That new software I previewed a while back for the OmniPod wireless insulin pump system is finally here! For physicians, anyway. But it’s all good. Hear me out:

This week, without a lot of hoopla, Insulet Corp. is rolling out a new software package for use in clinical settings by HCPs (Health Care Providers), called OmniPod Partner.  Any patient using the OmniPod can now request that their doctor get hold of this beta program and start printing out blood sugar and dosing records for review by both.  The super-fast software allows almost instantaneous downloading of results that can be viewed in up to nine different graphs.  It’s a pretty scary amount of information — as much as you could ever hope to record or make sense of, I believe.  Check out the sample screen shot published below, plus four more that I have published HERE.

A home version for patients (aka consumers) should be ready for distribution in the next few months, says Tim Brown, Insulet’s Director of Sales Training and Development. Tim, btw, is Type 1 himself for 24 years, and an OmniPod user who was gushing that he recently downloaded 3,100 results in eight seconds with the new software.

“This is guaranteed to be the fastest pump software out there,” he tells me, “and that is big because the biggest complaint with doctors is that some of the pump programs take 10-15 minutes or more to download. They don’t even want to have mess with it in their office, because it takes too much time per patient.”

The new OmniPod Partner program creates a HIPAA-secure file in a database run by Insulet’s technology partner NuMedics. It creates an ongoing record that can be added to at any time.

Meanwhile, the integration with the CoPilot program remains the development path for the consumer version, Brown tells me. “We’re trying to work towards an open platform, one that developers can use to build new functions on if they want to… We don’t want to lock patients into a proprietary system.”

Sounds good, but I’m having a hard time envisioning cross-vendor pump and meter programs, unless they are co-developed and co-marketed.  We shall see.  In the meantime, I’m calling my endo to get the OP Partner program going at her office asap.

I don’t know where it came from or how it happened, but I developed a nasty infection from my latest infusion site. Check this out:

At first I just thought it was another skin irritation due to my stupid allergic reaction to medical adhesives.  But this one was swollen and sore, and even hurt when I walked.

Having some experience with bacterial infections that can turn venomous, my hubby insisted that I go see a doctor right away. That of course meant dropping everything for a 20-minute trek out to my primary care physician, whom I barely ever see.  Naturally, she wasn’t in on Tuesday, so ended up in the suite next door with some on-call doctor who clearly didn’t know a thing about Type 1 diabetes.

The sight of my OmniPod on my shoulder made him jump.  Then he saw me checking my sugar, and asked “what my number was.” When I replied, “well, it’s 113 right now,” he broke a smile and said, “Oh, so you’re in very good control!”  As if one number at any given point in time determines your diabetes control. Sheesh! You’d think a doctor would know better than that.  After that I kept thinking, “113 is actually a little risky this soon after breakfast.  What if I’d reported a number in the 200’s?  Would you be admonishing me now for my poor control?!”

Anyway, he was nice otherwise.  After hearing my story, he opted for an antibiotic that was “less likely to cause allergic reactions” (thank you very much). I have to take the pill four times a day for 10 days, and I am instructed to use warm compresses on the infection site just as often, to increase blood flow. OK, I’m pretty used to medical inconveniences at this point, but what about people who have real jobs in offices? What do they do if their bellies need warming four times a day?

In the end, the only thing that matters is whether this has any long-term impact on my ability to keep pumping.  God knows I don’t want to return to injections!  Again, it’s not the pokes themselves that bother me, but the complexity of struggling to control my BG levels with two different insulins and varying insulin:carb ratios throught the day. Not to mention how much more difficult corrections are to figure out yourself.  Ugh!

But I can see I’m not the only pumper who’s ever experienced an infusion site infection, or other complications with getting your site right.  Stupid, sensitive skin.

I’ve always been squeamish about trying alternate sites for my insulin pump.  When Tiffany wrote about using her breasts back in 2005, I kind of shut down on the whole notion. Eeeeww! Just give me the belly and arms, thank you very much.

But now that I’m having issues with both skin irritation and lipodystrophy (overused infusion sites), I’m starting to eye the rest of my body for acceptable places to poke.

