Omnipod 5 and Periods?

Hi! This thread is more targeted toward Omnipod 5 users who have periods/menstruate, especially those who have changing insulin needs. The question is: how do you handle changing pods between different parts of your cycle? For example, if you have higher insulin needs as part of PMS, then a steep reduction during the period, would the pod start giving too much insulin during your reduced-needs time? Or does it adjust for that really quickly, so that I could just have a snack to cover the bit of insulin it would give me right after the change?

Context (kind of long):
I’m having all sorts of problems with Tandem X2 and Dexcom too (I’ve posted lots of other threads, many skin issues with Dexcom, and with Tandem I just can’t keep up with the tremendous amount of troubleshooting and settings adjustments that I think I’d need to make Control IQ work for me). Part of this is due to my lifestyle at the moment–I’m working full time and completing a Master’s degree, at the same time as we finish a home renovation project. Things won’t always be this bad but right now they are and I think I just want to try some other things, see if they fit better with my lifestyle.

I have fairly wild hormones around my period. About a week and a half before it, my insulin starts to work like it’s been cut with water. Slow peak times (about 2 hours before any action), and also it’s much less effective (I feel like I need 2-3 times as much as I normally would). Control IQ stacks very badly during this time since it can’t understand why my reading isn’t coming down. Then, my period starts, and suddenly my insulin works 3x as effectively–20-30 min peak times, need about 1/2 as much as normal. This goes for 3-4ish days. Then I hit the “normal” range of the month, where insulin peaks at about 30 mins-1 hour, and I need the normal amount.

This is all hard to predict, exactly what moment switches need to happen. Also, my period is not exactly regular, even though I am on birth control (Erin, progesterone only as estrogen causes very high blood pressure for me). This means the monthly time shifts. So, working with profiles on Control IQ is exhausting/scary and I honestly haven’t put in the effort, just letting myself deal with highs as they come. I’ve been eyeing Omnipod 5, as I like the idea of machine learning handling things (I’m studying analytics, so I understand the power of that!), also I could use some new infusion sites that could be helpful too. I also like the fact that it projects farther into the future than Tandem does; if it looks ahead 1 hour instead of 30 minutes, I feel like that could be helpful with avoiding stacking.

But, as I laid out above, my needs are not stable. I’m worried that the pods would learn to give me a lot of insulin based on the high need time, and then start auto-delivering it during the lower need time. Hence my question!

Thanks so much for any thoughts on this! :slight_smile:

No one seems to want to respond to this one, so I’ll throw in my two cents despite being spectacularly unqualified (no period, no Omnipod, though recently got free trial Omnipods but haven’t done the training yet)
I’d be surprised if any hybrid automated insulin delivery system approved for general use would be capable of making the kind of radical changes you’re describing in a useful time frame. They’re designed to be a little cautious. On the face of it, Tandem’s different “Personal Profiles” seem better suited than Omipod’s machine learning but Omnipod might be worth trying. It certainly allows for different infusion sites. I was able to get a free batch of pods with no long-term commitment.
FWIW, the thing about Omnipod “projecting further into the future” smells like marketing nonsense to me.
Anyway, apologies for not having any real knowledge. I feel like an experienced Omnipod user should respond. But maybe this response will get the ball rolling…?

I am so sorry you are going through this nightmare that many of us do but never talk about.

I am thankfully done with this part of my life but wow, it was a real challenge for me and my doctors for many years.

Like you, I was never on a regular cycle. Never! One month 28 days, the next 35 days, I’d have 2 periods in the same month. Just no rhyme or reason. It wasn’t until I started seeing an endo who specialized in pregnancy that it finally came around for me. And no at first, I didn’t want to have kids but she was super helpful getting me going on the right track.

I did switch from MDI to pumping. And we finally started tracking my periods and blood sugars. And month after month, I would start crashing a couple weeks before my period and than right before it started, blood sugars would sky rocket. So I just set up a pre period profile, a period profile and a regular profile. And while I never knew when the period was going to happen, as soon as my blood sugar started to drop, I would make the switch in my profile. And when the highs started, I make the switch. It wasn’t full proof because as most of us women know, the hormones can fog our brains sometimes and it would take me a day or so to realize what was happening. But it was very cool to finally have an answer and it worked. I did eventually have my children with her as the main part of my medical team!

I use this same thing with my current Tandem (MiniMed back in the day). I have a work profile and an off profile. Also have profiles when I am using Victoza and when I am not. Also have a sick profile.

Not sure if you and your medical team have looked at your timing of the highs before your period starts and what your pump is set and adjusting for your basal. I am always fascinated by how the pump is pumping something that isn’t close to my set basal at some points.

So my long winded suggestions, keep an eye on the calendar, record your period along with when the highs start. See what kind of pattern there is. Two weeks before, three weeks before? See what your pump is adjusting your basal too and what the profile is set for. And I’m guessing, like me you just need to watch and wait and make the profile switch when blood sugars head up.

Not enough research in this area for the millions of us women who deal with these problems every month. And most like you have the highs before, but some like me had the lows. YDMV!!!

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