My Transition from the Medtronic 670G to the Insulet Omnipod/Dexcom Pair

In the spirit of sharing one’s own personal diabetes management experience to the benefit of others, I’d like to share with you my thought process, experiences and results in converting away from Medtronic’s closed loop 670G system here on the left, to Insulet’s OmniPod pump and Dexcom’s G6 continuous glucose monitor (or CGM) on the right.

     

15 Years with Medtronic

Let me start by emphasizing that this was a Big Big Deal. After wearing the Medtronic for years as first a pump and then a combined CGM, the system had absolutely become an integral part of my life for the last fifteen years, all day, every day. I knew its controls, its sounds, its symbols, its logic, its software, its quirks and all those tricks no one wants you to even think about (let alone use) like unscrewing the reservoir from the pump rather than suspending. Shhhhh. Don’t tell Medtronic. I also knew Medtronic’s support team, ordering team, and had the complexities of insurance reimbursement well established. So yes, the change was a Big Big Deal.

So Why the Change?

I owe Medtronic a huge thank you for enabling me to live a fuller life with type 1 diabetes. And who knows, maybe I’ll go back to Medtronic in the future. But honestly, a couple recalls and the loss of the ability to see my CGM results on my iPhone led me to seek alternatives. And that’s when I was attracted to the Insulet OmniPod Dash and Dexcom’s G6 CGM.

Managing the Change  

I was ready to get started – paperwork done, reimbursement assured, training completed. Time to make the crossover. But nervous. Was I really comfortable just changing from my one tried-and-true system to two others, as if this was some trivial lifestyle change like changing my shoe brand, Nike to Puma? No way. This was about managing my blood sugar, fully recognizing that a simple operational error or a misinterpretation of data on my part could have drastic consequences. This was a Big Big Deal.

Double Monitoring

That’s when I realized that I still had about ten days’ worth of Medtronic continuous monitoring available to me, along with a brand-new set of Dexcom sensors. Of course, double monitor! This would give me a chance to build confidence in the Dexcom solution – really understand its capabilities – while still having the Medtronic sensor as a backup or safety net. Brilliant. And so I did for 10 days, from March 13 – 23, 2020.

My Results

Over this 10-day period, I captured my blood sugar results on all three devices at the exact same time and plotted the difference between the Contour Blood Stick Meter and Medtronic in blue and Dexcom in orange.

Key Results:
  • 13 out of 20 times, Dexcom’s values were closer to Contour’s than Medtronic’s, even though Medtronic was calibrated with the actual Contour value more than twice a day, Dexcom none.
  • Medtronic’s values generally ran higher than the Contour’s, 17 out of 20 times.
  • Dexcom’s values were generally split higher/lower than the Contour’s, 10 times higher, 8 times lower, and 2 times an exact match to Contour.
  • The largest deviation from Contour happened for data point 9. Medtronic came in at 185mg/dl, Dexcom 162mg/dl and Contour 130mg/dl.

 My goal of making sure I could trust and have confidence in Dexcom’s values to manage my diabetes was accomplished. This was a Big Big Deal.

How It’s Going – Pros & Cons

I’ve now been on the Dexcom/Insulet pair for about five months, and my blood sugar values have been great and improving.  See chart below.  My GMI is now at 7.0 and I’m working hard to push my Time-In-Range higher from 71% to a goal of 75%.  Unfortunately, in this COVID-19 environment, I don’t have a recent A1C value as a before and after comparison, though I was generally at 7.5 or even higher when using the Medtronic system.

Dexcom/Insulet PROS:

For me, the biggest advantages have been:

  1. No calibrations
  • No bloody, messy, untimely finger sticks
  • No expense. Medtronic can require as many as 4 calibrations a day, and with my insurance coverage that translates to  $0.33 each or about $40/mo
  • No annoying beeping, buzzing reminders to calibrate
  1. No tubing  
  • No wasted insulin filling up lengthy tubing
  • No tubing to hide under clothing for discreetness
  • No unintended tears off the body when the tubing inadvertently lassos itself around a doorknob or other catches
  1. No loss in CGM values during:
  • Downtime to recharge sensor
  • Warmup of new sensor every 7 days
  1. No loss in insulin delivery during:
  • Showers
  • Swimming
  • Vigorous exercise
  1. Ability to see blood sugars, trends and reports right from the iPhone

 These are all a Big Big Deal.

