My Thoughts on the Discontinuation of the Omnipod Eros System

Too soon.

Those were the first words that came to mind when I learned that the Omnipod Eros system – the one that comes with a bulkier, non-touchscreen PDM – was going to be discontinued at the end of this year. (You can get more information about this decision here.)

Now, you might be wondering why I’d have that reaction, especially considering I haven’t been on the Eros system in over two years. And when I am fully aware of the fact that the Omnipod Dash and 5 systems are out, available, and the latest/greatest offerings when it comes to pump therapy from Insulet.

The main reason why I think it’s too soon to nix the Eros system? It’s because of how it affects choice. By discontinuing it, this means there’s one less option on the market for people who are interested in Omnipod’s tubeless insulin delivery. Not so much in terms of the pod itself, as that design has largely remained unchanged as Insulet innovates products over time, but certainly regarding the PDM device.

It goes without saying that the Eros PDM is clunky, uglier, and overall out-of-date compared to it’s newer counterparts. The Eros PDM is a behemoth in size that relies on AAA batteries to keep it running and features chunky buttons that need to be firmly pressed in order to navigate from one screen to the next. Meanwhile, the Dash and 5 PDMs are sleek, touchscreen models that can be charged just like a cell phone. So I can’t deny that the Eros looks like it’s from the Stone Age when comparing it to the Dash and 5.

But this is actually favorable to some people. One thing that kept me from transitioning to an insulin pump for a long time was that I didn’t want to feel super attached to yet another physical piece of equipment I’d have to carry around; at that point in my life, I was already toting around my phone and separate CGM receiver (this was pre-Dexcom app days) everywhere I went. When I finally did start using the Omnipod Eros, it took time for me to get used to the PDM, but I came to appreciate it for its distinct heft, and could quickly and easily grab it from my bag without really having to look for it due to its size.

I liked my Eros PDM so much that I have more than one image of myself holding it up in my photo archives…

Now, I constantly get my PDM and cell phone mixed up – sometimes, I even go to text someone from my PDM, only to realize after I unlock it that I grabbed the wrong device. And I hate that I have another piece of tech that needs to be recharged so frequently. I monitor the battery life all the dang time, and have to plug my PDM in every few days to fully recharge it, whereas with the Eros all I had to do was swap out the batteries every 3 or so months. It doesn’t sound like that big of a deal, but I already have so much to monitor when it comes to my diabetes that I sometimes resent that I have to also keep an eye on the technology that’s supposed to help me simplify my management.

Moreover, a reason why the Eros PDM was so bulky was that it also doubled as a blood sugar meter. Admittedly, I scarcely ever utilized it as such, but it was always nice to know that I had the option of doing so if I wanted. Since the Dash and the 5 PDMs are essentially repurposed smartphones, the blood sugar meter function isn’t available on either, and I know this is probably a bummer to some people with diabetes who preferred using the PDM device as an all-in-one type of technology.

So while I get the decision to encourage more folks to upgrade to newer Omnipod systems, I’m also a little bummed for the individuals who were deliberately postponing that move, or not wanting to make it in the first place. I can totally relate to not feeling ready to make a diabetes tech change-up; after all, I waited almost 15 years of having diabetes before I even thought about trying an insulin pump. I benefited from being able to make that transition when I felt ready, and I just feel that it’s a shame that others won’t be able to do the same due to the pending discontinuation of the Omnipod Eros.

The Worst Time to Change a CGM Sensor or Pod

I’m not kidding when I say I think I’ve definitively identified the worst possible time to change a CGM sensor or pod – of course, I can only speak to a Dexcom CGM sensor and an Omnipod, so it’s probable that the worst time to do a site change may vary depending on the specific piece of equipment being used.

But I’ve learned from my own experiences that the worst time to do a site change is within a one-hour window of taking a shower.

Unless you want your pod to fall off and look sad like this one, maybe avoid changing it before taking a shower.

This is because I’ve found that the sensor or pod adhesive needs a solid block of time to firmly adhere to my skin. If I shower soon after completing a site change, I can almost guarantee that the heat and steam from the shower will be enough to dissolve the adhesive and cause the sensor or pod to fall off.

