Feeling Like a New Person with the Omnipod System
This article was made possible with support from Insulet, a Founding Partner of Beyond Type 2. This interview has been edited and condensed for clarity.
When you’re diagnosed with type 2 diabetes and put on insulin, the thought of taking multiple daily injections can be daunting. Included in that is the necessity of needing to calculate how much insulin to take according to the number of carbs per meal. Along with everything else included in type 2 management, diabetes becomes a burden on one’s quality of life. Now, imagine being offered a device that makes diabetes easier. Just ask former drill sergeant, John Hale. After being diagnosed with prostate cancer, he noticed his medications made it challenging to manage his type 2 diabetes. As a result, he started wearing the Omnipod DASH System, the only tubeless insulin pump on the market. In our interview with him below, read about his diabetes journey, battling cancer and how Omnipod has helped him feel like a new person and can help others with type 2 diabetes.
BT2: Hi, John! Thanks for chatting with us. When were you diagnosed with type 2 diabetes, and what were some of the symptoms that you experienced?
I was diagnosed in 1999. At the time, I worked full-time as a drill instructor for the sheriff’s department and attended law school at night. One day, I noticed that my vision had suddenly changed. I went from having perfect eyesight to barely being able to see the chalkboard in my classes. This was the first symptom that I noticed, though I did not immediately connect it to diabetes.
A few months later, my brother passed away and I drove overnight from my home in Massachusetts to his home in Detroit, Michigan to close out his affairs. I felt fine when I left my house, but halfway there, I began experiencing difficulty seeing the road. I had never experienced anything like this before and it really scared me.
When I returned home from Detroit, I called my primary care physician and made an appointment for a check-up later that week. I went to bed that night feeling relieved that I would be able to see my doctor in a few days, only to wake up a few hours later with an overwhelming and unquenchable thirst. It was so bad that my wife woke up too. She watched on as I drank everything in the refrigerator—water, juice, soft drinks—and ran back and forth to the bathroom, but nothing helped. We realized in the middle of the night that the situation had become an emergency and I needed to see a doctor immediately. The next morning, my primary care physician performed some tests in her office and said, “John, I hate to tell you this, but you are diabetic.” My blood sugar level was 33.3 mmol/L600 mg/dL. My doctor said, “I’m going to have to administer an IV until your blood sugar comes down.”
So, that’s how I discovered that I had diabetes. Despite all the measures that I had taken throughout my life to prevent diabetes, such as exercising each day and eating a balanced and healthy diet, I was diagnosed at 48.
Does diabetes run in your family?
Yes. Diabetes has taken an incredible toll on my family. My mother’s father died due to complications of diabetes. My mother was fortunate to escape the disease, but my father had it and his diabetes certainly decreased the quality of his life and contributed to the negative effects of his other conditions and ultimately his death in the 1980s. I have seven siblings—six brothers and one sister—five of whom, including my sister, were diagnosed with diabetes.
Was this diagnosis a surprise? What did you know about diabetes at the time?
Yes, the diagnosis was a surprise. I had witnessed the toll that diabetes had taken on certain family members, particularly those with poorly controlled or uncontrolled diabetes, with one of my brothers losing a leg and later his life to diabetes at 52 and another brother dying of diabetes-related kidney failure at 50. I was fearful of diabetes and thought that if I could stay in shape and eat right, then I would never get it. Unfortunately, no matter how much I exercised and ate right, I could not prevent diabetes. It was beyond my control.
Did you start insulin immediately or did they start you with Metformin?
I started insulin immediately, first Humulin and later Humalog twice a day, specifically once in the morning and once in the evening. I have never taken metformin for diabetes.
What other kinds of treatment options did your doctor give you?
My doctor recommended the standard options. She said, “John, you need to improve your diet—cut the fats, cut the carbohydrates, cut the sugar—and get more exercise.” This was disheartening at first because I felt like I was already doing those things and it wasn’t enough, but I took my doctor’s instructions to heart and vowed to do more.
Did you have any difficulty adjusting to your life with diabetes?
At the time of my diagnosis in 1999, I was 48 years old and very active through my work as a drill sergeant. I also played golf every weekend and often practiced during the week. During the first few years following my diagnosis, exercise was by far the biggest factor in controlling my diabetes, which made me feel like I had some control over the disease.
My situation changed in 2002 when I had prostate cancer surgery, after which I experienced an extremely difficult recovery. I was eventually able to return to work at full capacity, but I had little energy for anything else. I was no longer able to run like I used to, let alone perform calisthenics each day. It took a lot of hard work to get to the point where I could complete 18 holes of golf on the weekends. For a while, my blood sugar levels remained in control, with minimal to no dependence on insulin, even with my reduced level of physical activity.
That changed, however, in 2008 when my prostate cancer returned. I found that I could no longer control my diabetes without insulin. While I did my best to stay active, I couldn’t exercise or play golf with the sort of intensity or duration that once helped to control my diabetes.
Between 2008 and 2018, my ability to control my diabetes declined with each passing year. During that time, I had the guidance of an outstanding medical team and access to all the best medications, including Novolog, Basaglar Kwik Pen, Levemir Flex Touch, Trulicity and Ozempic (in addition to the Humulin and Humalog), but still struggled to control my diabetes.
When did you make the switch to the Omnipod Insulin Management System? How did you come to this decision?
In 2017, I learned that my prostate cancer had returned. As part of the cancer treatment, I began taking abiraterone and prednisone, which are both designed to slow the growth and spread of prostate cancer cells, and both essential to my care.
