I was sure there was a thread from a few years ago about this, but searching I could only find a REALLY old thread addressing this topic from the generation previous to the current. So…
Here are some things I’d really like to see in the next gen pod:
Ability to prefill a pod for up to three days. That is, fill it, and carry it around as a backup in case something goes wrong with the one I’m wearing.
Superbolus
Dual-wave bolus
More configuable (enable/disable) nags (screens, alarms, etc.)
The Ping/Vibe has this feature, but rolls it into one with the idea of an extended bolus and calls it a combo bolus (probably because the term “dual wave” bolus is copyrighted by Medtronic, I’m sure). You accomplish a “dual wave” bolus by setting a certain percentage to deliver immediately and a certain percentage to deliver over a period of time; you accomplish an “extended” bolus by setting the entire bolus to deliver ove ra certain period of time (with no percentage delivered up front).
I’m hoping the next OmniPod system will be a true bi-hormonal AP. Following are the three features I’d consider most important:
User choice of target bg for automated basal (90-120)*
Smartphone integration**
CGM integration**
*per peter_alaimo
**per Dave26
Additionally: Right or wrong, I tend to use the terms “dual wave” bolus and “extended” bolus interchangeably. I’m pretty pleased with the OmniPod’s extended bolus feature.
The 'pod has an extended bolus feature (which I use all the time).
I’d like to be able to program a bolus to deliver a portion now, and then another portion at a later time but as an “all at once” delivery, not extended evenly over time.
Nirvana would be a combination of all: Immediate spike now, a portion extended over a period of time, and another spike at some scheduled later time. Heck, the best of all worlds would be to be able to program a “bolus profile” with whatever shape you want.
Of course, that gets pretty complicated. Maybe just adding the simple feature to schedule a bolus… that would accomplish the same thing.
There are plenty of foods that “act” a certain way when I eat them, almost always the same way. I’d love to have a “slice of pizza” bolus program that I could enter the carb count on, then it would deliver a pre-programmed percentage immediately, another pre-programmed percentage at a pre-programmed interval, and deliver the rest as an extended bolus over a pre-programmed interval.
As it is, I have to monkey with all this for 3-4 hours after I have a piece of pizza.
A superbolus involves taking all the insulin that you would take for correction and a meal plus the basal insulin you would take during the time you want the bolus to cover.
So, I take a bolus of 6 units for my meal .75 units for correction PLUS .6 units (my current basal rate) x 3 (for 3 hours).
That would equal 8.55 units. Also, for the next three hours, I set my basal to 0. The idea behind this is that the meal you are going to eat may make you spike very high, but if you “steal” some insulin from the basal you’re going to be getting later, you can avoid the spike now. Then, having used that basal at the front end, you eliminate it on the back end to avoid going low.
My personal belief is that you need to understand what you’re doing when you superbolus, so having a button for it may be too easy. Plus, not everyone looks good in blue and red.
I could be wrong here, but if the next Omnipod has an automatic basal adjustment to target a certain number/range various forms of extended bolus options wouldn’t be as important.
[quote=“Timbeak48, post:7, topic:56468, full:true”]
My personal belief is that you need to understand what you’re doing when you superbolus, so having a button for it may be too easy. Plus, not everyone looks good in blue and red.
[/quote]I understand where you’re coming from on this, Tim.
I lean the other way… I don’t think people that are capable should be crippled because others are not. I just don’t believe my life should be made more difficult because others can’t, or more often won’t, understand something.
Those would be nice features in all pumps. I would also love to see (in all pumps) the ability to create temporary +/- % bolus ratios for both carbs and corrections, that could be used on active days or sick days or hormonal days… And I’d love to see what the old Cozmo had, where you could program the pump to use different correction ratios based on blood sugar (so a higher blood sugar could, if needed, use a lower ISF than a lower blood sugar would).
I like the idea of having a super-bolus built-in, but I’ve never been all that successful with it. It’s very difficult for me to suspend the pump for more than 30 minutes without ending up high for hours.
The fact that these systems are, more and more, headed towards automatiion makes me wonder how many of these complicated user features we’ll see, especially because most pumpers don’t use the more advanced features to begin with…
I also hope that some day pumps are controllable through mobile phones, if only because it will FINALLY mean these technologies will be fully accessible to people with severe visual impairments.
@Timbeak48 explained it very well. I wrote up an example of use for my son Caleb here, and also included a link to John Walsh’s write up on the topic. I’ve used different derivations of a super bolus, and for a time we were using it every day for Caleb’s breakfast bolus. We still use it for breakfast for certain meals.
I heard that Insulet submitted a new PDM to the FDA. Hopefully that comes out shortly. The bulkiness of the current unit is annoying considering that it has to be carried everywhere.
I would so love not to carry a PDM in addition to my phone. Plus, an app could easily accommodate the specialized boluses that are being discussed here. Someone mentioned recently that the new PDM will not have a meter, so there’s a third device that will have to be accounted for, although I don’t think I’d keep it with me.
iPhone integration would be wonderful. I have also always wished for a simple way to dose from the Pod itself. Add a button to the Pod so you could do a simple unit by unit bolus if you forget or don’t want to take your PDM with you.
