We’re happy to see that the next-gen Omnipod DASH tubeless insulin system is now widely available, following a limited launch after last summer’s FDA approval. That's the upgrade to this popular patch pump that brings wireless connection via Bluetooth and a color touchscreen controller that's essentially a "locked down" Android device.
We talked in-depth with two users about their first impressions of this new system, including the Pros and Cons.
But first, for those unfamiliar with DASH, here are the particulars of this first major update to the Omnipod platform since 2012:
Touchscreen PDM: DASH comes with a new PDM (Personal Diabetes Manager controller) that's a "locked down" Android device, i.e. doesn't allow for other apps or cellular phone use. It has Wi-Fi connectivity and the software can be remotely updated over the air. It's roughly the same size as the previous PDM (1 cm thick and weighing 6.17 ounces) but has a four-inch color touchscreen. The new PDM sports an improved food database from Calorie King that includes up to 80,000 food items, and you can manually enter BG and other data as well as personalizing meal entries for quick access.
New Pods: The system comes with new insulin Pods, and the current model Pods are not compatible. The new Pod retains the same form factor -- 1.53'' wide by 2.05'' long and .57'' high, weighing 30 grams without insulin -- but has Bluetooth Low Energy wireless capability built in, to allow for communication with the touchscreen PDM. It holds 200 units and is designed for 72-hour use (same as before).
No Built-in Meter: In what may be a downside for longtime Omnipod users, the new PDM no longer has a built-in fingerstick glucose meter like the current system does. Instead, it uses the BLE communication to talk directly with the Contour Next ONE meter from Ascensia Diabetes, and one of these meters comes packaged with the system. DASH stores up to 800 readings/90 days of data. And don't forget that Insulet has partnered with Glooko to allow BG results and other D-data from the Omnipod system to be beamed to that data platform.
New Rechargeable Battery: This change may also be a downside for those who appreciated the use of no-fuss, ubiquitous AAA batteries in the old PDM. The new system takes lithium ion batteries that require recharging, and can be more difficult to find in stores when in need of quick replacements.
Mobile Data Apps: Insulet (Boston-based maker of Omnipod) plans to soon launch two new apps to accompany DASH, for easy iOS-based monitoring of BG results, dosing records, Insulin on Board (IOB), etc., along with a widget for viewing CGM data right on the smartphone alongside your Omnipod data. While Android is a work in progress, these apps will only be iOS-compatible initially:
- Omnipod DISPLAY app: will allow users to discreetly monitor their system data directly on their smartphones, with no need to pull out the PDM. This app will include a "Find My PDM" feature allowing users to track its whereabouts.
- Omnipod VIEW app: will enable parents and caregivers (up to 12 people) to easily monitor their loved ones’ BG levels on a continuous basis.
- The iOS Today View widget: will let users and their care teams see their own data or a loved one's shared data from both the PDM and their CGM on a smartphone with just one screen swipe.
Exciting new features, for sure!
Q&A with Two New Omnipod DASH Users
Our D'Mine team met Kerri Parker from Los Angeles, CA, through a Podder group on Facebook. She had only been using DASH for about a week, but had previously used the second-generation Pod known as "Eros" for about a year before that.
DM) What drew you to Omnipod and the DASH system? Did you read user reviews?
KP) I’m really glad you are writing an article because there is absolutely no customer feedback posted online. I’ve searched and have barely found anything! While I loved the old system, it had its faults. Since I am very active I need a tubeless pump and the Omnipod is my only option.
I was partially sold on the upgrade because the Omnipod DISPLAY app. It’s advertised on their site and in the DASH Starter Kit. This is the app that lets you see your pump stats on your smartphone. On setup, I learned the app isn’t ready for release yet, which is a bummer, but it’s set to be released sometime this summer.
Did you experience any other issues getting started with DASH?
Getting it approved with my insurance was a challenge, but not awful. I had to file an appeal to get my insurer to cover it. Between the back-and-forth of getting prescriptions, appeals, and chatting with the folks at Insulet it took about three weeks to get everything straightened out and covered.
What were your first impressions of DASH upon startup?
The touchscreen is a plus. It’s simple to learn. I went through all the online tutorials to make sure I learned the in's and out's in about an hour.
Programming was a cinch. It’s much faster to type in all your settings and edits on the new PDM than the old one.
My fingers don’t hurt anymore from pressing PDM buttons.
It’s very easy to check your IOB (insulin on board) and see that you have a Temp Basal running. But it does take an extra swipe compared to the old system to see what rate your Temp Basal is.
