and my Verio said I was 204. That’s the difference of at least 1-2 units of insulin for me in order to correct that high! Even more frustratingly, because I didn’t trust the result from either machine, I checked my blood sugar again immediately and the Verio said 242, while the Livongo said 228.

WTF?!

That particular example was extremely confusing because I didn’t know which piece of technology to trust. And that’s the big thing for me: I need to know that I can depend on whichever blood sugar meter I’m using to deliver accurate results.

So again, remember that I’m no good with numbers, and that this is simply an estimation…but if I had to guess how many times the Livongo agreed with the Verio, I’d say it was no more than 7 out of 10 times. And I’m super bummed about that, because I’d genuinely hoped that I could trust my Livongo meter and use it full-time whenever I was taking a break from my CGM. Given the fact that it seems to be accurate when my blood sugar is in range, though, I suppose I could use that as motivation to work harder to prevent hyperglycemic readings…but I’m not perfect and I know that they will still happen from time to time. And I deserve a piece of technology that will accurately report them to me so I can make the best possible treatment decisions.

In theory, I still like the Livongo: It has a great design and some of its features (e.g., test strip reordering) are totally unique. But in practice? It leaves a bit to be desired.