Omnipod Dash + Dexcom G7 + AndroidAPS

I was asked by an Insulet (manufacturers of Omnipod) representative if I would like to share our T1D story with Pharmac (the government organisation that decided which medicines and pharmaceutical products are subsidised) via Diabetes New Zealand. Pharmac recently put out a “Request for Proposals” to fund CGMs and insulin pumps. I love the Omnipod and our Dexcom CGM and wish all New Zealand T1D’s would have access to them.

Below is the letter I wrote.

To whomever will listen,

Our 3 year old son, Sam, was diagnosed with Type 1 Diabetes when he was 18 months old. We are fortunate enough to be able to “self fund” many T1D treatments not currently subsidised in New Zealand. For the past year and a half my wife and I have been trying different Type 1 Diabetes technologies and treatments to improve Sam’s short and long term health and simplify our day to day management.

The treatments we have tried so far with Sam are (in chronological order):

1. 2 weeks of Multiple Daily Injections (MDI) with only finger sticks to measure Blood Glucose Levels (BGL).
2. 6 months of MDI with Dexcom G6 Continuous Glucose Monitor (CGM) (self funded).
3. 6 months of Dana-i Insulin Pump (self funded), Dexcom G6 CGM (self funded), CamAPS hybrid closed loop (self funded).
4. 4 months of Dana-i Insulin Pump (self funded), Dexcom G7 CGM (self funded), AndroidAPS (free)
5. 2 months Omnipod Dash Insulin Pump (self funded), Dexcom G7 CGM (self funded), AndroidAPS (free).

Although most of these therapies have pros and cons, MDI with no CGM is by far the worst therapy we have experienced. A CGM is required to manage the diabetes of a child, anything else is horrible for both the child and the caregivers. CGMs have been around for two decades and New Zealand not subsidising them is shameful.

Our current treatment setup using Dexcom G7, Omnipod Dash and AndroidAPS has yielded Sam’s best results. We have had excellent control over his blood glucose levels while giving him the freedom to be a child.

Dexcom CGMs have helped Sam with:

1. Alerts and remotely following: We can sleep and only be woken if we need to act.
2. Algorithms: AndroidAPS use Dexcom CGMs to adjust insulin delivery to reduce both high and low blood sugars.
3. Sensors last 10 days and are tiny. Sam barely notices his G7 being inserted, and doesn’t notice it while it is attached.

Omnipod Dash helped Sam because they are:

1. Tubeless, water proof, and out of the way on his arm: The Omnipod Dash is small enough he barely notices it, and since it is water proof and out of the way he is free to do many activities without being restricted by diabetes.
2. Controlled from a phone. Catching a child and holding them down to deliver insulin, interrupts life. The Omnipod Dash is controlled remotely from a phone, Sam doesn't even know when he is being given insulin.
3. Easy to use and insert. The Omnipod is replaced every three days in an intuitive and easy to learn process. This reduces the chances of issues which can impact insulin delivery.

If Dexcom CGMs and Omnipod Dash were subsidised more people would have the benefits Sam has:

1. Sam’s HbA1c levels are nearly in the non-diabetic range. Sam’s last HbA1c was 6.1%, his time in range most days is above 70%. This gives him the best chance at not developing long term diabetic complications.
2. Sam’s lows are detected and treated early. The CGM reports his blood glucose levels frequently and accurately, enough to predict lows and react accordingly.
3. We sleep through most nights. This is something that is only possible with a CGM and pump and the technology to connect them together to adjust insulin delivery automatically.
4. Sam is like any child. He gets a new Omnipod every 3 days, a new CGM every 10 days, and a few finger sticks in between. Other than that he doesn't know he has diabetes.

The only reason why Sam has these benefits is because we have access to technology not readily available to most New Zealand diabetics. Subsidising Dexcom CGMs and Omnipods would dramatically improve many lives, like it has Sam’s.

Graham Jenson

I hope this helps.