I’ve played around with the timing, too, and I’ve discovered that the more time I put in between a site change and shower, the better – an hour seems to be the absolute minimum. It can be a little inconvenient in the times that I have to forgo my CGM data for a longer period than I’d like, but my goodness, is it wonderful when the stars align and I can take a completely device-free shower. This doesn’t happen often as my sensor and pod change days don’t usually happen on the same day, but it’s undeniably a nice break when it does.

So, there you have it – a word of caution from me, a semi-pro CGM and pod wearer with about a decade’s worth of experience wearing both devices – the worst time to undergo a site change. A pod or CGM failure almost always can’t be helped, but I think it’s worth knowing how to prevent the likelihood of one or both of them needing to be replaced sooner than expected.

Feelin’ Odd About my Pod

I don’t often perform pod changes in public. This is mainly due to the fact that I’m most comfortable changing my pod in my own home, where I have all my supplies readily available…and more importantly, it’s where I feel safe taking off a pod from an old site and putting a fresh one onto a new location.

So you can imagine the level of unease I felt when I had no choice but to change my pod at my office for the first time since starting my new job.

I did this plenty of times at my last office job, but that was always behind the privacy of a closed conference room door that I could lock and that nobody could see into. This level of discretion meant that I could take my time with my pod changes without worrying about someone seeing me and getting the wrong idea about what I was doing (even I can admit that it looks a bit suspicious to see someone in a non-hospital setting drawing an unidentified liquid out of a vial with a syringe).

Both fortunately and unfortunately for me, my new office space is so modern in its design that every single conference room is encased with glass walls and doors – making it all too easy to peer inside each one to determine whether or not it’s occupied. That’s great for off-the-cuff meetings, but not so much for someone who needs just 5 minutes to change an insulin pump site.

Due to the lack of privacy in my office suite, I had to venture out to the main building bathrooms as a next resort. But I wasn’t just going to use any old bathroom. No, I sought out the one that had what I suspected to be the least amount of foot traffic and also the cleanest sink, because I most certainly was not going to lock myself into a stall to ensure more privacy when changing my pod. Absolutely not. Sure, it would mean that I had the stall door blocking me from view, but it also meant I’d have to change my pod without a table in front of me to put my supplies on, and I wasn’t about to do that because it would virtually guarantee that I drop something on the unsanitary bathroom floor – or worst-case scenario, maybe even break my vial of insulin. I wasn’t about to risk that, so I set about changing my pod at the bathroom sink, keeping my fingers and toes crossed the entire time that nobody would walk in while I was at any stage of the process.

My mission was accomplished; a few moments later, I was rocking a brand-new pod and also marveling over how something fairly mundane (because I do it every 72 hours or so) could cause me such anxiety and make me feel self-conscious about needing to do this medically necessary routine in public. I’m not accustomed to feeling odd about my pod and the maintenance actions I take to keep it running smoothly – and to keep myself healthy, to boot – but there’s a solid, highly realistic chance that I’ll have to publicly change my pod again in the future. Hopefully, I can work on it so that changing my pod, whether within the walls of my own home or in the most public of locations, is something that I feel normal about doing, and worry less about whether or not people are judging me over it.

Battery Blues…No More?

Earlier this year, I wrote a post about my dissatisfaction with my Omnipod DASH PDM’s battery life. Basically, I was frustrated that the dang thing needed to be recharged practically every day. But what bothered me even more was how suddenly the battery life would seem to drop – it would dip from 100% charged to 40% in the matter of a few short hours, and worse, it would do this totally inconsistently so it was nearly impossible to predict when my PDM would need a sudden charge.

I thought my PDM problem would be solved when I got my new Omnipod 5 PDM; however, it persisted. And that’s what indicated to me that there was some type of user error going on that I needed to get to the bottom of before I resigned myself to having to charge my PDM everyday.

So I called customer support and told them about what I was experiencing, and explained that on paper, I was doing all the right things to preserve battery life: using the dedicated charger, using minimal screen brightness, hitting the power button to shut off the screen when it wasn’t in use…I wanted to know, could they offer me any battery-saving tips?

Little did I know that a simple solution to my battery blues was just one phone call away!