Insulet, the makers of my OmniPod pump, have been insisting for some time that the thigh is a nice option.  My thoughts were: “Yeah, if you’re a guy, with no hair on your legs… or if you’re the type of person who never takes off their pants.”  I don’t happen to fall into either category.  So I can’t say what made me try it.  Other than the combined facts that it’s been so hot, the skin on my belly is sore, and I want to wear sleeveless tops without a plastic chunk hanging off my arm.  In short, desperation.

Well, after years of resistance, I now feel a bit like the big guy in Green Eggs and Ham:

Say!
I like the thigh (no glam)!
I do! I like it, Sam-I-am!

And these look just like my legs… NOT

The pod on my upper thigh is surprisingly comfortable.  Of course it’s a little awkward in bathing suit season, but I’ve actually realized that this particular part of my body is almost always hidden — either by my swim cover-up, the pool water, or whatever outfit I’m wearing when not swimming.  In cool weather, my husband and a few ladies in the gym locker room are the only people who’ll ever see it.

And changes in insulin absorption? I’m still experimenting to determine whether a few recent highs were just my usual mistakes, or some trouble with dosing through the legs.  A leg-induced glucose high?  In other words, a thigh high?  Maybe…

At the ADA Conference in early June, I was lucky to get a sneak preview of some of the cool upgrades coming to Insulet’s “paradigm-shifting” wireless insulin pump system. I’ve waited to post this because I was hoping to get my hands on some images of the new (not-yet-released) stuff, which are not forthcoming.  Dern.

You all know I’m an OmniPod user and devotee.  But until now, the software for downloading your blood glucose and insulin dosing records off the system basically just sucked.  The program, called Pathfinder, could not path-find it’s way out of a subdirectory {or insert similar computer-related diss}.  But just wait until you see version(s) 2.0.  By comparison, this is going to rock hard. OmniPod makers Insulet Corp. are actually developing two different software programs:

1) A web-based system called OmniPod Partner, developed in partnership with NuMedics (out of Portland, OR).  This online program will offer a total diary log, modal day reports and much more. “It’s easy to use and can navigate up to 5,200 data points,” Insulet’s Director of Development Tim Brown tells me. “This is not a glossed-up Windows program; it’s pretty utilitarian.  But the cool thing is, this program can integrate existing glucose data into it.  That means you can build a file using existing data from whatever meter you already use, and then download OmniPod data into it.”

The idea is that many new OmniPod users are also new to pumping, and don’t want to lose their previous BG trend data when making the switch.  Anyone already using NuMedics Diabetes Partner program, (employed at 70 centers nationwide), can continue to use their same existing file as OmniPod Partner.  This new program should be available any day now — and it’s free of cost, the company tells me.

2) The second, really powerful and exciting program, is the one that will replace Pathfinder.  It is actually a new integration with Abbott Diabetes Care’s CoPilot logging program.  It’s a colorful and bright program (tested on colorblind and vision impaired PWDs) that will offer 11 different reports specific to the OmniPod: modal day, total diary log, pump settings report, a view of up to seven different basal programs, and a function that will let you click on any time of day to see the basal rate, bolus and other activity at that moment in time.  It will also include an overview of sensor readings for continuous glucose monitoring (CGM) once that functionality is integrated into the OmniPod (!).

“This is the future of our platform, with integrated sensor data… Of course we can’t talk about specifics of future products, but we expect this CoPilot program to both work with the existing OmniPod and to grow with us,” Brown says. The new software will be introduced before the dual pump/CGM product as a “CoPilot extension” this Fall.  That means it’s a free download from Abbott’s web site.  The only cost to the user would be ca. $4.95 for a standard mini USB cable to plug into your PC or laptop.

Both of these programs are already HIPAA certified.

The demo I saw was of the latter. It looked nicely interactive, the way you could scroll over data points and all the pertinent info would just pop up.  Of course the graphs of modal day are really useful.  This is much more comparable to other pumps’ downloading software, especially Roche’s Diabetes Assistant. What’s also really nice on the new OmniPod program is the ability to include data from different meters. Obviously, the next big step is the dual OmniPod + CGM system.  Insulet is collaborating with both DexCom and Abbott Diabetes, so it’s still a mystery whose CGM system will be integrated first.  But if the software progression is any hint, then I suppose we have our answer.

