Journey to Podlandia

I’m crossing my fingers that I’ll be starting the OmniPod 5 soon. I’m coming off 6 years of pumping (T-Slim) with some MDI breaks in there from time to time. I’m happy with my numbers but some automation is useful and the hypo safety net is comforting. So, unless it bothers readers here I’d like to make this a continuing post where I’ll share my experience.

My endo sent the OP5 Rx to my mail-order pharmacy a little over a month ago but Magellan refused coverage. My “rejection” letter stated my numbers were already excellent and I didn’t need the technology - come back and submit again when my diabetes was a dumpster fire. It stung a bit but I resigned myself to the idea of need-based care and moved on. Then last Friday I get a follow-up letter saying my endocrinologist had appealed and the OmniPod 5 had been approved. I really don’t know what was said to make this happen.

So starts the journey.

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@mremmers What’s your reasoning for abandoning Tandem and their current t:slim X2 pump in favour of the Omnipod (5)?

My Tandem X2 is almost at the end of its 5-year Medicare warranty. It’s a great pump with a transparent algorithm that although not a perfect fit for my body (dislike the fixed linear 5hr DIA) it has a great build, lots of features (love the square wave bolus), and terrific customer service. But this is also the perfect time to revisit what’s out there.

When I look at when I tend to put the pump away and go with MDI it’s mostly related to summer and water activities. Then I stay MDI a while into fall because I really like not being tethered. So, I’m going to give the OP5 a try. I’ve done extensive research and I’m quite aware of many of the quirks and shortfalls, but, I’m curious if I can make it work. There isn’t a big investment on anyone’s part as it’s more of a pay-as-you-go purchase. It will cost me $1 a day for the pods. And if I crash and burn I can always go back to Tandem. I like tech and I’m looking forward to the challenge, actually.

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If anyone has an experience they’d like to share here - great! I already have a plan for startup and when I’ve mentioned it elsewhere I get lots of thumbs down. I’m going to start in manual mode and run it there for at least a month. My feeling is if I can’t get it to where my numbers are good in manual mode then I have no business giving control up to auto mode.

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I’ve been using the Omnipod 5 since June and unfortunately don’t have any red hot advice/tricks to share. Lately I have been 100% in Auto mode which does an excellent job at minimizing lows and creating a flatline BG at 110 while sleeping. Those are the plusses. It’s impressive to see how the algorithm takes a few hours to settle you in at 110 no matter what your BG trend is when you go to bed. It’s hard to remember the last time I had a low BG in the middle of the night…major plus. The minusses are my average BG is overall running a little higher than I’d like and when a post meal high BG occurs the Om 5 is actually pretty useless at bringing it down (I often use a syringe for correcting BG over 200).

Anyway good luck with the trial runs and keep us posted!

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I’m waiting on the edge of my seat. I’m here to provide tech support, to the degree that is possible. I’m too scared to try it myself, but I’m happy we have some Wild young Things to test this system. That’s what keeps things moving forward. Fingers crossed. Sounds like you have a solid emergency backup plan. Your one of the first. God love ya’ for breaking new ground! The Troggs - Wild Thing - YouTube

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Hah! I’m a 72-year-old “Wild Young Thing” but I’m sticking to the philosophy that my numbers don’t define me. Mostly. :wink:

My Omnipod system has shipped and delivery is expected tomorrow or Thursday. I’ll not be taking my Tresiba tonight but rather correcting every 4 hours, as needed, with Novolog. Tedious, but I’ve done it before too many times.

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Too many times to count; once for five days running!

I think your a perfect candidate to try it out. I’ve been shoveling snow for 4 hours and that’s the kinda stuff that breaks system automation. There’s just no model that can handle it. Absent those really extreme events, I think you have a good shot at seeing decent performance out of the system.

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While I cannot use a pod myself due to its fixed cannula system, I’m hoping it is a big success for you. Insulin automation, when it works, is a huge benefit to quality of life.

Pay no attention to the “thumbs down” remarks made in some forums. I find that your experimental philosophy is a complete winner in the long game that we play. I’m in your age cohort.

I look forward to your reports going forward.