That’s when I was informed that disconnecting my PDM from Wi-Fi would be a good starting place; after all, the Wi-Fi connection only comes in handy when uploading my data via Glooko. I was amazed, but the moment the customer support rep said this, it made total sense. This whole time, I’d been connected to my home’s Wi-Fi for essentially no reason because it has nothing to do with how my insulin is delivered (the system uses Bluetooth for all communications). I only ever entered my Wi-Fi information in the PDM because silly me thought it was needed for effective operation, but nope, turns out the only thing it’s good for (besides uploading data, of course) is sucking the life out of my PDM battery.

As soon as I ended the call with customer support, I turned off my PDM’s Wi-Fi settings and charged it to 100%. Nearly 24 hours later, it’s sitting pretty at 80%, a much better battery life than it was displaying previously. Problem solved, and proof that I definitely have more to learn about how to best utilize all aspects of my Omnipod 5 system!

Imaginary Beeps

While busy at work one afternoon, I was listening to a Spotify playlist (as I often do), when I could’ve sworn I heard my Omnipod beeping to alert me to a failure.

Oh noooo…I thought. I remember sitting in my chair, with my head cocked and music blaring, as I tried to confirm that the beep was indeed emitting from my pod.

I was so certain that my pod was failing that it didn’t even cross my mind (at least initially) that it could’ve been my music playing a little too loudly.

And then I realized…it wasn’t my pod after all. It was the song that I’d been listening to. Roughly 2:45 into the song “Honestly” by Cartel, the music rose to such a crescendo that I could’ve sworn that it was my pod failing, but nope, it was just the pitch of the sound emitting from my speakers.

What a relief! But also a stark reminder that this phenomenon occurs on the regular. I mistake beeps from standard household appliances, alarm clocks, television commercials, and the outside world in general for Omnipod beeps. And I’m struck by it every single time.

The sounds of diabetes, just like diabetes itself, are just something I’ve come to accept – in the many unique forms they appear in.

High…Why?!

Ugh, high again? Why does this keep happening?!

I mused to myself as my Dexcom vibrated incessantly, alerting me to the state of my blood sugar.

I’ve actually been wondering that very thought (and cursing out loud about it) more often than I’d like in recent weeks.

High blood sugar = the diabetes version of kryptonite, at least for me.

It’s been about 3 weeks since I started the Omnipod 5, and I guess my high hopes for the system to revolutionize my blood sugars came to be a little too literally. The 5 has been a godsend in terms of 1) helping me sleep through the night as I’ve only woken up once this month to correct a low OR high blood sugar and 2) catching lows before they happen or before I have to eat something in order to bring my BG back up.

But what the 5 and I are struggling with is the exact opposite of the latter, and that is catching highs before they happen – and then reacting accordingly. I’ve found that I’m dealing with more rapid and prolonged spikes than I thought I’d be. I’m doing what I can to proactively treat them myself by bolusing when they occur, but for some reason, it seems to take a solid 2-3 hours for my blood sugar to come back down nearly every time.

After consulting with some of my diabetes pals about this, and giving it some further contemplation, I’ve got a 3-step action plan to combat these highs:

  1. Give my Omnipod 5 more time to learn my body’s patterns – I’ve heard across the community that it can take several weeks for this to happen most effectively, so I need to try to be patient and wait for the results to occur.
  2. Continue to correct for highs when they occur, and do so swiftly. One of my colleagues said this helped a lot in the beginning, so I will continue to monitor for highs diligently and not be shy about bolusing for them (as long as I’m not stacking insulin too much).
  3. Pre-bolus, pre-bolus, and pre-bolus some more. I’ve always been a believer in the power of the pre-bolus, especially since I know that Humalog typically takes 60-75 minutes to start working in my body. I’m going to build pre-bolusing into my schedule and try to do it at least 30 minutes before I actually eat each of my meals, and we’ll see where that takes me.

Hopefully, this plan of mine coupled with my automated insulin delivery system will nip these high episodes in the bud before long. I can’t wait for “why, high” to become “smooth sailing” and translate into beautiful, level Dexcom graphs!

Omnipod 5: My Initial Impressions

As of this writing, I’ve been wearing my new Omnipod 5 pump for about 2 ½ days. I will be changing my first Omnipod 5 pod later this evening, but before then, I wanted to jot down my initial impressions of the system as a whole so far.