The Bluetooth is surprisingly solid. I’ve had Bluetooth connection issues with my Dexcom, so I assumed the DASH would be similar, but so far not a single glitch in BLE connectivity.
The pod expiration time/date is much more conveniently displayed.
Calorie King integration is awesome! I’ve used it a handful of times just to play around. But it is a little glitchy and I’ve been finding that buttons are not responsive sometimes.
I was hoping for a PDM that felt like current Samsung phone technology. Despite the touchscreen, this PDM feels like it was designed a decade ago. There are a few buttons and holes on the device that are obsolete, like Omnipod asked Samsung to find the cheapest phone they already had on the assembly line and convert it to a PDM.
The casing comes off really easily, which is maybe not a great thing for longevity. The protective cover that comes with the system doesn't feel very snug and there are not yet many options on the market for a bright, colorful and easy to find protective case.
The battery lasts approximately a day. I would have thought that Omnipod would consider the battery a top priority. When I called them to order a second battery for emergencies, they said there is no such thing.
The interface isn’t as intuitive as you’d think. I’m pretty tech savvy and even I fumble with the PDM to find the button to turn it on.
With the DASH it takes seven gestures to get to the bolus button -- more if you don’t realize the PDM is upside-down: 1 button to light the screen, 1 swipe, and a 4-digit passcode then enter. The old system was four gestures. Note the DASH comes with a Contour meter but my insurance covers the OneTouch which still fits nicely in my case as well as an extra pod. My meter and PDM are much easier to view and take in and out now. I put tape on my PDM so I can quickly recognize which way is up when I want to quickly turn it on.
The bolus calculator takes a few more seconds to compete than you’d hope for. Every time you enter your BG, a status bar pops up and blocks the bolus button for 6 seconds. It took me a week to figure out you can swipe the status bar away but still it’s an added gesture that takes an extra second.
The brightness settings are buried in the menu system. I need to turn down the brightness for bedtime and turn up the brightness for daytime. It takes 10 gestures or clicks to get to the brightness function. The old system gave the user access to the brightness button as soon as the PDM was turned on.
Thanks for breaking out what’s working well for you and what’s been challenging. How has this system impacted your diabetes management?
Overall, Omnipod -- both DASH and the old system -- helped to drop my A1C significantly from 6.3% to 5.2%. I have become a little obsessive about constantly keeping my blood sugars in range. The PDM is in my hand at least once an hour to either check my stats, deliver insulin, or program a Temp Bolus. The DASH PDM easily fits in a pocket now to make this super-convenient.
I’m assuming the DISPLAY app will make my routine even more streamlined. If there are no delays on the app release, I will be able to view the DASH system info on my smartphone and watch later this summer.
What advice would you give to someone who is considering DASH?
The Omnipod DASH is definitely worth signing up for. Learning the new system is a breeze. The DASH allows for finer tuning of insulin adjustments. The integration with Calorie King is a super-convenient addition and the future smartphone widgets are worth the upgrade. Honestly, the hardest thing you’ll have to do with the DASH is figure out how to get insurance to cover it, and your Omnipod rep should do most or all of the legwork there.
Our team met Sondra Mangan in an Omnipod group on Facebook. Diagnosed in 2006, the Tacoma, WA, woman started using the Dexcom CGM a year after diagnosis and the original Omnipod in 2008. She's been using the DASH system since its limited release in March, so she has quite a bit of experience navigating the many iterations of Omnipod over the years.
DM) Hi Sondra, did you experience any issues getting started with DASH?
No. The DASH Starter Kit that Insulet ships out with your initial DASH Pods order contains lots of helpful materials – plus as part of the "DASH Ahead" program, you need to complete the online training found in the company's customer portal Podder Central. It is great! Seriously, the trickiest part was getting the PDM battery installed in the device.
What did you initially like about DASH?
First, Insulet did an amazing job of integrating printed and online training. I highly recommend that everyone go through both before getting started.
On seeing it, I immediately loved the small look of the new DASH PDM. The new case has enough room for me to carry a Freestyle Lite meter, lancet and container of strips in the zippered pouch. I’m using up my Freestyle Lite strips first, plus I needed to do a Prior Authorization appeal to get my insurance to cover the new Contour strips.
What aspects do you think could be improved?
I like using it, but think it’s going to be better when the apps are finally released. The customer service person I chatted with said she prepped all last weekend in anticipation of many calls about functionality when the apps were supposed to be released last Monday – but that didn’t happen. And there has been no announced new release date. I asked her to put in a suggestion to just release the app with the “Find My PDM” feature – it was built into the phone, so you’d think we could have gotten that in the first product release.
