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Is a tubeless system and a pump, the same as comparing Ford to Chevy?

I am 47. I was diagnosed T1D in Dec of ’15. I have been doing injections but recently I have decided to consider pump therapy. I am in aw of the artificial pancreas/ closed loop discussions that are a reality for diabetics, with the recent breakthroughs with Medtronics and the 670G as well as advancements by Bigfoot and T-slim. However, I have avoided pump therapy up to this point due to not wanting to be attached to a pump but, recent unavoidable highs have encouraged me to take a more proactive approach to managing my diabetes. Not wanting to be connected to a pump has me interested in the Omnipod but, with my recent uncontrollable highs as well as being introduced to a closed loop option, I fear if I went with an Omnipod for the tubeless benefit, an opportunity to truly manage my highs or the true benefits of a closed loop system would elude me while I was enjoying my tubeless lifestyle.

Obviously, It comes down to personal preference and for everyone that loves Medtronics there is an equal number that like Omnipods. Does something that operates like an artificial pancreas encourage folks to “get connected” or is Omnipod bringing more to the table than simply a “no tube approach” ulitmately making this a typical Chevy vs. Ford discussion?

  • #121969
  • Omni pod is an insulin pump, a disposable insulin pump. The entire apparatus is attached to your body and control is through a wirelessly attached devise. I’ve been told that the makers of Omnipod hopes to have an approved “closed loop” within a couple of years. You are correct saying that currently the only approved “closed loop” is the Medtronic; other manufacturers in development and approval processes.

    Investigate the several available choices and get advice from your dare providers as to what is preferable for you. Personally, I got my T1 management well refined before gong on a Minimed [Medtronic] several years ago, in my 48th T1 year, and like you, I resisted being tethered to anything. In retrospect, I should have accepted a pump 30 tears prior.

  • #121974
  • i don’t get the analogy, but I do have an insulin pump. I waited 27 years to try one because the original pumps were so scary I just couldn’t even look at one.

    all pumps… all of them, have in infusion system (metal needle, cannula, etc.), a reservoir full of insulin. and a tube that connects the two. there is a electro-mechanical system to “pump” the insulin from the reservoir through the tube and then under your skin. ON this level they are all exactly the same.

    Omnipod makes the reservoir/pump/infusion system & battery a single disposable unit and hides it all under a hockey-puck you glue to your body. the only thing wireless about it is the controller.

    Medtronic, J&J, and T-Slim make the pump/reservoir/battery system into a “pager” and a remote infusion system you stick to your skin like a band-aid. The wire everyone is so concerned about is really a pipe, and it’s just longer because people tend to like to put the actual pump in their pocket, on their belt or in a head-band.

    all pumps have the same basic safety protocols in the programming, and all but the t-slim use a basic stepper motor to move insulin.

    so pick the pump you like even if it’s that you like it because of the cool screen or the color.

    My background is technology and I really like and use high tech systems instruments and devices every day. In my opinion, and it’s just my opinion, the accuracy of today’s CGM is the weak link for any closed loop system and in my humble opinion is no where ready to accurately control blood sugar automatically. The best insulins (compared to what your body used to make) are still very slow to start working and work way too long for any closed system to be a real artificial pancreas compared to a non-diabetics ability to regulate blood sugar. When you have poor accuracy in your measurement, and then sloppy insulin absorption and long “tails” you may find that the AP falls short of the miracle system to control blood sugar. whether you agree or not is up to you, but the AP still requires finger sticks, calibrations, pre-meal bolus and carb counting, post meal regulation and mods for activity, and pretty much everything we are doing right now every day, plus the maintenance and operation of a second pump with glucagon in it. to me, it’s more like a battery hybrid car… a stepping stone to better systems and controls in the future.

  • #121980
  • Joe, thanks for your reply. What I was essentially asking was, in a sea of seemingly more suffisticated pumps, would I be blinded by the freedom and “tubeless option” of the Omnipod and ultimately sacrifice management opportunities offered to me by pump manufacturers like Medtronics if I partnered with Omnipod.
    I am unclear of what in between meal management would look like with Omnipod considering the 630g and many others offer a basil suspend as well as the ability to manage highs, as in the 670g and others offering the closed loop system. These are very important features to any diabetic but, if Omnipod offered effective ways to manage both highs and lows as effectively as competing brands AND be tubeless, well, I guess that would be like comparing apples to apples as it pertains to Omnipod and competing brands (or my previous ford vs chevy analogy). However, if Omnipod is only bringing the convenience of no tubes to the table and giving me limited management opportunities, compared to Medtronic’s and other competing brands, that may simply not be enough for anyone looking for an opportunity to manage both highs and lows regardless of the convenience of going tubeless.
    Thanks again for your insight.