Meanwhile, Insulet was showing its answer to the “dual infusion site” issue on the show floor at ADA.  Most manufacturers still clearly believe insulin delivery and testing of interstitial fluid have to happen in two separate cannulas.  To deal with this, Insulet’s booth at ADA was prominently displaying an image of a pod with a little cannula sticking out both ends.  Clearly the idea is that with a pod very similar to the design on the market now, they could integrate continuous monitoring simply by adding another small infusion site right under the pod you’re already wearing.  Not bad, although I’d still prefer just one poke.

I’m still hoping to provide a screenshot of the new software and an image of the dual-purpose pod, so be sure to check back soon.  Exciting stuff, for us OmniPod fans!

A few notes today on what’s up with my personal diabetes regimen:

I restarted the Guardian RT continuous monitor a few days ago. I find that I have to take breaks because my poor belly is scarring up fast due to long-term OmniPod and other sensor wear. As a result, I’m getting many more frequent occlusion errors — which means a clog or blockage at the infusion site. In this case, it’s not a tubing or even cannula problem, just a problem of too much thick skin (scar tissue) in the areas where Pods and sensors actually stay on my body. I do wear the OmniPod on my arm in-between, but I haven’t yet figured out how to get the Guardian MiniLink sensor placed there. And here’s why:

The most gi-normous needle I have poked into myself since getting diabetes (or ever). Not liking that thing! Also, see that big blue device in the background? That’s the inserter-doohickey. You have to hold it a pretty exact 45-degree angle to get that big fat needle in right. How do people manage to use this inserter succesfully on their own shoulders or back, I wonder? I might need to call my friend’s husband, the ICU nurse, to help me out here.

btw, the Medtronic folks requested that I note they have customizable early warning alarms to prevent highs and lows, too, just like Abbott’s new Navigator (finally coming to market later this year). The Guardian gives you a choice of up to 30min. in advance, with alerts that can be set for 5 min. increments. There’s also a snooze function, that works just like the one on your alarm clock. Sometimes I think the finer details of certain features are more important to the engineers than the patients, no?

In any case, have I mentioned the Apidra? Yup, I started on Sanofi’s new faster fast-acting insulin about two months ago. I “waited it out” since the first month was rough going for me — running high a lot in part due to illness and infection. Now that things have settled down, I still have to honestly report that I haven’t noticed any dramatic differences in my post-meal BG levels. What has changed, however, is how rapidly the corrections kick in, which is a nice plus. I won’t be going back to “slower” insulin any time soon (unless I run out of money — all that surplus Novolog is still chillin’ in my fridge).

And here’s something neat: I discovered that my little Securitee Blanket insulin cover is just the perfect size for the Apidra vial! Very handy. Although I really do wonder if it hasn’t occurred to Sanofi how potentially dangerous it is to make Lantus and Apidra vials the exact same size and shape. I almost mixed them up more than once.

I’m still loving the OmniPod, except for aforementioned occlusion issues — a problem that plagues all pumpers at times, I suppose. Oh, and that episode about 10 days ago when my PDM suddenly died just as I was attempting to bolus in a tiny little chic French creperie in San Francisco. When I say “die” I mean it let out a piercing beep that wouldn’t stop and flashed a message to call Customer Support asap. No delivery - Yipes! Of course I had no backup supplies along.

Luckily, all we’d ordered was a salmon & feta cheese omelette with salad, so I figured I’d be OK until we got home. Except for the beeping. No matter how many times I pushed buttons, it just wouldn’t stop. “Is that you, Mom? Is that still you?!” my 10-year-old daughter asked sheepishly, as the persnickety French cafe owner glared us down. I yanked the battery, ate fast, and drove home like a demon.

Thus, the rediscovery of my Securitee Blanket to start carrying extra insulin and supplies around, even when I’m not officially travelling. You just never know. Insulet did FedEx me a new PDM right quick, I might add. Still, lesson learned.

Thus, this week’s seven words of wisdom for people with diabetes:

Eat carefully. Test your sugar. CARRY BACKUPS.

Well it’s about 8 months, maybe almost 9, since I started pumping insulin using the tubeless Omnipod system. Many of you have sent queries wondering whether I’m still on it, and still happy? The answers are: yes and yes.