Dexcom/Insulet CONS:

For me, the biggest disadvantages have been:

  1. Avoidable highs and lows. Since Medtronic’s pump also knows your blood sugar value from its own CGM, it is able to increase insulin delivery automatically during highs, and suspend insulin delivery during lows. This provides an extremely important safety net without any involvement by me. Especially during sleep.
  1. Not an integrated solution. Medtronic’s Pump/CGM pair provides for a common set of user experiences – not two – same controls, same sounds, same logic. Versus two different approaches that must be learned for both Dexcom and Insulet. Medtronic’s solution is all managed through its one pump interface, whereas the Dexcom is operated from my iPhone and the Insulet pump from a separate Android-like device.

These too are a Big Big Deal.

Tips:

If you find yourself in a position where you are looking to convert from Medtronic to the Dexcom/Insulet pair or vice versa, or you are considering any change in your measurement tools, give double monitoring a try.  I think it will ease your concerns, give you time to learn your new system, and build your confidence in new approaches to improving blood sugars. And that is a Big Big Deal.

I hope this has been helpful.  Good Luck my friends.

40 Comments
  1. Avatar

    I too after 25 years of Medtronic made the change. Not only have my time in range improved but my mental outlook is wonderful. No tubing, for the first time I can wear anything I want too.
    I no longer have to worry about tubing.
    I thank Medtronic for all the years of training and keeping me alive. I now love Omnipod Dash and Dexcom and look forward to the future. They are so easy to use, not at all complicated.
    Thank you

    • I’m all for competition and understand that it’s an important part of a capitalist system BUT…it sure would be nice if the top scientists from all the different companies decided to work together to produce one excellent system that combined the best features of all the competing products.

  2. Avatar

    I too use the Dexcom G6 and Omnipod combo and am highly satisfied for all the pros listed above.
    I am anxiously awaiting the release of the Insulet Horizon system which will integrate the 2 and offer the same regulatory features as the medtronic 670 and the Tandem IQ, with the convenience of the existing devices. Early 2021??

  3. Avatar

    I was a die hard Medtronic customer for 20 years, and had high hopes for the 670G system. I wanted a closed loop system that worked to ease my burden and involvement, especially overnight.
    I enrolled in a clinical trial for the Omnipod Horizon system, and have been so pleased. I honestly did not know how cumbersome pump tubing was, and still feel quite liberated with the tubeless system. Instead of pulling my pump out of whatever spot I’ve hidden it, to see my CGM values, and make adjustments, all I have to do is use my cell phone like PDM. So convenient. I too am grateful to Medtronic for all those years, but with their newer systems the pump is great, but the sensors are horrible. To get the sensor to work accurately I basically had to eat or drink nothing the first day, then time my meals around required calibrations, and my sensors never lasted more than 4-5 days. The Dexcom sensor is far superior in my opinion. I do not plan to return to Medtronic for sensor wear, and am so excited for the eventual FDA approval of the Omnipod Horizon closed loop system! Thanks for this review and comparison – I often thought about double monitoring but did not do it!

  4. Avatar

    My pleasure everyone. I so enjoy connecting with each of you. And glad to hear about your experiences as well. Good luck with your CGM, I really don’t know how I even managed my sugars before. My wife and I usually go for a bike ride toward early evening and with out fail, My CGM beeps away indicating a steep downward movement. A few sips of Gatorade and I’m back on track. Can’t do that with finger sticks.

    Stay well,
    Dan

  5. Avatar

    I was diagnosed at age 33 and was on MDI for 27 years. After a very difficult three weeks on the Tandem T:slim in June, I switched to the Omnipod DASH system and found it to be much more user friendly and tolerable. Among the advantages: easier to fill the Pod with insulin, don’t have to contend with 2 feet of tubing and don’t have to deal with a multiple step, fiddly infusion set. I look forward to the Horizon loop software and hope it will further smooth out the highs and lows.

    • Avatar

      Thanks for sharing your experience, Judy, and glad you found something that works for you. We are also looking forward to Horizon!

