Yeah, that’s the one thing they are intentionally vague on - how the alogrithm works exactly. All they will say is that it does all the work for us so we don’t have to.
But there is a wide variety of “us” individuals, and it likely won’t work great for all.
1 Like
I look forward to trying it. My gut feel is I will find a way to benefit from the closed loop at night/sleeping and stay with manual basal/bolus all day. I hope my insurance covers it!
3 Likes
Sounds like a rational plan, John. Well set automated insulin dosing systems are known for doing a great job overnight when not eating. Another option, one which I’ve been doing for several years now, is to let the algorithm do its job and then choose to step in with a manual intervention when appropriate. I intervene 2-3 times each day with an Afrezza dose, for example. I inform the algorithm of these interventions so that it can recalibrate itself with my manual Afrezza boluses.
While I don’t doubt that people are capable of better management for certain discrete periods, the ability of an algorithm to stay on the job 24/7 every five minutes is a performance that humans just can’t match. Any task that demands your attention every five minutes all day long is one we just can’t dependably do. In addition to the never-ending tedium of such a life, it would displace almost all the things that make life worth living.
It’s hard for me to envision a time anytime soon when I would let an algorithm run the show absent interventions from me. When/if that day ever comes, it will truly be revolutionary. Even then, I think I would be keeping one eye on the system’s performance. It’s mighty hard to turn off the vigilance habit that has hardened over the years.
2 Likes
What I saw when I switched to CIQ was my average glucose went up but my SD and CV went down. I was all paranoid my A1C was going to be in the 6’s, but I still remain in the 5s. I attribute that less BG variability and chasing the “perfect” BG. I just let CIQ do it’s thing.
So from an A1C standpoint, for me, I’m getting less concerned about the higher target bg. What I really wish they would focus on is having the algorithm consider another variable like consumed carbs or meals(xs,sm,lg,xl). I might even use the bolus calculator if they did that…lol. I just think the current algorithms are missing key pieces of information that would make them much better.
So why lower target would be nice, I think their might be other things that would provide more benefit to the majority of users.
2 Likes
Yeah, when glucose variability goes down, it not only drives up time in range but it diminishes the number of hypo and hyper readings. Cutting out the lowest lows and the highest highs can balance their effects out. Your report of A1c stability does not surprise me.
I personally think that patients and doctors should place much more emphasis on managing glucose variability when dealing with CGM use. That would naturally lead to the effect that different foods have on glucose variability; that raises an issue that some are not inclined to address.
3 Likes
Agree! The sensor, though, is the weak link for me. Yesterday, for example, my CGM read 135 but my fingerstick was only 85. 
2 Likes
I was not part of this study. I used a pod during a glucagon study. It was used for insulin and another for glucagon. I wasn’t a big fan due to the needle, no metal and no choice on length. One type fits all?! And I also wasn’t a fan of how large it was. Wearing on leg or tighter shirt, it showed much more prominently.
That being said, another choice on the market is what we all need. The more choices, the more the companies have to work to get better and meet the needs of people.
Each of these pumps have their fans and detractors. There is no pump that makes everyone happy. I mean, I love my pump system but does it do everything I want, no but you have to pick and choose which option is a deal breaker.
I know the phone option will be huge for most people but it sounds like it will take some time for all phones to get approved but it is great! Who wants to carry a phone and receiver?
So, I feel this is great news for many people. It gives people another option. I won’t be in my mix any time soon but for those who love the tubeless option, this is super exciting.
And remember most people with diabetes are not as involved in their day to day diabetes management. Most want easy (myself included) and anything that can take some of the weight of diabetes off my shoulders, I welcome! After dealing with this crap for most of my life, easy is so much better!
Can’t wait to hear how people are loving this new system! It was a bummer to see that the pods from each system are not interchangeable! Just another way to ring more money out of us and the insurance companies
1 Like
I couldn’t agree more 
I’m an experienced tandem control is user. The part of the Omnipod algorithm that I don’t like is that it looks. 60 minutes into the future. Rate of change can change very suddenly. You may be rising very quickly after a meal or treating a low and then level out very quickly, especially with Lyumjev. That why I stay in sleep mode. Have had too many lows from auto corrections even with decreasing my correction factor by 50%. I will add I’m on Ozempic as well so I think that contributes to the quick turnaround I sometimes see. Never liked the idea of carrying a PDM. I would never have it on me and I’m not someone who is stuck to their phone 24/7. Like to have my insulin delivery capability on my body. Pods are too big as well. I’ll stick with Tandem
1 Like