  • #121987
  • Joe, I agree 100% about there being a LONG way before there is a TRUE closed loop. The accuracy
    of the CGM I use (medtronic enlite) is so unreliable. There is no way I would ever rely on the
    system to command my insulin needs. The CGMs are going to have to be made to be MUCH MUCH more
    reliable.

  • #122026
  • Ronald, Female age 58 Diagnosed at age 56 with Type 1. I had lots of trouble trying to stabilize my numbers
    with injections. 3 Ambulance rides due to unconsciousness due to low blood sugar. I was willing to do the hard work to maintain and control this STUPID disease, but
    nothing else was willing to work with me. I went on the pump and have had MUCH MUCH success in getting things
    more normalized. I researched all of the pumps and the majority of them offer the same kinds of options
    but present them in different ways. So,Omnipod has no tube. I would NOT let that be the decision maker.
    To me the tube is almost not even there. I get the extra long tubing so I have lots of options of where to place the pump.
    I use the Medtronic 530G. The latest is the 630G, BUTTTTT I would wait until the 670G comes out. It will have
    additional features. You do need to still finger stick, carb count, pre-meal bolus etc. It is NOT hands free, but
    it has been worth it to me. Hope this helps.

  • #122027
  • I want to thank everyone for their insight regarding this life changing decision. I still have a lot of research of my own to do but, your willingness to share your life experiences here, has been invaluable. Thank you.
    Ron

  • #122085
  • hi @ronald,

    i just saw your question, thanks for the clarification. ill try to answer but these are just my opinions and I don’t want to offend anyone.

    similar to what @kc6uus has already said, the next generation of medtronic may (if the CGM is what they claim it to be) might have the advantage of auto basal/auto suspend. 630 and eventually the 670 are not closed. they will potentially auto suspend based on a CGM reading, in other words, they shut down automatically if your CGM reading is below set point. the 670 has potential but it is all talk now…and IMO, the weak link will be the accuracy of the CGM. The next generation POD may also integrate with Dexcom and have special functions as well… I prefer not to take a better CGM at advertised value, so let’s compare what you will get right now from either.

    first, check with your insurance company to see if they have an issue or massive deductible for either one. things being what they are, financials may also play into a decision.

    programmable basal- multiple drip rates by program based on time of day
    both

    meal bolus – manual or assisted
    both

    special meal bolus (dual and square wave)
    both

    so I guess it comes down to which one you like more… really.

  • #122090
  • My first cgm was Minimed – hated it. I have Dexcom G5 now – fabulous! Was just approved to replace finger sticks (except calibration) this paired with Omnipod allows me to live a fairly close to normal life. For me the tubing was an issue – omnipod allowed me not to worry about it. Also better choice of basal, bolus, & extended options. I’m looking forward to the next gen as it will incorporate both devices – hopefully – into a more up to date device – possibly accessible thru cell phone.

  • #122128
  • @ronald, another thing you may want to consider is how much insulin you use. I was torn between the Omnipod and the t:slim when I got my pump two years ago but ultimately chose the t:slim because it has a bigger reservoir and I require a lot of insulin because of insulin resistance.

    Just something to think about. Good luck with your decision! Remember, too, that insurance companies only cover the cost of insulin pumps every four years. So, you could go with the Omnipod now while hybrid closed-loop systems are still in their testing phases, and then switch to a pump with more hands-off management capabilities when (fingers crossed) it’s available in 4 years.

  • #122432
  • So I was on a Medtronic pump for about 5 years and it was ok. The tubing was a pain and so was its vulnerability to water.

    I now use the Omnipod and for me it was a game changer. I love it. There is so much freedom with it and it is waterproof.

    All that said, the closed loop option has me interested as well. We are so lucky to have so many options!

  • #123229
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