I upgraded to the Omnipod 5 recently and am about 5 pods in, expecting the algorithm to keep my BG flat, but it’s still nowhere close to the manual control I maintained with my DASH system. The correction boluses seem timid, and then once my target is finally achieved, it’s quick to turn off the tap completely, which invariably leads to a rise. My Dexcom graph looks like a rollercoaster ride, lurching from 70 to 170 and back.
Also, one of the things I was looking forward to was it correcting unexpected night time highs which occur if I eat too late. But it’s slow to react and by the time I wake up I’ve still been at 150. My manual basal rate is 0.65/hr. When I look at the history in auto-mode from a nighttime spike, it’s very conservative, rarely ever dosing above 0.1 every 5 minutes (1.2/hr). Does it get more aggressive with time? I’ve used the bolus calculator for every bolus and avoided Afrezza to correct highs so as not to confuse the algorithm, but it’s still far from the control I can achieve manually - usually no more than 15-20pts of std. deviation from my target. I would love to see the algorithm get there, but I’m wondering if it ever will
The algorithm seems too wimpy to do this if your BG is rising in response to a meal or carbs or if you are using correction bolusses. One of the irritating things it does is reduce your basal immediately after a correction. It also counts some portion of the micro bolusses as IOB so beware.
The way I handled this was to switch to manual mode for 3 meals a day and when significant corrections are needed.
The bolus calculator does two things that I don’t agree with. It uses the surprisingly high IOB inferred from the past few hours microbolusses (which most of us would consider to be basal not IOB) and it calculates a bolus based on the target BG of 110-150 that is used for Auto mode. I get around this by calcing my own IOB and bolus and targeting BG 80 with that bolus.
Quick update - so I’m at least 10 pods in now, and the variability has definitely lessened. It’s doing a great job now of keeping my levels steady through the night. Occasionally, I’ll see a quick rise from dawn phenomenon between 3-4AM, against which I feel the algorithm could react more quickly and aggressively. This morning I peaked at 155 at 5AM when I woke up and did a correction bolus that got me to 110 by 7AM
