I stand corrected. Thanks @Helmut
Totally agree. I won’t be switching to the OmniPod 5. That is a shame since allowing users to set their own target/correction BG has been proven to work with DIY Loop.
@Trying, I have to avoid thinking about it. It upsets me. It is OK for me to buy a gun with the clear risk that I kill myself or others with it. But it is not OK for me to set my BG target to a healthy level. This arrogance of government employees gets to me. They should not assume that everybody is much dumber than them. Most likely only a few people are.
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@Trying, I understand that the FDA approved algorithm is the logic consequence of a one-size-fits-all approach and the American attitude that any problem is always somebody else’s fault. I don’t see any signs of a culture shift towards more personal responsibility. Quite the opposite. Changing away from the one-size-fits-all approach is our only hope. @Terry4 brought forward an excellent proposal that I hope will find its way to the FDA: Allow a lower BG target in response to lower observed BG variability. It makes a lot of sense to allow people that demonstrate good control to run a tighter ship. It would also provide an incentive to lower BG variability. Let me end on a positive note and hope that this will happen.
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There has always been a fear hypo when it comes to the FDA.
There is almost an expectation that we can’t manage normal sugars because we will go low and die.
Of course the real worry is that we will go low, die and our families will sue the pump manufacturer for allowing us to set our rates so low.
When I firsts started my Tandem, I was very irritated that the target was 120 and even sleep mode at 112 seems high.
The reality is I could tweet it to get under 100, but I e learned to accept 112 for now.
When they loosen that restriction, I’ll def go lower.
Here is the kind of stuff the FDA uses to determine the https://care.diabetesjournals.org/content/35/9/1814
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@Helmut Again, totally agree with you on all points! All (adult) T1s are used to taking responsibility for their own actions and should be allowed to do so by having the ability to set their own range that they are comfortable with and is best for their own health. I’m not sure how a lower BG target in response to a lower observed BG variability would be implemented but perhaps that is something FDA would approve. I think that is just another Govt control that is not especially needed nor wanted by those who want tight control, and only complicates the situation. My preference is to allow DIY Loop parameters to exist in the FDA approved version. DIY Loop provides a simple and elegant solution to a complicated system. I sincerely hope we can continue to use DIY Loop.
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All the academic medicos and researchers have adopted the A1c number as an independent indicator of glucose management. Well, that works for populations but not so much for an individual whose actual glucose management does not precisely match the A1c number.
Time in Range (TIR) is a great idea to counter the weakness of the A1c number but then the medicos decided to use an uninspiring and unambitious 70-180 range as the standard.
Glucose variability, as measured by CGMs as standard deviation (SD) and coefficient of variability (CV = SD/mean), is a number that people with diabetes and doctors have yet to embrace.
When glucose variability goes down, BG averages can then safely fall and A1c’s can follow. I think we should concentrate on glucose variability.
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Shoot. Liability? For me the trade off of convenience isn’t worth losing loop time in range, sd and a1c.
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Keep in mind that we are very early in the world of automated BG management. Just because the number is 110 initially doesn’t mean it can’t be changed later once the concept is proven in thousands of real-life patients rather than a controlled study. It’s sad that these things take a long time while we as patients must bide our time waiting.
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Thank you!!! I have training on Wednesday.
Hi Terry!
Yes! I am definitely going to look into diy looping after I get the basic controls of the Eros. Training is on Wednesday this week, even though I haven’t gotten my scripts yet:(
When you diy loop, does your iPhone do all of the work?
Do you use the built in meter on the Eros?
Just planning out what I need to carry around.
I use DIY Loop with a MiniMed 722 pump. So, no, I don’t use the built-in Omnipod meter.
You will need to carry your phone with the Loop algorithm installed. You’ll also need a small radio translator device to enable communication between your pump and phone. The original one is called a RileyLink but there are some newer models available. One is called Orange Link and another Emma Link if memory serves me.
No. This is a hybrid closed loop system in that you’re still required to announce meals (and give the needed insulin) and sometimes add manual corrections. Where this system really shines, once you find the correct settings, is overnight. An all-night in-range blood glucose is possible and is the biggest benefit most people cite when you ask them about DIY Loop.
While the algorithm on the phone does not do all the work, it does take care of a lot of the grunt work of diabetes. It looks at glucose levels every five minutes and then decides whether to add, subtract, or stand pat with the pump-programmed basal rates. (There are also Loop algorithm versions that use an auto-bolus correction style.) This relieves you of the most of the minute to minute challenge and allows you take in a fuller perspective.
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I think your question may have been meant as, “Do you need to carry around the PDM while looping?”
The phone will replace the PDM completely, I think you won’t even need it to insert a new pod.
@Terry4 is correct that you do still need to do things like announce meals and whatnot.
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Haha, it is already proven in thousands with the DIY Loop systems!!
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@Trying – You’re right about the heft of the positive DIY Loop data. Unfortunately, I’m only aware of one project in the DIY universe where data is being formally collected and presented to the FDA for scrutiny and approval.
That’s Tidepool’s application with the FDA to certify their software, a direct descendant of DIY Loop, as a legitimate way to automate insulin dosing. As I understand it, the FDA received Tidepool’s application and is currently considering it.
I can only hope that a great deal of the wide-ranging user flexibility of DIY Loop will survive the FDA approval process. I prize my current DIY Loop ability to target 83 mg/dL (4.6) and end up at 93 mg/dL (5.2). I hope to keep an open mind as this situation evolves. It may very well mean that it will take Tidepool Loop a few iterations to line up with my expectations.
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DIY Loop systems: I’m sure that’s exactly what the FDA needs in its approval process.
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I just like that the FDA is beeing more cooperative and open lately. If we just have patience, there are several choices coming down the pike.
And for what it’s worth, I don’t think DIY loop is going anywhere anytime soon. I myself will stay on it until there is a compelling reason to switch and that gives the same level of control I’m used to. The support community is still just as good as it’s ever been if not a bit better.
Has anyone heard of a time table as to when the old eros pods will be discontinued? i hope not for quite some time.
I know I’m a little late to the thread, but I just wanted to give a counter argument to your fear of pod failure. If you keep tresiba as your basal, even though you are protecting yourself from pod failure, you’re losing one of the best advantages of using a pump, the ability to use a temporary basal or suspend insulin altogether when exercising or see a low trend early and want to correct it without consuming carbs.
From my 10 years of being a podder, I have had 100+ to 1 experiences where I turned down my basal vs having a pod failure and wishing I had some other background insulin working.
Definitely are pros and cons both ways, you just have to decide which ones are more important to you. Hope all goes well, you don’t regret going tubeless!
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Hi! Ben! Thank you so much for your response. It definitely made me feel better about my upcoming journey. I’m starting the Eros version of omnipod on Monday. I am going to look into looping as soon as I get the hang of it. Already ordered the orange link bc it’s on back order.
I have to just remember that it’s typical to mostly read peoples troubles with it, and that many people (like yourself) have great success with it. I see that with dexcom posts all of the time and my G6 is mostly excellent!
Thank you again!
Sincerely,
Laurie