One other thing that bugs me about the DASH, but it could just be me – in dialing in BG numbers, the HI has been moved to over 599 – really! 599! It would be easier to get to numbers if they reduced the HI to a max of 400. I think that would be better. Also, not being able to copy a basal program is really annoying. I'm pretty sure that in one of the press releases, Insulet's President and COO even mentioned that the system could do that, but it cannot.
How has this system changed your daily diabetes management?
Even though I know that Dexcom G5 is approved for insulin dosing, using the older Omnipod PDM I continued to do a fingerstick first for most meals just because I was getting out the PDM to do a bolus anyway. Now that the meter is no longer integrated, but tucked away in the zippered pouch, I find myself trusting my Dexcom more for dosing – and that makes it so much easier.
It is very easy to enter your BG numbers into the DASH Bolus calculator, whether from Dexcom or from a fingerstick meter. If you are using the Contour, you just press a button and the BG number is transferred to the PDM.
I also love the preset Temp Basal list function. If I get an alert at night, I can just look at my Dexcom, pick up the PDM and pick from the list to meet my needs at the time. I’ve created several different temp basals like 100% reduction for 1 hour, 2 hours, or 50% reduction for a given time period. I have found that now I can get an alert, check, and set DASH in just a few moments and get right back to sleep.
What tips would you give to new DASH users?
Do the online training course, and read the manuals. There are small things that work differently and it will be better to know in advance. You might miss enhancements if you just assume it’s “just like the Eros” PDM. My settings transferred right over and I haven’t needed to change from the last PDM – but check for yourself to make sure you are still getting the insulin you need.
The Bluetooth seems to work a little differently on the DASH PDM – when I’ve been away from my DASH PDM it drops the Bluetooth connection, and I need to “tell it” I’m back. I do this by hitting the bolus button, and it connects to the pod almost immediately. I’ve seen where folks complain that they put the PDM right next to the pod and it doesn’t connect—my workaround seems to fix this.
Make sure to write down your basal settings; there is currently no way to copy the basal programs like I could on all previous PDMs. I spent 20 minutes on the phone with Customer Support verifying this – stupid question from them to me – did your doctor tell you to change basal or change settings?
What else do you think people should know about DASH?
There are a few things: It is not a horrible experience carrying a separate meter. There are cases and screensavers available for the Nuu Mobile A1 phone, which is the model used by DASH.
Folks think it’s just a cell phone. I put “Medical Device” and my phone number on the screen saver in case it’s lost or stolen.
The alert sounds are very different – you might even miss them if you don’t pay attention. It is much easier to ignore the 90-minute after-pod-change FDA required alert, as it’s a soft chime.
Charging is quick. I can go two days between charging and plug in while I’m in the shower, and by the time I’m dressed it’s at 100%. Uploading data to Glooko is just a little different, but works fine.
While there are some neat new features, if your insurance isn’t covering DASH as or if your copay would be a financial burden – staying with Eros pods for a while longer while insurance gets settled out will be fine. After all, this is a building block for their future Horizon system. But once the new Omnipod Display and View apps are released, the true power of DASH will be revealed.
Fighting for Insurance Coverage of DASH
Here at the 'Mine, our own Rachel Kerstetter in Cleveland, OH, says the tubeless Omnipod was the only pump she wanted after her T1D diagnosis in August 2011. She's been using Omnipod since, and when the DASH system came out, she was excited to try it -- even though it didn't offer direct-to-smartphone-control and is not yet the closed loop version.
But when she tried to make the switch, Rachel hit a snag -- the fact that her insurer covers insulin pumps and CGMs under the traditional category of "Durable Medical Equipment (DME)," rather than as a Pharmacy Benefit, even though Insulet has worked to categorize DASH as the latter in the hopes that it would smooth the reimbursement pathway.
"I probably could go through an arduous appeal," she says, "but when I compare my $0 out-of-pocket costs for DME versus a guaranteed high cost through Pharmacy Benefits, it’s not appealing enough for me to fight."
This is actually a major issue preventing many current Podders we've spoken to from transitioning to the new DASH platform. In an endo appointment in May, Rachel's doctor at the Cleveland Clinic shared that they had anticipated the Pharmacy Benefit coverage would make the system more accessible to patients, but unfortunately they've seen the opposite happening so far.
Of course, we know Insulet is fighting to rectify this, in order to achieve more widespread coverage soon.
Meanwhile, all new technology comes with Pros and Cons... we are glad to hear early DASH users are finding it helpful.