When does the Omnipod 5 algorithm properly learn?

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

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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.

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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.

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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

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I lowered the duration of insulin setting and that helped wth highs. I also walk or use an elliptical for 20 minutes or so when I can after meals to help boluses. Bolusing 15 minutes early can help counteract a red line before meals but sometimes I forget to eat enough cards or fast enough to catch up with the bouus.

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Chris and everyone, thanks for sharing your experience. I am on my 4th OmniPod 5 and am helped by your best practices in keeping my Dawn Effect (and post prandial BGs) under control while on Automated mode. Question, should I stay on Automated Mode and suffer through the highs so that the OminPod 5 learns better?
Its GREAT how the automated OmniPod keeps me from going low at night and I am SLEEPING so much better. HOWEVER, I quickly went to 160 BG this morning at 6 a.m., even BEFORE eating protein and salad with a bit of cheese and black tea And THEN my experience is that the BG takes hours to come down as the OmniPod 5, as you said, is only giving tiny basal amounts every 5 minutes.
So, this morning, I switched back to manual mode and my basal is increased to help bring BG down. Not at all sure that the Automated Mode is going to ever work for me!

Chris, perhaps you can give us all an update on how the OmniPod 5 Auto Mode is now working for you?

Hey RLS1! I’ve reverted to a hybrid model I used pre-omnipod 5, in that I would inject daily basal insulin, and use the Omnipod for bolus only. The benefits were that if a pod failed, it wasn’t an emergency, or I could make an easy transition to MDI if want to take a break from pumping.

With the Omnipod 5 I take a basal injection that’s about 60% of what I need, and I keep it in automated mode. It makes a huge difference, as all the Omnipod is doing is trimming the rises and most of the heavy lifting is done by the basal. It also means I’m unlikely to go low due to the basal dose alone

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