We all know there are no miracle cures. But I can honestly say that 1) pumping has changed my life, and 2) there’s no way I would be here right now, enjoying pumping, if it weren’t for the no-strings-on-me option (currently only offered by Insulet).

PUMPING GOOD
Allow me to remind you that prior to pumping, I was on 8-10 injections per day. Mostly just little pricks from a 31g pen needle, mind you, but that’s so not the point. Pain of injections was never an issue. It was the G-D inconvenience. And the G-D poor glucose control. With no way of making micro-corrections, no way of assessing “insulin on board,” and only the vaguest idea of what my basal insulin was doing, I was just plain G-D frustrated. My A1c wasn’t bad, but I was having lots of bad days, lots of uncomfortable lows.

Now, as you may know, my post-meal glucose levels are still not perfect (ooh, did I use the “p” word?), but they’re mostly good, and I haven’t had a bad low in, well… I can’t remember exactly how long. At this very moment, my 90-day BG average comes up as 131, an A1c of about 6.4, according to this chart. I’ll take that, sans the lows!

I never have to fuss with screwing on needle caps before I eat. If I decide I want more, I just push a button. I can go a whole day at Disneyland — eating and walking at unexpected intervals — and actually enjoy myself. Woohoo!

PODING GOOD
And then there’s the Pod part. I personally am ecstatic about the all-in-oneness of it. Meaning the easy-to-use PDM (controller unit) is also my glucose meter. So I just carry around the one gadget. I switch off between sticking the pod to my abdomen and my shoulder, and I’m constantly grateful that the unit is unencumbered by long plastic tubing. I do not want long plastic tubing hanging off my body. Not now. Not ever.

Have I had troubles with the Omnipod? A very few. Twice early on I had to call the company to replace the PDM because the fingerstick meter was acting a little crazy. Both units kept administering insulin flawlessly, I must add, but the meter needs to work as well. The company sent a replacement overnight.

Once or twice I must have hit a vein, because some blood pooled up at the cannula insertion spot, and I got a good squirting when I pulled that pod off. Eeww. But I’m guessing that sort of thing can happen with any infusion site. Also when I wear it on the shoulder, the pod sometimes pulls off after hitting a door jam, or after vigorous exercising: the adhesive starts to rip, and then the weight of the unit can dislodge the cannula. But that’s pretty rare. Once when I had it on my tummy, during a particularly animated lunch conversation, I sort of jumped up to make my point, and ripped the pod right off my belly with the edge of the table. Yikes! No pain, but also no gain.

Anyway, these are isolated incidents. In my work here at DiabetesMine.com, I’m encountering more and more companies with fantastic visions of small wireless insulin pumps. Neat. But so far, Insulet is the only one to make this dream come true. May they make it in good health!

[Editor’s Note: Want to hear from other OmniPod users? I believe you can find all 2,450 of them HERE.]

[PS - And if you haven’t filled out our survey on the importance of diabetes technology, please do so right now, HERE. Thanks!]

My Inbox continues to overflow with questions about the tube-free OmniPod insulin delivery system, which I’ve had the privilege of using for the last 5 months. So I figured I’d be economical about it and compile the answers here for public consumption:

Amy’s OmniPod FAQ (Frequently Asked Questions) — A Strictly Personal Viewpoint:

Now that you’ve had several month’s experience with the Pod, how are you liking it?

Me loves it. I can’t tell you how convenient it is not to have to mess with needles and pens all day long, not to mention the much improved BG control! I was down to an A1c of 5.9 at last count, irregardless of a few inevitable SUS episodes along the way. My best measure of satisfaction is that I’m excited about just having the thing, and still enjoy doing the “show and tell” bit whenever people with good questions inquire.

What are the downsides?

Well, it sort of is like wearing a small brick attached to your abdomen or shoulder. I would like the pod to be flatter, and less obtrusive, especially during intimate moments. (Let’s just say my husband’s a heavy guy — it’s all muscle!! — so that brick can press into me pretty uncomfortably at times…)

When you wear it on your arm, have you had any problems sleeping on the Pod — rolling over on it or anything?

