Alexa, Congrats on your move to continous infusion (pumping/podding). I think you’ll really appreciate the advantages.
PROS: 1) Exact hourly control of basal rates. This simplifies trying to match your increased insulin needs (dawn phenomena, variable meal size/times, unplanned change in activity level) that multiple injections of long+short-lasting insulin just can’t cope with. 2) Push-button convenience to take insulin. (Also, discretion is important to some who are shy about their diabetes. ) 3) Less scar tissue with 1 site every 3 days (usually) rather than 2-6 shots per day. 4) The integration of CGM data with auto-adjusted basal is very close to having a “bionic pancreas”. Both Tandem and OmniPod have excellent automatic adjustment in their latest firmware. These still require that you figure out your meal carbs. Medtronic’s closed loop comes even closer, since all you need to tell the pump is “I’m eating” and the firmware takes care of the meal, too. (Reports online suggest that is not as easy to stay in “auto mode” for this to work, however. For the month that I used the 630, I was not impressed by the Medtronic CGM compared to any of my Dexcoms or the discontinued Abbot Navigator.) BetaBionics (not quite on the market yet) looks even more promising, with a simple setup, and the only input needed being “I’m eating a smaller/larger/average meal.” I can’t wait to see this pump in the wild!
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Cons: 1) COST $$€¥££££$$ of pump and the ongoing supplies. 2) Initial setup of any pump is more complicated than a single shot. 3) Site-change day is more hassle than any single shot (but only happens every 3rd day, usually.) 4) The above hassles & complexity get really annoying when a site or pump fails unexpectedly, and usually at the worst possible time.
MY POD TECHNIQUES:
- Clean the site 2x with alcohol, vigorously swabbing from the centre outward in a spiral. I can feel the difference on my skin surface the 2nd time after pushing the skin’s oil away from my site. (This method was taught when I started pumping in 1993, and I’ve never had adhesion problems, even when spending days in water parks…)
- Carry a just-in-case syringe. It doesn’t take nearly the space of a spare pod, and you should always have that + some insulin, anyway.
- Use alcohol to remove the pod if the adhesion is TOO good and it’s time to replace.
- My biggest hassle with podding (2nd generation) used to be occasionally forgetting to bring my PDM. This bulky controller (see picture below) is one of 2 reasons that I switched back to pumps-with-tubing after 4+ years of podding. (The other reason was that OmniPod wasn’t innovating as much as the “wired” pumps…) Integrating the controller into a cell phone app fixed the bulky controller issue, as well as my tendency to forget to bring it along when dining out.
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Finally, my Pod experience is very simular to Tom’s: very few failed Pods and even fewer torn off accidentally in nearly a decade of using gen2 and my new gen5s. I too get a raised bump in the “triangle” around the cannula (I call it a Pod-hickey) which is fine in less than an hour (usually minutes) without a mark or bruise. My theory is that the full cartridge within the pod displaces 200 units of liquid volume BUT the pod is so airtight that the displacement pressure pulls whatever it can into the only opening on the bottom of the Pod. Ergo, your skin gets pulled into the “triangle” around the cannula = Pod-hickey.
I never had anything like Tom’s red outline-how strange! But one time I did get a chemical-burn that I attribute to residue from Nair exfoliant interacting with the adhesive on the Pod tape. It only ever happened once, and this hirsute Scandahoovian uses a lot of Nair in little Dexcom- and Pod-sized areas! (The “burn” resolved to light scabs that healed the same as any other surface abrasion.) In hind- sight, that Pod started feeling uncomfortable after a day and I shouldn’t have been so lazy/miserly about changing the Pod sooner.
The only cause that I can associate with any pod failure (either generation) seemed to be electro-static. I know for a fact that the static sparks while folding a flannel sheet caused one Pod to freak out. It’s happened very rarely, mostly on pairing the Pod to the controller (app) during setup, and if I had to guess, I think the failures I’ve seen have been 2 per year and probably less.
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