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Omnipod 5 Advice

Tom1982

Tom1982

Well-Known Member
Relationship to Diabetes
Parent
I’ve read conflicting reports of the first few weeks on Omnipod 5. Is it best to leave the pump alone to do its thing (with the exception of meal bolusing) or does the algorithm get better quicker by correcting when needed?
 
I am not using Omnipod but when I went on to HCL initially I kept interfering and confusing the algorithm. Once I left it to its job, apart from bolusing and responding to alerts, it became a lot more effective. The pump does a check every five minutes and does autocorrections as necessary. I found that a difficult transition but glad that I did the switch.

Not sure who is looping with Omnipod, but they may have other advice.
 
@PattiEvans was looping with Omnipod 5 and Libre 2+ but has gone back to manual mode as she can get better results than the HCL. I think you have to let the system learn without interference, so there will be a few weeks with higher levels while the algorithm learns, from what I have read. Hopefully Patti will be able to confirm. Not sure if it makes a difference as to which sensor you are looping with, but I doubt it.
 
Tom1982 said:
I’ve read conflicting reports of the first few weeks on Omnipod 5. Is it best to leave the pump alone to do its thing (with the exception of meal bolusing) or does the algorithm get better quicker by correcting when needed?
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Best let it do its thing, pump nurse told me it can take a few weeks for algorithm to get to grips with things.

Maybe I was lucky but found algorithm was quick to work out my body's insulin needs, what is crucial is to get get your carb count right as near as possible, since moving to O5 & Dex 6 my TIR is much improved, so give device time @Tom1982
 
I concur, let it do its thing, the odd adjustment may be necessary. I found I had to increase my evening bolus a lot more than expected. As someone said 'let the bolus do the heavy lifting'

Incidentally, I hear an app is due this year so one can use a phone instead of a the controller. Does this mean the learning process will need to be redone? Or is info stored on a cloud somewhere?
 
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Hi there

I didn't like the combination of Omnipod 5 and Libre 2+. I know we were told not to correct, but I just couldn't sit back and see high teens and 20s without doing a correction. Of course unless you switch back to manual you can't use Temp basals, which I have always used and found effective. I thought the software was poorly written and it didn't give me the information that I was used to having on the phone. It just never seemed to "learn" at all. I also found that having the sensor on the back of an arm was extremely limiting in where I could put the pods. They only seemed to be able to talk to each other if I positioned the pods in a limited area on the side of my waist corresponding to the arm the sensor was on, or on the same arm. I'm afraid I gave up a week ago and switched back to manual permanently after 6 months of trying. I'm changing the sensor and pod this evening and I'm going to start the sensor with my phone. Hopefully I can get back the sort of control I had previous to going onto this HCL.

Don't let me put you off though - it may well have been my fault... but I did hear from someone that this system is a "very gentle HCL" and perhaps I just wanted something a little more aggressive.
 
PattiEvans said:
It just never seemed to "learn" at all. I also found that having the sensor on the back of an arm was extremely limiting in where I could put the pods. They only seemed to be able to talk to each other if I positioned the pods in a limited area on the side I'm afraid I gave up a week ago and switched back to manual permanently after 6 months of trying. I'm changing the sensor and pod this evening and I'm going to start the sensor with my phone. Hopefully I can get back the sort of control I had previous to going onto this HCL.
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@PattiEvans I was wondering how you got on, I am about 6 weeks in.

I have had more success with my site location only site I can’t use and previously liked using with the dash is my stomach, even with a site less this is limiting for me with the libre being able to be worn arm only.
I have a complaint with Omnipod in progress on this.

Now with 6 weeks data I must say I was as good if not better than the algorithm, because I can’t use my pre set basal it didn’t manage my period (which was my reason for going from MDI to pump and then this) it takes 3ish days to adjust to the new situation which is slower than I was. All my levels are 1% better overall TIR, over and at hypo all that amount improved but actually that’s because I have a few days better control, most the same and actually a fair few worse than I would ever get. A lot more 50ish TIR days than I would have, and I’ve had a few 30ish days which I only got if sick.