Actually, I thought this would be more of a problem than it is. Most of the time, I don’t notice it during sleep at all, even when it’s on my shoulder. Only when I somehow place it smack in the middle of my right shoulder — the one I sleep on — do I find it really uncomfortable at night. Note that the pod itself is not disturbed in any way, no matter how I may roll around on it

Have you actually worn the thing with a bikini yet?

NOPO. In fact, I just treated myself to several new Tankini’s for this season. The pod’s pretty well hidden under them, and thankfully they are “in” right now. But this is strictly personal preference: I do now have one diabetic friend at the gym (!) who wears a bikini unabashedly with her Minimed pump hanging out. I love the little round un-tan spots from her former infusion sites. I love the fact that should could care less.

How far apart can the pod and the pump be, and still communicate?

A few feet, I believe, although that’s hardly an issue since you usually have the PDM in your hand — and therefore close to the pod on your bod — whenever dosing or entering commands. The bigger issue is that you’ve got to have the PDM angled right (not too high up or facing the wrong way), otherwise you get a “pod status not available” message. Meanwhile, if you choose to leave the PDM behind while going off for a several-hour bike ride (my bad), the pump will continue to deliver whatever basal rate is programmed, even without the PDM being nearby. If you urgently needed to stop delivery, you can always just remove the pod.

Have you had an problems with infection at the insertion sites?

Thankfully no. I did have a little trouble with the adhesive peeling off, so the Insulet rep recommended Mastisol, which worked great. But last week for the first time, my skin got all irritated under the adhesive, so I may have to try another brand of medical adhesive spray/cream.

Does the flow of insulin get impeded, leading to getting less insulin that you think? If so, is it easy to “unstuck” the flow?

Haven’t had any experience at all with that — even when I thought maybe the pod was delivering less insulin (because I’d hit a high BG patch), I pulled the pod to check and discovered it wasn’t at fault at all. Since there’s no tubing, and only a tiny cannula for the insulin to travel between the pod and your skin, it seems extremely unlikely that the flow would get blocked in any way.

Does the device allow a major bolus “hit” if necessary, or do you manage that using the old-fashioned syringe?

Weird question. This is insulin pumping. No more shots involved.

What’s the status on insurance coverage for the OmniPod?

The company tells me lots of plans already cover the OmniPod, including several in California. I’m not up on exactly which plans or to what extent (not my department). For specifics, please call the company at 800-591-3455.

Do you track other manufacturers to see if someone will out-pod the pod?

Why yes, of course. Not that I want to see Insulet get trampled or anything (!) — I’m just always looking and hoping for something new and better. Aren’t we all? I recently posted reports on some pretty exciting stuff currently being developed: a “nano-pump” from two Swiss companies, and the next generation in patch pumps, reportedly coming from Medingo Medical Solutions in Israel. There’s even more new stuff on the horizon, so keep your eyes peeled for reports here at DiabetesMine.com.

As a follow-up to my latest OmniPod report, I have done some homework on the Insulin on Board (IOB) issue. Of course, I couldn’t let this go

It turns out I opened a big can of worms, ’cause this feature is highly complex.

First I queried Insulet Corp. on why they made their IOB (aka BOB for “bolus on board”) function work the way it does: it currently shows only insulin delivered as a correction — and not remaining insulin from a meal bolus — therefore it can prompt the user to take a post-meal correction too soon after eating if the BG reading is too high. When I posted this, some folks shouted that this approach was “disconcerting” and potentially “a big safety issue.”

Hmm, representatives of Insulet tell me that during product development, they surveyed a number of doctors, and the consensus was split fifty-fifty on how to handle IOB. Some pumps, like the Paradigm, apparently treat IOB exactly the same way. But many others do consider remaining meal bolus, and based on this, block the user from taking another meal bolus while a previous one remains in the system. In other words, if you wanted to eat an additional apple after a meal, the pump wouldn’t let you bolus for that food while it still sees an active bolus dose.

Insulet apparently wanted to give users the freedom to bolus again without hesitation. But of course we have to be careful. This can lead to insulin stacking and lows.

However, the Insulet folks did say that considering customer feedback on their IOB function is “on the top of our priority list for future development.” I guess I’m not the only one tripped up by it.