  6. Avatar

    Diagnosed T1D at age 23 in 1984. Needle-Phobe. Tried Jet (air) injector…not my thing. Gave it to an older T2D friend who used it for a number of years til it wore out.
    I went on my first Medtronic pump in 1993, just prior to pregnancy. Excellent control during pregnancy, but was absolutely NOT a fan of being tethered to what I called “life support” 24/7. Took it off at L&D and resumed MDI. Around 2004(?), I’d heard they had a removable system, I went back to Medtronic. Went on 670G in 2017 It’s been great, but have definitely had accuracy issues. Auto-Mode did not work for me, so have stayed using Manual Mode. Never received advanced training, so am not comfortable adjusting anything based on the online reports. The feature I find the most helpful (along with the detachable feature), is Alerts and Suspends before low. I’ve been considering alternatives, but am hesitant to try something new. Use mostly hips, backside, and a little bit of stomach for insertion rotation. Not a fan of using legs or arms. Researching options online has not been very productive for me. Would love to know if there are any (local?) clinics offered that one can attend to get more of a comprehensive, hands on examination of a variety of options. I know in these times, the conferences are not going to be happening.
    Any suggestions? Good online resources for comparisons? Sorry for the length! Stay safe people! J

    • Avatar

      Hi Julie,

      We are holding a free virtual diabetes conference on November 7th, and representatives from Dexcom, Tandem and Insulet/Omnipod will all be in attendance at our health fair so you can ask them questions directly. You can register here: https://tcoyd.org/tcoyd-nov-2020/

      You may also want to pose your question in an online community chat for people living with type 1. We have a T1D Facebook group here: https://www.facebook.com/groups/524361121705572

      • Avatar

        Thank you Lynne!
        I had already registered for that Nov. 7th Virtual Conference!
        Will check out the online group….Thanks!! Stay safe! Julie

      • Avatar

        Thanks so much!

  7. Avatar

    Type 1 and a needle phobe! That would be challenging.
    If you contact Insulet (Omnipod) they will provide a non-operative pod that you can wear to see how it feels and if it suits you. Insulin delivery is operated with a cell-phone like device called the PDM. Omnipod 5 with Horizon (loop) software will be available in 2021 (hopefully sooner rather than later) per a tech support person at Insulet who I spoke with earlier today.

  8. Avatar

    Type 1 for 54 years and started using Medtronic when they first started in a little garage in Burbank, California …. so appreciated all their knowledge and having a system that was so much help to keep my BS in good shape. My Medtronic pump was very scary /hard to give up, but was happy to start on a new adventure to further increase my numbers…Time in range holding now at 80%-90% A1C 6.5 and retinopathy stable.
    In 2019 I stared using the insulet Eros, Dexcom G6 and the DIY loop …really looking forward to using the new Horizon system next year, hoping all will be covered my Medicare
    Thank You so much TCOYD for this wonderful survey.

  9. Avatar

    Hi,
    After years with two Roche Diagnostics pumps and now looking for an alternative here in the USA. Roche Diagnostics pulled out of the US market so I can’t get a new one or its supplies here.
    I’ve been looking into the Medtronic 670 that Medicare may approve of. The Omnipod seems interesting after reading this too. Like to hear more, or if someone uses the Tandem pump.

  10. Avatar

    Thank you for Sharing! Im reviewing options after 2 years on Medtronic 670G. Its not been a good 2 years. I appreciate you for taking the time to share your experience!

  11. Avatar

    I don’t really know where to start but thanks to your articule, I figure it out. Medtronic had been my life for 15 years, but the automode is not really what I was expecting, it’s always a promise never fullfiled it! So, they want to upgrade you to the new one. I hate having sensor and pump sides all over my body, but I am grateful this technology is accesible for me… Is there something better???… Voila!!My husband in the middle of my frustation with sensor issues and poor service from Minimed gave me the answer!!! Got as Christmas present a 30 days free trial of Onmipod Dash, but honestly I don’t figure it out yet, loved the idea of doble trouble with both systems. Now I need the sensors from the other company!!!
    Something that bugged me, is the fact Omnipod DO NOT DELIVER MICRO DOSIS. Anything you can say about it???
    Thanks so much!!!

  12. Avatar

    This is helpful.
    From multiple fingerpriks (4-8/day) to CGM with Dexcom was a big change. That was October. I was driving myself nuts trying to get HbA1C below 8%!!
    Now I know better when/where the highs are happening, as well as the lows.
    A welcome and not-so-welcome change actually. It’s nice to live in a state of unawareness but now that excuse is gone.
    Anyway, now contemplating going from MDI to some type of pump or other. The Tandem Slim X2 was top of my list but now the omnipod — god, more research.
    Thank you very much for posting this!

  13. Avatar

    Michael, congrats on improving your blood sugars with CGM. As someone who used MDI for 27 years, I recently switched to the Omnipod and found to be much easier to tolerate than the Tandem T:slim (which I had tried for about a month or two). If you aren’t used to infusion sets and 2 feet of tubing etc, I would recommend the Omnipod for smoother transition. And once the Horizon loop software is available for the Pods, it will help with finer-tuning blood sugar control. Good luck.

