I have been on the OmniPod 5 for about six weeks now and feel the transition and control from the DASH to the OM5 has been successful. In the past, I liked placing my Dexcom 6 on the back of my upper arm, but I have changed that to placing it on my abdomen so that it is within “line of sight” with the Pod which I also wear on my abdomen. My question is this: Has anyone who uses the OmniPod 5 put the Dexcom 6 on the FRONT of the upper arm while placing the Pod on the abdomen and had successful line of sight communication between the D6 and the Pod?
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Update: I decided to try putting the Dexcom G6 on the front of my upper arm, and I have had fairly good results. I may see a slight increase in momentary readings being disrupted but nothing that keeps me from getting probably 99% of my G6 results. I generally am a back sleeper, so I have no disruptions in the evening, and traditionally I get more accurate readings when the G6 is on my arm rather than on my abdomen. So if you are using the OmniPod 5, give the front of your upper arm a try for your G6. You also may have positive results.
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Further Update: After about 7 days with the Dexcom G6 on the front part of my arm/shoulder, it started to peel off (which never happens when I have it on the back of my arm or on my abdomen) and the readings became very sporadic. I talked with a diabetes educator today who told me that Dexcom once again is HIGHLY recommending that OmniPod 5 users put the Dexcom ONLY on the abdomen. This was a nice try for me, but in the end I think I will just use my abdomen for the Dexcom G6.
This is because they Dexcom G6 is only approved by the FDA for use on the abdomen. In Europe the use of arms is OKed. Anyway Dexcom must stand by the line.
As to why the sensor unstuck on your arm, well it could do that on the abdomen as well. I will say that I ripped one off on day 9 when I was pulling a Tee shirt off.
I know about the FDA/abdomen only approval, but I have used the G6 on the back of my arms for years with no problem. By putting the G6 on the front of my upper arm, very near where the arm and shoulder meet, I had more movement in that area each time I used my arm. The added movement dislodged the G6. Obviously, no such movements occur on my abdomen which is why I never had any problem with the G6 adhering there. I needed to try the front of the arm because of the “line of sight” requirement of the OmniPod 5. No big deal. I now have the Pod and the G6 both on different places on my abdomen, and I have had no signal loss at all. I wanted to try the arm, but I have a small stature and thin arms, so I just did not have enough tissue area to make it work for me. Others may have more luck than I.
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I get that about the excessive motion causing the sensor to unstick. I have such poor results with the G6 on my abdomen, but better on the back of my upper arms.
Odd things happen when I sleep on my left side regardless of where the sensor is or the T:Slim. My phone is charging on my nightstand which is to the right, but that shouldn’t cause a loss of CGM signal to the pump. WOOOO HOOOO, this stuff is haunted. 
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I still place my G6 on the back of my arm. Pod is usually on my abdomen. Every so often a reading will be missed, but not often. I don’t use automode except at night, and I don’t always do that either.
I’m sure that impacts my willingness to forego the line of sight requirement.
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When I went in for training, my Diabetic Educator really emphasized the need to try AutoMode as much as possible. The AutoMode needs to learn your routines and your body’s needs, and you do have to have patience to let it learn without trying to micromanage the system. However, once it started to learn my system, my TIR numbers greatly improved. If you switch to Manual Mode most of the time, why pay for the technology if you are not going to use it?
You are correct that in Manual Mode, your OmniPod 5 acts just like your DASH since you are using those DASH settings, so I would imagine that the line-of-sight is not a big deal. Personally, I am happy to put the G6 back on my abdomen if it allows the AutoMode to help me stay in range both during the day and throughout the night. My last reading was 84% in range and NO highs or lows throughout the night. For as long as I have been diabetic, I am happy with those results.
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I’m very happy it’s working for you.
I am not interested in using automode all the time. I have very good control, including regularly hitting 85% in range. There was a $75 extra charge to get the Omnipod 5 intro kit, but my supplies otherwise costs me the same amount.
I liked the idea of having the option to turn off the alarms (or widen my alarm range) at night while the device would still adjust my basal to keep me in range. I do not like that the Omnipod 5 is not transparent about how my basal insulin is being adjusted in automode. I think that is the primary issue with Omnipod 5. I do not have the same schedule every day, so there would be little point in having the Omnipod 5 try to learn any routine.
You’re right though, the automode has not performed as well as I’d hoped. Perhaps that is because it has to learn some routine in order to work properly. If learning routines is a requirement, then I will be overall quite disappointed with the technology and just have to use manual mode all the time.
If you don’t mind me asking, what is your range?
The automode seems to correct/avoid lows quite well for me throughout the night, but it’s pretty bad with highs.
If somehow I end up moderately high at around 140-160 at midnight, I could stay there for 2-3 hours before I start to go down - I’m inclined to think the eventual decrease is driven by my lower basal needs in the early morning hours than anything else. Since my alarm is set to sound at 160, this is likely how it would all play out in manual mode anyway, so I don’t seem to be gaining much. I’m not sure if that is due to the routine-issue you mentioned or just what is to be expected with the Omnipod 5.
