With an Insulin Pump, Type 2 Diabetes Requires Less Effort
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.
Russ Bell is no stranger to diabetes, including how Omnipod, the tubeless insulin pump, is used to manage it daily. However, that experience came from helping his granddaughter manage her type 1 diabetes (T1D). When Russ was offered the opportunity to use the device for type 2 diabetes (T2D) and with the wish of his granddaughter, he decided to become a podder, too. In the interview below, Russ shares his type 2 diabetes story and why his T2D management requires less effort because of Omnipod.
BT2: Hi Russ—When were you diagnosed with diabetes? Do you have a family history of it?
I was diagnosed about 11-12 years ago. I had swelling in my left leg, and nobody could seem to figure out what it was. My nurse practitioner thought it was my blood sugar, so they checked it considered me to be borderline, just above the threshold of type 2 diabetes. I don’t know exactly what my A1C was, but my numbers were between 120 and 135 when they pricked my finger. They put me on metformin and that seemed to help with the leg problem and my blood sugars. My mother was a diabetic, but I never really put two and two together.
What changes did you have to make after your diabetes diagnosis?
I had to start eating a little bit better or trying to, at least. It’s easier said than done, of course. But, I try to stay away from sweets and tried to lose some weight. My doctors started me on Victoza, which made me sick, but I would still take it. They also had me on Lantus insulin with metformin, but I was still not getting their desired results. Eventually, they took me off the Victoza, put me on Humalog for mealtimes and had me use a sliding scale for insulin dosages based on where my blood glucose numbers were. I’m on a Dexcom and the Omnipod DASH now.
What was it like managing diabetes at that point?
I didn’t see myself as a “good” patient and everything was kind of overwhelming. I had to take my insulin in the morning and the evening, take pills twice a day and take insulin for meals. When I was doing that consistently, my numbers were great. But when it gets overwhelming, it’s hard to maintain that kind of progress.
How did you get started with Omnipod to manage type 2 diabetes?
Over six months ago—January of this year. My daughter, who works at JDRF, told me about it. She mentioned (Beyond Type 1 Science Committee Member) Julia Blanchette, who referred me to a diabetes care specialist who helped me get started with it. My 9-year-old granddaughter has type 1 diabetes and wanted me to be a podder, too, so it was like a chain reaction. I decided to give it a shot because I was already struggling with being consistent with doing what I needed to do. I would prick my finger once per day, but not the several times necessary with the medication I was taking, and I was struggling to be consistent with taking my medications like I needed to. Omnipod was my way of easily getting back on track without as much effort.
How did Omnipod help you improve your diabetes self-care? How did it feel to have a patch-like device on you at all times?
It didn’t bother me. I’m not a little person, I’m a large, hairy man so my problem is trying to find a good spot to put it on, that I don’t knock it off. I use Skin Tac to keep it on, which has helped a lot, especially when I exercise in the water.
What were some changes that you noticed? Did you notice that you were able to track, I guess, how much you were eating? Did it become easier to just remember to take your insulin? And how did this impact your overall blood glucose numbers?
My A1C dropped significantly in the first three months—I went down to a 6.9 percent A1C from an 8 or 9. It’s nice making adjustments when I see my blood glucose numbers on my phone, particularly when I’m running high. I go grab my personal diabetes manager (PDM) device and punch in my sugar to give me the insulin I need to bring it down to normal levels.
There are some things I need to improve on, though. I’m still bad about making sure I take my device when we go somewhere. I’m still bad about that, which is probably why first three months, I made sure I kept looking at my Dexcom and treated myself. Doing that helped me stay pretty steady for the first three months. I was below 6.7-6.9 mmol/L120-125 mg/dL constantly. When I started having issues with my blood glucose, my doctor helped me make adjustments to my basal rates.
It’s probably easier to kind of make those adjustments because even if you’re not recording everything, you at least have some of the data in your PDM that shows you how much you’re eating. Even if it’s just a guesstimate of how many carbs, that information is still useful for your doctors.
Right. It’s helped me a lot because my granddaughter has type 1, so we’ve been dealing with it for four years. So I know that I have to go in when she eats. I have to. I don’t have a choice. Me, I’m kind of lackadaisical because I have type 2 and I still make my insulin, but with her, we have to make sure that we’re on her. We’re watching her blood sugars all the time. We tell her “It doesn’t matter if you eat it, you just have to tell us, and if I treat you for it, you have to eat it.”
So, she manages her type 1 pretty well and that’s helped me a lot because I know how many carbs are in certain things. If I just throw a guesstimate in there, at least I know I’m doing something.
Do you think more people with type 2 diabetes should have access to devices like Omnipod?
I’d say yes because I’m sure I’m not the only one who knows what to do but struggles. After all, diabetes can be overwhelming. With Omnipod, I may not make the best decisions all of the time, but at least I know I’m still getting insulin into my body because of the basal feature, which gives me insulin throughout the day. It helps to prevent my blood glucose from going sky high or dropping off like crazy. So yeah, I’d say it’s worth it for anyone who has type 2 diabetes. It’s no big deal, you just have to find a place to wear it.
There’s this stigma that being on an insulin pump just reaffirms the stigma that starting insulin means one “failed” at diabetes. But we tell people that having these devices can make life with diabetes easier. Do you have any words of encouragement for people who may be in that situation?
The encouragement is: you have it, so why not try to make it easier on yourself? Hang in there. There are things you can do. You’re a person with type 2. In my case, my doctor asked me to drop some weight so I could get off some of the medication. But that doesn’t mean I wouldn’t be a type 2 anymore. Wearing Dexcom and Omnipod does make life easier, and I don’t have to use as much effort as before. It’s more convenient and I would also say secure.
I would add that I wish the medical community or whoever controls the price of these devices would realize that many people aren’t on these things because they can’t afford them. Medication costs are ridiculous. I’m on Medicare, and it’s still so expensive. You begin to understand why people don’t take their medication, especially if you’re on a fixed income.