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Well, already I’m having to go with Plan B. My first USPS shipment notification had the OmniPod arriving on Thursday. So, I took my Tresiba as usual last night at 11:30 pm. Then this morning an update - the pump is arriving today. I could wait to start it until tomorrow but I lack that kind of willpower.

So instead of tapering off long acting by giving frequent corrections with Novolog, I’m going to start the pump and go with temp basal rates, ramping up my basal insulin dose every 6 hours, over a 36-hour period, when I’ll then be at my usual basal rate. Tresiba is a glorious insulin but it has a long tail.

If I were to be starting in Automatic mode this would suck as the algorithm is learning bad info - it’s all about the total daily insulin use and doesn’t know about the Tresiba that will linger in my system for 42 hours. I think that’s one of the reasons people report the first pod worked great and then the next few consistently under-dosed. Maybe. Just guessing at this point.

My immediate impression, just shy of two days in, is of relief. The only issue is Glooko not capturing the first 24 hours of OmniPod data. But my CGM data shows all was well as I tapered off Tresiba. The boarding process was flawless and I forget I’m wearing a pump. I only pull out the controller when needing to cover food. All my settings from MDI are working well on the OP5 in manual mode. With Tresiba I didn’t get a pre-dawn rise but I did on Novolog on Tandem, so i set up a 4-8 am basal bump. So far, morning numbers are fine with a flat line. Onward!

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Today, I’m just kicking the tires a bit. My three days on my first pod are almost up. The site feels good but this is where, on the T-Slim, I’d tend to notice slower insulin absorption. My n=1 experiment consisted of a 9:00 am breakfast of steel-cut oatmeal topped with blueberries. So, carby. I pre-bolused by about 20 minutes and took the suggested bolus in manual mode. At the one-hour mark my CGM=167 and two hours PP at 136 and three hours at 121. I’m good with these numbers. I’ve been told that if you are eating decadent food as part of a science project the calories don’t count so, maybe pizza to try out extended bolusiing? :wink:

Regarding that screenshot - my gray alert area is set 55-250. I hate spurious alarms.

This is fascinating–thanks for sharing the info! I plan to try the Omnipod 5 maybe next year. My main concern is making sure the Dexcom is giving stable, accurate readings.

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@Lisa_H1 Yeah, that is certainly a weak link in automated insulin delivery. My CGM tends to run high by about 15-20 points on the very first day then it settles down. But I’m not shy about checking with my meter when a number simply surprises me. I seldom need to calibrate.

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I was on tubed pump for 15+ years. Have been on omnipod and would never go back to a tubed pump.

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I think I’m going to like the OmniPod. Going tubeless is a game-changer for sure. I’m now one week in, using only manual mode, and I’ve had zero issues. I’ve not made any changes to my settings after the first 24 hours. My diet is the same as usual meaning 80% of the time I’m pretty low carb (<75g/day) and the other 20% is restaurant meals, where I’ll eat carbs but not go wild. Here is my report for my first week on OmniPod in manual mode.

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Still here, seven pods in, and all is well. I remain in manual mode and plan to stay here until mid-January. I want my TDD and average to be well grounded before turning on auto mode. Type A? You bet. :wink: Here are a couple of views of my last week. I would like to get that average down a bit. I haven’t made any changes to my setting since day 2 when I added a small dawn basal bump. I wonder if all I’d need to do is shorter my DIA from 3 to 2 hours. I know my body chews up drugs at an extraordinary rate. I’m really liking the OP5.


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Today was the day I turned on auto mode for the first time. I have spent the last 7 weeks in manual, getting to know the pump and testing my settings. Overkill? Youbetcha. Especially when you consider I’ve been using the same settings since day two. The only problem I’ve encountered is some leaking around the cannula with larger boluses, especially on day three. So I now extend all boluses that are over 5 units and I have had no leaking when using that technique. But extended boluses aren’t available in auto mode. I’m going to test a few possible workarounds and get back on how it goes. But other than that the OP5 has performed flawlessly. Here is a screenshot of my turning it on and the first couple of hours as it keeps me hugging that 100-110 line.

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