  14. Avatar

    Hi all,
    First off, you are all amazing for sharing your experiences, and I am so thankful for people like you that take the time to pay it forward and post here. Once we get our heads above the water again, I will be sure to do the same!

    I don’t even know if this is the right forum to ask this question, but basically I am looking for a little more guidance with starting the Omnipod for my 12 year old son. Brief history— we are American but living in Singapore currently. He has been on the Dexcom with insulin pens (no pump) since diagnosis 2 years ago. (Pump wasn’t recommended as we were on such low doses of insulin bc of a large honeymoon stage). Now we are coming out of honeymoon and into puberty, and blood sugars are getting more out of control. He is a very active, athletic boy, and we swim a lot here, so I think the Omnipod would be our best choice.. However, I wonder if I should wait for this Horizon system to come out? Does that mean he wouldn’t have to carry around the extra Dash thing in his pocket? I am also reading about the Loop app with the Omnipod (non-FDA approved, but he would still need to carry the RileyLink?) This could all be old knowledge, too, as it is all coming from my own research (and I am finding there is a lot of ground to cover…)

    The obvious answer would be ask the endo, but although we have great medical care, we don’t have the latest medical equipment like Omnipod in Singapore (We would ship it over like we do the Dexcom supplies, or find a way to source through insurance company/third party medical shipping).

    Does anyone have advice for us on starting the Omnipod/Dash/Horizon/Loop, and if not, a forum in which I could direct my questions too? Or a specific place where I can get more comprehensive information on using the Dexcom with the Omnipod? (Just want to make sure we know what we are in for before we go through all the hoops to get it here!)

    Many many thanks!

    • Hi Kate,
      I use the Omnipod/Dexcom combo and loop…it is amazing and good for kids. I do not think you should wait, and the Horizon is already delayed with no final approval in sight. I would get the older Omnipod first for your son to get used to it, and then go to Loop and you will not need to carry around that big dorky controller…just a small Riley Link. Set up is easy. We have a few lectures on our video vault on pumps and hybrid closed loop systems: https://tcoyd.org/video-vault/

      • Avatar

        Hi Kate,
        If you are on Facebook, this group might be of interest to you as well:
        https://www.facebook.com/groups/LOOPandLEARN

      • Avatar

        Many thanks Dr Edelman. This is great information- I think this is the combo for my son. Of course we now have our heart set on it, and just found out Omnipod will not ship with the 3rd party medical supplier (through our insurance) that ships to Singapore. We will now ship it to our parents in US, and have to painstakingly try getting it through the Singapore customs with the temperature-controlled cold boxes with Fed EX! Always a challenge, but at least we have a clear goal now;))
        Really appreciate your help. Thanks again!!

  15. I don’t have the answers but I can recommend someone who will. Her name is Ariel Warren. She has her own website and is active on YouTube. She’s a long time t1d and is working at an Endocrinology clinic as an educator also. Her book is in the library too. She also offers one on one online consultations. Tell her that I recommended her. I’m Michael Carney. Good luck

  16. Avatar

    Hi, Kate,
    My advice (as someone who used MDI for 27+ years and transitioned to the Omnipod recently) is for your son to start on the Pod even though the loop software is not yet available. There are features of the Pod (e.g. setting temp basal rates) that he can learn about before the loop software is added. My time in range has improved since switching from insulin pens.

  17. Avatar

    Thanks so much, Judy. This is very helpful information!

  18. Avatar

    I have a question for all you pumpers. I am T1 on MDI’s. I am seriously considering either an Omnipod or a Tslim. One thing I keep coming across is people on pumps do not seem to be getting as good of numbers as I am on injections. My time in range (Dexcom G6) is usually around 90% and my last A1c was 5.6. Of course to get this takes many injections a day (up to 10), which is one reason I’m considering a pump. Will I be able to get the same control and numbers with a pump?

  19. Avatar

    Thank you for taking the time to share your experience! My husband has had type 1 diabetes for 46 years & going on the Medtronic pump has been life changing! He chose the Medtronic because one of our good friends heads up the Minneapolis office. Our son became a type 1 at the age of 22 & he chose the OminiPod/Dexcom system and loves it! My husband would love to switch, but the $4,000 out of pocket is what’s keeping him on the Medtronic. When that one dies, then he’ll for sure switch! He’s been on it for 2 years now & they typically last 6-8 years. Our insurance company will pay for a new one every 4 years. But we need to replace a vehicle first! Being a diabetic is expensive! It’s really a disease for the “rich & famous”!;)

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