The PDM: A bit larger and more brick-like compared to my Dash PDM. Actually, the size is pretty on par with my iPhone. I like that the screen is larger and it seems more sensitive to touch than my Dash – all good things. Except I can’t figure out why it makes chiming sounds only sometimes after I enter my PIN! I’m sure I’ll learn the cause of that eventually…

The pod: Basically indistinguishable from my Dash pods – the only difference I’ve spotted (or rather heard) has to do with the mechanical ticking sound my pod makes when it’s delivering my basal insulin. The old pods had a set frequency, whereas the 5 pods seem to go “tick, tick, tick” in bursts of three or so. Not sure why, but I know I’m still getting my basal rate delivered, which is what counts.

The set-up: Inputting all of my settings into the 5 only took me about 15-20 minutes. It was so easy that it likely would’ve taken me less time if I wasn’t so thorough and careful about triple-checking my settings. I also think it was relatively seamless for me because I was already familiar with 90% of the PDM’s functionality – the only thing I had (and still have to) explore further is automated mode…see below.

Baby’s first automated insulin delivery system!

Automated vs. manual modes: I can go back and forth between automated (insulin delivery is automatic and the system responds to highs and lows based on data it receives from my Dexcom) and manual (I have to make my own adjustments, just like I did with the older versions of Omnipod). This was a helpful feature for me because I inexplicably got scared of automated mode the first night I wore the pod. I didn’t know what to expect from it – should I trust it right away? Would I notice it working? What if it didn’t? Ultimately, I decided I wasn’t comfortable going to sleep in automated mode, so I kept manual mode on because I wanted to have more control. I waited until the following morning before I turned it on, and since then, I’ve been on automated mode and I’ve spent a solid chunk of my time in range. A few highs here and there, but all my lows seem to be detected before I drop too much, which is just awesome.

Dexcom integration: Similar to the overall set-up of the system, it was extremely easy to get my Dexcom synced up with my Omnipod. All I had to do was enter the 6-character transmitter ID into my PDM and give it a few moments to pick up my Dexcom’s signal. And that was it! I’m sure things will get a little more dicey on days that I have to do both a pod and CGM change (coincidentally, I’m going to do just that in a few hours for the first time…eek), but I do have confidence in my ability to time the changes well so I don’t go without automated mode or Dexcom data for too long.

Let’s talk about sleep: The indisputable best part of this system so far is that I’ve slept soundly the past 3 nights. No CGM alarms going off and waking me up, no frantic shoving of food in my mouth from my bed or late night bolus delivery. And best of all, no waking up in the morning out of range. Now it’s not like that before the 5, I was waking up every night to do something diabetes-related, nor was I starting off each day with a high or low. But I was getting to a point where these things did happen at least on a weekly basis, and naturally, I was getting tired of it. So while I’m acutely aware that I need more time to get to know the system (and it also needs to figure me out), I have hope that it will help me make a major improvement in my diabetes care and management.

All in all, it’s been a relatively smooth start for me and my Omnipod 5. I totally expect some bumps down the road, because that’s normal when starting up any new piece of diabetes technology. But for now, I remain grateful for a comfortable transition to the system.

Diabetes in the Wild: Doggie University Edition

I’ve enrolled my dog, Violet, into Doggie University.

You see, Violet is a perfect pup…except for the fact that she is highly reactive. If she sees another dog on a walk? She barks. A person? She barks. A car? She sometimes barks. A leaf blowing in the wind? Yes, she’ll bark even at that.

Her extreme observation skills are impressive, but not exactly what I’d call acceptable behavior in terms of how a well-mannered dog should react to any external stimuli. So I decided to start formally training her with the help of a local trainer.

Violet loved her first day of school (in which she spent the full day playing with other dogs and getting introduced to some basic commands), but I wanted to be more hands-on with her training. That’s why I got a 1:1 lesson with a trainer so we could work together with Violet.

And it turned into a completely random and unexpected diabetes in the wild encounter – just as they usually tend to be!

Here’s my sweetpea, demonstrating her mastery of the “place” command!

I walked into our lesson and the trainer asked me, point-blank: “Do you have diabetes?”

I was surprised. How did she know? The blank expression on my face must’ve been obvious to her, because she then pointed out that she could see my pod and Dexcom on the backs of my arms. I was literally wearing my diabetes and completely forgot about it.

