At my review this week, we talked about the OmniPod HCL. Apparently, it has one of the “gentler” algorithms which would raise my HbA1C.
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Excited...first step to pump
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Bruce Stephens
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Doesn't apply to me (my HbA1c has been 49-52 for years now), but I can imagine that very much being worthwhile for some people. And for many people, some of the time.
A lot of parents are quoted as saying that HCL is worth any amount of money just because it can regularly produce a good night of uninterrupted sleep, and adults have reported much the same. (It's not all about HbA1c, after all.)
And presumably algorithms, sensors, etc., will presumably get better. I'm hoping by the time I'm offered HCL, the choice will be really easy to make.
Ivostas66
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I have the Omnipod 5. It is set to 6.1 as my target and I have been amazed at how often I go to bolus prior to eating to see that I am sitting at exactly 6.1. Most nights I wake to see I had a flat fish throughout the night around 6. My time in range is close to 90%, but prior to being on the pump it really varied, averaging around 65%.
You do need to be very accurate with carb counting. You are also supposed to let the pump 'do its thing' when your BG is high. This has caused me to be elbowed a lot during the night when my alarm is sounding and telling me my BG is in the low teens, pump is clicking as it delivers insulin, but not much movement in terms of BG dropping.
One good thing about the Omnipod system is that you aren't tied in for a lengthy period of time. The Medtronic and others have a 4 year sign up. If you don't like them, you're pretty much stuck with them. If you fall out with the Omnipod, you can change!
This is not just an OmniPod thing.
The same is true with the Medtrum which I have and maybe other patch pumps. However, Medtrum HCL is not approved at the moment.
Tdm
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I think 6.1 is the lowest target you can set on omnipod but you can set more agressive targets on the dana an ypso
As prev said, its more about a good nights sleep for me. And being able to excercise without topping up on carbs throughout
Satan’s little helper
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Inka
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You are also supposed to let the pump 'do its thing' when your BG is high. This has caused me to be elbowed a lot during the night when my alarm is sounding and telling me my BG is in the low teens, pump is clicking as it delivers insulin, but not much movement in terms of BG dropping.
That would drive me mad! I ‘just’ have a pump (I turned down a loop) and find that that’s sufficient to get a pretty much straight line overnight @Tdm This is due to the ability to programme the basal rate hour by hour and control any DP.
That would drive me mad! I ‘just’ have a pump (I turned down a loop) and find that that’s sufficient to get a pretty much straight line overnight @Tdm This is due to the ability to programme the basal rate hour by hour and control any DP.
nonethewiser
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If for whatever reason you do end up in teens then you can still bolus rather than wait for pump to do its thing, pump will take that bolus into consideration so as to not drop you low later on.
I do this if needed, but hcl does produce a nice flat line during night which is worth its weight in gold.
SB2015
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For me that is a big YES. It is worth a small increase in HbA1c to have the improved mental health. Improved TIR (which is much more relevant that HBA1c) with a LOT LESS EFFORT. My funding for HCl was definitely based on emotional well being, and they had seen the evidence of the improvement whilst I was fortunate enough to be able to self-fund for four years.
I hope that Partha is right and the HCl becomes available for all those that want it. Studies have shown that it is cost effective when viewed in the long term impact, but sadly budgets are all too often looking in the short term.
Inka
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The other thing to remember is that it may not be suitable/ wanted by everyone with Type 1*. Some people hate the idea of being attached to something. Some people react to the cannula. Some people do not find the CGM accurate enough. Some people do not want/need to change from what has worked for them for decades.
And some people might have been pump users for years and not want it, like me. I’m not yet convinced it would do any better job than I would, and having read some people’s experiences here where they’ve had to fiddle around with settings to stop going too low during exercise or have to trick it by inputting or omitting carbs, etc, that all sounds like more faff than a pump by itself is. Also, I don’t want my phone tied to me like that, eg having to be inches away to run the loop.
I think the higher HBA1C criteria is too blunt a tool (because it excludes people who might benefit), but I think the loop largely benefits those who are getting not so good results on MDI for whatever reason.
And some people might have been pump users for years and not want it, like me. I’m not yet convinced it would do any better job than I would, and having read some people’s experiences here where they’ve had to fiddle around with settings to stop going too low during exercise or have to trick it by inputting or omitting carbs, etc, that all sounds like more faff than a pump by itself is. Also, I don’t want my phone tied to me like that, eg having to be inches away to run the loop.
I think the higher HBA1C criteria is too blunt a tool (because it excludes people who might benefit), but I think the loop largely benefits those who are getting not so good results on MDI for whatever reason.
Bruce Stephens
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I don't think we know that yet, do we? I think we know that's so for some people (mostly those with sufficiently high HbA1c). I think Partha Kar is expecting some studies that would extend the benefits to people with lower HbA1c, sufficient that the criteria can be removed.
Tdm
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But life is not just a1c. Getting a good nights sleep is healthier, but may not show on a1c.
Being able to take excerise is healthy, but may not show on a1c.
Quality of life is important, but may not show on a1c
rebrascora
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Bruce Stephens
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Oh, absolutely. I think that's what we should expect when they reconsider the criteria: some more generous accounting for the non-HbA1c changes. (I think that was part of the reason for offering it to all children: if your teenager isn't paying attention, even sucky HCL might handle things better. And if a child isn't sleeping well that means parents aren't either.)
Tdm
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I so am looking foward to good night sleep!
I know people say...go to bed on a higher level, but I just find it goes down of its own accord if i do that.
And i can be nice and level, but then dip around 3am. Or 4am. Still, thank heavens for cgm!
By the way, my posts about weight etc were kinda quotes from daphne...like a sort of live-tweet of the course. The glasses reference was cos one of the example went with a picture of a woman in some 'dame edna everidge' glasses. (Kitten frames?)..mind you, i think they may be back in fashion.
Anyway, after a certain amount of annoyance and stress and looking through my old daphne coursebook, i finished the pump quiz and passed (thank goodness)
Now, its just waiting. I'm thinking a year or two.
I know people say...go to bed on a higher level, but I just find it goes down of its own accord if i do that.
And i can be nice and level, but then dip around 3am. Or 4am. Still, thank heavens for cgm!
By the way, my posts about weight etc were kinda quotes from daphne...like a sort of live-tweet of the course. The glasses reference was cos one of the example went with a picture of a woman in some 'dame edna everidge' glasses. (Kitten frames?)..mind you, i think they may be back in fashion.
Anyway, after a certain amount of annoyance and stress and looking through my old daphne coursebook, i finished the pump quiz and passed (thank goodness)
Now, its just waiting. I'm thinking a year or two.
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