Meanwhile, I also queried a couple of pumping experts on the whole IOB/BOB function, and their thoughts on safety and efficacy:

* Virginia Valentine wrote back to me, saying simply, “I would agree that using only the correction for the IOB does not make sense.”

* John Walsh, author of Pumping Insulin, had A LOT more to say –

“I have had a few Paradigm patients and talked with several others who are in relatively good control except that they have “unexplained” hypoglycemia that is sometimes frequent. Unexplained, that is, until I show them that their pump is not subtracting any BOB when it is in excess of their correction need from the carbs they are eating. The recommended boluses in these two pumps as well as in the Animas (when the BG is above target) will be excessive whenever the BOB is greater than the correction need.

From my unpublished data, this situation arises in 1 out of every 9 boluses (or about every two and a half days for the average pump user), although I would estimate that in only 1 out of every 20 boluses would the dose be sufficient to cause a significant low. Well over two-thirds of boluses are given with BOB present.

This danger is offset to some extent by the relatively high average glucose levels for most pumpers, but I cannot explain the logic for why these pumps were set up to handle BOB in this way. The engineers appeared to lack direction from a competent medical board. The only rationale that I have been offered after much questioning is that “All carbs need to be covered by a bolus.” Well, excess BOB is exactly that, bolus insulin. Why any excess bolus insulin taken earlier in the day should not count as much as a current bolus baffles me.

Two other things need to be kept foremost in mind for an accurate BOB calculation. The first is whether the duration of insulin action has been correctly set. Many pumpers set their DIA too short. When they do this they hide the true activity of their boluses.

The second is that BOB is only calculated after a BG has been entered
into the pump. The pump cannot accurately account for BOB unless it has
a BG to make a calculation for both carb and correction requirements.

Unfortunately, only about 1 out of 7 boluses has both a carb intake and glucose value entered at the same time. Most pumpers are doing blind bolusing.”

Eeew, that sounds scary. Since I’ve actually had relatively few lows since starting on the OmniPod in February, I guess I’m flying pretty well “blind” over here.

In any case, if you want to learn more about how the D-industry handles BOB, see John’s latest presentation on the issue, especially slide 19. This man knows his stuff.

Speaking of anniversaries, this Saturday marked my three-month milepost using Insulet’s revolutionary new wireless insulin delivery system, the OmniPod. I feel I owe you all an update. So if the details of cutting-edge insulin pumping interest you, read on

THE BIG PICTURE
On the whole, I’m at a loss for words to describe how thoroughly this product has changed my life. Let’s just say (conservatively), that I was taking about 6 injections/day before. That’s at least 540 injections I’ve been able to skip in the last three months. Hallelujah!

But skipping injections is a benefit of any insulin pump, of course. The thing for me is, despite the no-needles advantage, I am 100% certain I would not be a pumper right now if my only choice had been a traditional pump attached to my body via 43″ of plastic tubing. That’s still a big No Thank You for me.

With the OmniPod, it almost feels like all I have to deal with is a glucose meter. Period. Because the PDM (wireless controller unit) actually doubles as a glucose meter, and it’s all I need to carry around. (God, how I love that!) I just check my BG, and the bolus wizard tells me automatically how much bolus or correction insulin I need. I don’t even have to deal with the two-step process of using a separate meter and then plugging the results into my pump.

And that issue about losing the controller unit? Get over it! First off, we all have to carry our glucose meters around: do you lose yours regularly? I personally never have. Also, as one fellow OmniPoder put it: “It’s a valuable like my car keys or my wallet. They go with me wherever I go, and I’m careful not to lose those, either.”

THE NITTY GRITTY
Obviously, with any medical device determining your health and well-being 24/7, customer service is key. I wanted to note how fabulous the people over at Insulet have been — and not just to me, ’cause I publish on the web; I happen to know that lots of other customers are having the same great experience.