Are you aware of any charts or data Omnipod provides that shows you on a per hour basis how much insulin was given vs how much basal normally would have been given? I’d love it if there was a chart in the app that showed this. It would be so helpful in understanding how automode works so that I could use it more effectively instead of giving it what feels like blind control over my health.
I also would like to see something like that. But the only data provided on the PDM is the every 5 minutes basal/bolus amount under History Detail. Somebody with excess free time could manually chart it but it would take hours. I’d like to see Glooko add this to their reporting.
I am not really sure how helpful such a chart would be since you, like most of us, do not have a strict regiment of activity each day. As John58 said, the Controller does provide some information on basal/ bolus comparisons and a good summary of what was given during the day. I am more concerned with time in range than in how much insulin is given in AutoMode verses Manual Mode. My programmed range is 70 - 180. My goal is 110 during the day and 120 during the night, with correct above 120 at all times.
I admit that I continue to work with Diabetic Educators and making educated changes to my Controller myself to avoid too many highs. Like you, I see more highs (between 200 - 275) than I would like, especially after meals, but that it why I just adjusted settings to take care of that problem. I also dislike that the OmniPod 5 looks one whole hour ahead in making decisions about the insulin given; I have been told that Insulet is working on getting that down to a more realistic half-hour look ahead.
I DO like that I can look at the Controller’s CGM Info graph and see when the pump in AutoMode is giving me insulin or has totally turned off any insulin for a long period of time. I am sensitive to insulin, so I was shocked when I saw the number and length of “red line” (insulin totally turned off) times I have each day. If I were in Manual Mode, I would be getting insulin whether I needed it or not, but in AutoMode, the pump prevents many lows by not giving me any insulin when my glucose is in a good place and I do not need anything. Today, for example, I red-lined from about 12:45 - 4:15 and my glucose was at 100 at the end of that time.
One thing that I wish the graph would show is how much insulin is given in a bolus. The symbol comes up that a bolus was taken, but you have to go back to the History graph to see what that bolus dose was. OM5 still has some bugs to work out as the system progresses.
Everyone is different, and everyone, thankfully, has the freedom to choose what works the best for him or her. OM5 and I are still learning about one another, but I am happy about the direction I am going with this system.
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For some reason automode has done this at nonsensical times. For example, I decided to try it during the day yesterday, and it red-lined when I was flat at 135 even though I’ve set the pump to target 110. In an attempt to prevent a high, I input enough carbs for a unit of insulin, but it stayed as a red-line for nearly an hour. I ended up going high to 170-180 and had a heck of a time getting my bg level back down - it’d have been so much worse if I’d actually eaten the carbs input! So yeah, the red-line is great when it makes sense… not so great when it doesn’t. I’m not willing to hang out in the 160+ range while it attempts to figure out something I honestly don’t think it can. It would need to have so much more information (eg activity levels, fat/protein content or glycemic index in food that influences digestion rate) to be able to react in real-time in the way it is marketed. My conclusion is that it will avoid lows at all costs, leaving me in what I consider a high range all the time if needed. I don’t think that is actually healthier unless I were elderly.
In automode, the IOB number shows basal+bolus on board and of course, my insulin duration is playing a role in how quickly the value declines after a bolus. There would need to be a great deal of calculating in order to regularly understand what proportion of that is basal and how much more/less than my typical basal rates. I don’t think the pump would be making my life easier anymore. I suspend my insulin in manual mode if I start trending low, but it is difficult to do that at night - hence my hope that I could use automode at night.
When using manual mode, the IOB value is just the bolus value, so it’s much easier to predict relatively well where my bg level will be based on upcoming activity levels and food intake, and then I can adjust accordingly.
Anyway, thanks for your helpful responses. Lots to think through. I’m inclined to think the system is an overall bad fit for me, but I’ll probably still try using automode on nights when I would really prefer that my alarms not sound. I will keep trying to figure out the best ways to make that work. Not having any bolus on board when automode is activated definitely seems to help.
I’m glad it’s been working so well for you.
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I agree with you that the OM5 is set up to avoid lows at all costs, and I suspect that your having the red-line situation at 135 was both the algorithm trying to learn your body and what would happen if it did not give you insulin along with the irritating reality that it is trying to look a whole hour ahead.
I have been in AutoMode for about 8 weeks now, so it finally is attuned to how my body will react at various levels and tries to give me appropriate insulin to keep me in range. Do I sometimes go higher than I would like? Oh, yeah. And at those times, I just hit the bolus button, leave the Carb section blank, use the CGM reading, and let it give me insulin. It usually will deliver a pretty accurate amount, but if it suggests 0.0 insulin, I can change that to an educated guess at what I feel I need. You always have options to treat a high if you feel you have the experience to do so.
I smiled at your quote that says highs are not healthier “unless I were elderly.” Sigh. Sadly, although I don’t think of myself or feel that way, society would term my 68-year-old self as “elderly.” So I guess I will tolerate an occasional 160 - 180 range just to keep everyone happy. You are right. We all must do what we feel is best for each of us.
Have a good, safe, happy November everyone!
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