I said, “Yup, I am! Do you know someone who uses either of these devices?”

She nodded eagerly. “My sister has type 1 diabetes, too, so I’m pretty familiar with all the technology.”

I smiled warmly at her; after all, it’s always nice when a diabetes-in-the-wild interaction is as pleasant and straightforward as this one. We chatted for a couple of minutes, in which I told her about my job working for a diabetes nonprofit, and she shared with me that she’s aware of some of the bigger diabetes organizations out there and “all the great things they’re doing for people with diabetes”. I loved how she acknowledged that, and how seamlessly we were able to transition from a casual diabetes convo to putting my pup to work.

All in all, it was a great lesson for both me and Violet – in terms of how quickly Violet caught onto things and how well that quick diabetes talk went. I enjoy it when people feel free to ask me about my diabetes upfront rather than bemusedly ogle at my devices. It’s a reminder that even when it feels like the diabetes community has a long way to go when it comes to combatting stigma, there’s still plenty of allies out there who really do get it.

Swimming Into a Pod Failure

The latter half of July in New England has been hot, hot, hot this year. It’s almost pleasant compared to last year’s rainy summer months, but let’s emphasize “almost” in that sentiment.

Fortunately, something that makes the heat a bit more bearable is the fact that the condo complex that I live at has a pool! And what’s even better is that it’s pretty easy to find slots of time on the weekends to hang out by it and enjoy it undisturbed by other community members. Case in point? My boyfriend and I found an hour on a scorching Sunday evening to take a dip before grilling some chicken and veggies for dinner.

We had only just entered the pool up to our waists when a familiar screeching sound blared in our ears. Yup…my pod had just failed.

My community pool! Not pictured? My wailing pod!

Rather than get cranky about it, though, I just shrugged and figured it was no big deal, I had to change it in the next few hours, anyways. I was about to rip it off my abdomen when my boyfriend pointed out that the moment I submerged myself more fully in the water, then I wouldn’t hear the screaming pod anymore. Sure enough, he was right – I could only hear the shrill sound when I was underwater, making for an interesting soundtrack whenever I swam under the water’s surface.

We swam and chatted for about an hour before deciding that I probably shouldn’t procrastinate any longer when it came to putting on a new pod. So we dried off and headed inside, and discovered that my blood sugar had lingered in the low 100s the entire time. That was a welcome sight to see – my assumption is that I’d had enough insulin on board from earlier in the day that coupled with the exercise I got from swimming to prevent any sort of blood sugar bump.

So even though I literally swam right into a pod failure, it worked out in a funny way. It’s nice to know that pod failures don’t always have to be a total nuisance.

It’s No Big Deal

“Does it hurt?”

“Wait, no, I’m not ready!”

“I’m LITERALLY afraid that I’m going to hurt you!!!”

These are all phrases uttered by my dear friend who was ultra-curious about the site change I had to do in the middle of our hangout. She wanted to watch me do it, but I stepped it up a notch by asking her to play a key role in it: I invited her to remove my old pod from my leg.

A routine pod change is no big deal to me.

“Just do it, it’s just like ripping off a band-aid. I can guarantee you won’t hurt me.” I said, in an attempt to reassure her. I also swore I wasn’t lying just to make her feel better, because I’ve rarely ever experienced a pod-rip-off that truly hurt.

“But there’s something in you, right? Like a needle?” Her face creased with worry. I smiled and told her that yes, there was a cannula that was in my skin, but I couldn’t feel it.

“Let me start it for you,” I said, when I realized she still wasn’t quite ready to rip it away. I peeled up an edge of the adhesive and she started squirming.

“You don’t have to do it if you don’t want to -” I said, but just as the words left my mouth, she finally tore off the pod. Much to my chagrin, a drop of blood appeared and she squealed as I began to apologize profusely and explain emphatically that it didn’t hurt, it’s just that sometimes blood will appear and nothing can be done about it.

“I can’t believe you have to do this every 3 days…” she said, her eyes widening in wonder. I told her I’ve done it so many times now – literally just over a thousand, according to my calculations – that it’s no big deal. I’m used to it. It’s just life with diabetes…lots of repetition and more math than I’d like.

I accepted my reality a long time ago, and I’m truly at a place where it’s no big deal.