As a responsible blogger, I did want to report that after I complained here about the innacuracy of the OmniPod’s built-in FreeStyle meter, Insulet contacted me immediately and offered a replacement unit. Apparently the problems I was encountering are not common. I suppose I could/should have called them right away with my concerns, but I just assumed that most next-gen products run into a few bugs initially. Anyway, the new PDM unit arrived via next-day FedEx, and after a very long tech support phone call to help me transfer all my settings, I am up and running and highly accurate again! (Note to self: never work in Customer Support, as it requires too much patience)

As far as daily pumping goes, I’m still experimenting with correction factors and basal rate options. For example, I just learned that the OP “insulin on board” feature only shows insulin delivered as a correction — not a meal bolus — therefore I’ve often taken a post-meal correction too soon after eating, knocking myself into a nasty low. You live and learn.

I’ve set three different temp basals for workouts so far, and am still trying to figure out how low to go versus eating during and around cycling workouts. As any Type 1 serious about cycling will tell you, this is a science unto itself.

I’ve also been alternating belly and behind-the-shoulder sites — trying to predict what I’ll be doing that week for optimal placement. I hate wearing the unit on my shoulder during aerobics, not so much ’cause it looks silly as that it bobs around too much (even on my skinny arms). For cycling, however, it’s perfect on the shoulder. Although I find I have to contort a bit and hold the PDM behind my shoulder whenever I want to bolus or get a Pod status — otherwise it doesn’t connect. (All little stuff that shouldn’t be an issue versus the massive inconvenience of injections, but see? The OmniPod’s got me spoiled now…)

MIND GAMES
This might sound twisted, but I actually love changing the pod. It’s a very simple process, and every time I do it, it reminds me how very ecstatic I am to have the OmniPod. Lookey here! See that big needle? That’s not going in me, no sir! That’s just to fill the pod… and then click! the cannula is inserted automatically and I’m on my way.

OK, but the final truth of it all is, it’s still hard having diabetes… I’m still running over 180 a lot of afternoons (lunch is always such a crap shoot), and I’m either too high or too low many nights — often seemingly without rhyme or reason. USER ERROR, I know. What the MD’s might have once called “noncompliant”? Aw, shut up! Even with the greatest D-management tool ever invented, it’s still a volatile disease and I still want to have a life… What I’m most grateful for is that the people at Insulet Corp. seem to understand that.

I suppose it might be different for people diagnosed as children, who can hardly remember what life was like without diabetes.  But for me, diagnosed in my mid-30’s, it still shocks me sometimes…

Sometimes lying in bed at night, I think maybe it’s all a mistake — maybe I could just stop taking all the meds and using all these devices, and my body would just go back to doing what it used to do.  Maybe it was just a blip, like a bad cold or rash that hung on so long you almost believed you’d have it forever.

Sometimes when I have a really bad day (like this Saturday), where my blood sugar plummets to 60 and later soars to just under 300, the frustration is hard to reign in.  I know it’s the disease making me moody, but knowing that doesn’t make it any easier.  I’m just so GD mad and sick of it all!

And here I am, one of the incredibly lucky ones: nearly two months ago I started on the new OmniPod tubeless insulin pump, generally considered the state-of-the-art insulin therapy at the moment.  And it is amazing.  From a design standpoint, this two-part system is in a league of its own. The little insulin pod that you attach to your body is controlled wirelessly from a compact unit that looks and feels similar to any consumer PDA, and uses simple English language for commands. 

I call the OmniPod my little miracle machine, since it’s made life so much easier and more pleasant than when I was on shots.  Talk about frustration: the newspapers like to report that pumps replace (gasp!) “up to 4-5 injections a day.”  Hell, with my crazy schedule and all the corrections, I was up to more like eight.  And trying to “fine-tune” my dosing was like playing pool with a blindfold on.

So I’m fortunate and deeply grateful to companies like Insulet…

But then it hits me: pending the miracle of a cure, this thing isn’t going away.  And when I consider living the rest of my life with this XL half-kiwi lump on my abdomen, I don’t feel so lucky. Every time that unit on my belly presses against something and it hurts, or I wear it on my arm and it catches on the door jam and nearly pulls off… Every time I look closely at my overloaded purse, containing at least 3 separate and distinct digital devices (don’t get me started on packing for travel with diabetes!), I pray silently for further innovations and convergence.

The time has come for those of us living with these devices to stop quietly accepting what we’re given, and rather make some noise about what we really want as these products evolve.   

Just some additional thoughts from one of 20m+ Americans living with it…