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
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.
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!
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
Christopher5 was your decision to go hybrid something you did on your own? Or was this a decision that was made in consultation with your doctor? Did you need to make any pump adjustments in order to make it work safely?
Good question. I ended up educating my endo on how to do it, and he thought it was pretty cool. He agreed that the algorithm is far too timid and this was a clever hack. I know what my MDI basal requirements are, cut it in half, and then progressively added a unit every day to find the optimal balance to minimize my glucose variability, i.e. flatten the curves, but to also let the pump provide some of the basal. No pump adjustments were needed, because the Omnipod 5 system “learns” your individual requirements
Hi and thanks for the guidance! I have been on travel for a long while and finally getting back to this. I’m using Tandem most often but want to try using Lantus with the OmniPod. So in this comment, are you saying that you took half of your MDI and applied that to your long-term Basal insulin dose? I typically took about 12 units of Lantus in the mornings and 8-10 at night - twice a day. I see how this could very well help my glucose variability which has been very dissatisfying with OmniPod 5.
I’m about to try the same thing with tresiba. I think I’ll start tonight. The omnipod 5 is just too conservative in auto mode for me otherwise. I’d be happy to compare notes
Sam, I expect to start mine on Wednesday or Thursday and will hope to update this list. I will start conservatively with my Lantus, perhaps 8 units morning and none at night since OmniPod does well for me at night.
I was also thinking of starting with 8u tresiba, but in the evening for me. Will be interesting. This is my last ditch effort with the omnipod 5 before switching to the tandem mobi— which is in the mail as we speak
Just a quick note… been doing 8u of tresiba in pm since Monday and running the pod on auto all the time.
I know it’s too early to take to the bank but so far it’s been an amazing improvement.
average bg levels have moved from 130s to 110s.
it hasn’t been long enough to meaningfully calculate standard of deviation or coefficient of variation— but at a glance I can tell you my blood sugars have been much more stable and closer to goal
I’ll probably do a write up on FUD once I actually have more data to explore.
of course, cuz that’s just how it works… my tandem mobi just showed up today, of course… because I just finally seemingly figured out how to get the omnipod to work well for me
I’m starting my 3rd day with OmniPod and a morning dose of 8 units of Lantus. I’ve had no major low blood sugars and my high BG after meals is better controlled. I will continue to do this for a week, or so, since it seems to be working. It is SO true that the OmniPod was created to simply maintain a stable blood sugar, not bring BG down from highs well.
I know the O5 takes your total daily dose (TDD) and applies 50% (I think it’s 50%) of that toward basal.
It averages the 3 days of the pod though, right? It does not look at the numbers and adjust them day-by-day, it only looks at the last pod’s TDD for the 3 days and uses that amount for the next pod, is that right?
So when it is pod change time, what if you dump a large bolus right after you take the pod off before you deactivate it. That would increase your TDD average, and therefore increase your basal amount.