Immediately after starting these medications, I found that the prednisone caused my blood sugar to spike, typically up to 19.4 to 22.2 mmol/L350 to 400 mg/dL each day, nearly twice my normal baseline. For the first time since being diagnosed with diabetes, I found myself administering four or five shots of insulin per day, which, as you might imagine, was quite unnerving. This entailed pricking my finger before and after each injection, which ended up being about eight-to-ten finger pricks each day. Not to mention, with so much of my attention focused on tracking my blood sugar levels, I barely had time for anything else.
After a few months of this routine, I could not take it anymore and I told my primary care physician, “This is getting crazy. It’s almost unbearable how much time I’m spending with this insulin.” Discontinuing my cancer treatment, specifically, the prednisone, was not an option. (In fact, I am still taking prednisone twice each day.) My doctor referred me to an endocrinologist to explore new options for diabetes treatment and control.
After a series of unsuccessful consultations with two or three endocrinologists, my doctor recommended one more: her husband. He is the person who recommended an insulin pump, which I initially declined because I was concerned it would be too fragile and interfere with my ability to move around, play golf and hang out with my grandchildren, particularly with the tube that hangs from the pump. He then explained that there was a tubeless pump, the Omnipod, and he demonstrated how I could wear it on my thigh, waist and the back of my arm. He also explained that it would inject a constant dose of insulin and allow me to calculate how much insulin I needed to offset any carbohydrates that I would eat. This turned out to be life-changing.
Did you get the pod right away?
Unfortunately, after I agreed to try the Omnipod, we hit a snag: my insurance company initially declined to pay for the device. That is, until the endocrinologist and I explained to the insurance company that using the Omnipod Insulin Management System would result in cost savings to their company, particularly when compared to the cost of all the lancets, test strips, meters, needles, insulin and other supplies that I was already using each day. My insurance company considered what we said and ultimately approved my use of the Omnipod.
What was it like switching to a tubeless insulin pump?
Before the Omnipod, I was practically bedridden. My blood sugar was so high every day that I was afraid to get out of bed because I was afraid of having a heart attack or stroke. On those days when I could get out of bed, my mobility was severely limited. I struggled to do the most basic things, such as bend over to tie my shoes. I could not accept that this might become my new quality of life.
On the first day that I had the Omnipod, I put it on in the morning and by dinnertime that evening, my blood sugar was down to normal at 6.9 mmol/L125 mg/dL. Not only that, but just about every test thereafter was also within or near the normal range. I was elated by these results. I began to feel much better each day, youthful even. I noticed that I was able to be active again. I started swinging my golf clubs in the backyard. Not only was my energy returning, but with the simplicity of the Omnipod, I was spending significantly less time trying to manage my diabetes.
I have used the Omnipod for about two years now, and I couldn’t be more delighted with the product. Not only has it given me a sense of control over my diabetes—my blood sugar typically falls within the range of 7.7 mmol/L139 mg/dL and 8.9 mmol/L160 mg/dL, with an A1C between 6.4 percent and 7.4 percent—but I feel like I have my life back. I have four grandchildren ranging in age from 12 months to 9 years old, and there is nothing that I love more than spending time with them. I absolutely love that I can get down on the floor without hesitation and play with the grandchildren or teach my granddaughter how to ride her bicycle.
I feel like a new person with the Omnipod.
Are you using less insulin now compared to previous years?
Absolutely. I do not recall exactly how many units of insulin I was using before I began using the Omnipod, but it was more than 150 units per day (or more than 450 units over three days). Now I use 200 units every three days.
Since transitioning to the Omnipod, my monthly expenses are also much less. Before the change, my monthly expenses for diabetes supplies, including insulin, was approximately $6,675.90. Since switching to the Omnipod, my expenses for diabetes supplies has been approximately $2,618.92 per month. Generally, my out-of-pocket expenses are around 10 percent of that amount.
I have become quite confident in the Omnipod, particularly since I have not experienced a failure in nearly two years of using the system, but I do still keep a supply of insulin, pens, needles and test strips in case of an emergency.
What are some other features you like about Omnipod?
I love the food library. Since I began using the Omnipod, I have learned a lot about nutrition and tracking carbohydrates. Specifically, I have learned to limit my carbs to approximately 150 grams per day and to spread these out over the course of the day to avoid overtaxing the Omnipod system. This involves making good food choices and eating in moderation. Every now and then, I even allow myself to indulge in foods that I had all but given up on, including pizza and ice cream. With the Omnipod, I have learned that none of my favorite foods are off the table as long as I stay under my daily carbohydrate limit.
What do you think is the best way to spread awareness about insulin pumps for people with Type 2 diabetes?
That is a pretty complex question. I would say that the best way to spread awareness about Omnipod is through targeted marketing and advertising that accesses not only the broad range of patients who will benefit from the Omnipod system, but advocates, medical professionals and insurance representatives. Omnipod provides a unique opportunity for each of these identities.
- For the patient, it provides freedom and control.
- For the medical provider, a solution.
- And for the insurer, an affordable treatment, and management system that decreases a patient’s risk factors and improves overall health.
We may not be able to defeat diabetes, but we would put a big dent into the disease if everybody were given the opportunity to use Omnipod. It is one of the best systems for managing diabetes that I have ever seen. I just hope every person with type 2 diabetes who requires insulin treatment has the good fortune to use Omnipod. It worked for me and I totally believe in it.