I don’t think they are very good quality pods compared to the dash. I’ve had 5 faults since 10th Dec.

I hate the alarms. And I hate that they keep going off and off and there’s no way to stop it, when it is misbehaving I am sleeping worse because on the dash I would know if I’d done something to correct the issue and could wait for the result this just keeps doing the alarm again and again so actually both me and Mr are sleeping worse sometimes now. Like last night, I’m not sure if the hypos are more stubborn.

There are pluses but mainly that is that I don’t think about it as much so the manual load and effort generally is less and the normal none menstruation or ovulation days on a whole are better.

Activity mode for reducing lows during exercise Is great for walking and I imagine if that’s an issue for the user during other exercise it will be very helpful.
It’s not at all for rugby or running for me, and again without turning on manual mode you can’t tell it the parameters have changed and it should do a different basal.

There’s still a load of wins, and I will like @PattiEvans ride it out for longer and see what happens over time and with bloods.

My husband has see the impact and keeps saying not even to wait it out based on the faults, and lack of improvements.
The more I read about how the algorithm the less I like it, because I am not sure how much it learns rather it adapts which I could do on my own.

@Tom1982 I do think you should give it a go for her just don’t expect a magic wand solution. As parents it will be a lot less effort on your part and I imagine that will improve her quality of life a lot. There’s not yet a menstrual cycle for her to deal with so again the background settings don’t change every few weeks because of that.

Some days I really don’t think about it at all and if it’s as good as her current levels, and TIR then this is definitely worth the switch but if you are after better I am not sure it’s the right solution.

I will ride it out and keep you updated, go into it with an open mind, and hopefully your team have other options, that’s been mentioned to me. I did like the Dash so I’m not sure about another pump to get HCL again to just back to the dash.
 
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Does the 5 actively correct if high? The first few hours (in fact, most of the night) on a new Dexcom are miles out, for example, it was reading 2.6 last night and she was actually 10.3! We calibrate a couple of times on the first night but would the inaccuracy of the reading cause issues or potentially be dangerous?
 
Tom1982 said:
Does the 5 actively correct if high? The first few hours (in fact, most of the night) on a new Dexcom are miles out, for example, it was reading 2.6 last night and she was actually 10.3! We calibrate a couple of times on the first night but would the inaccuracy of the reading cause issues or potentially be dangerous?
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Yes, it does correct as needed, and pause insulin if low. So faulty or inaccurate sensors will require manual mode. Which as you already know the Dash it is easy to manage if needed.

It would be dangerous if you didn't know yes. I think that's why the advice is always check if its unexpectedly high or low before you treat, it does do alarms at some points, but the corrective actions to stop you getting to the alarms (keep in range) would happen automatically without you knowing unless you watched the PDM, but this is the same as the Dash now if the Dex is wrong right, if you didn't check, then manually you would do the wrong thing, so I think this is same.

I haven't finger tested like this past few weeks since before the first libre back in 2020, and I have had full days (including Christmas day) of the PDM not reading the sensor, so manual and finger tests.

Some on my start up day where moving from MDI, 3 from other pumps so at least they knew about some background amounts for them, and general pump knowledge, I don't know how I would cope from MDI to HCL if I had to go into manual as they don't cover it at all, or they didn't in my session.

I know I am listing a lot of faults but 70% of the time it works fine, and my mental impact and the effort is so much less now. Other than that 30% of the time when the alarms keep me up all night / morning like last night / this morning - I may be grumpy 😳
 
Hi @Tom1982.

I’m due to start HCL on Tuesday with Omnipod 5 and Dexcom G6. I’ve been listening to the Omnipod 5 Juicebox Podcasts in preparation - there are 3 podcasts and they’ve answered a lot of my questions and given me a better understanding of it all. Have a listen!
 
Bloden said:
Hi @Tom1982.

I’m due to start HCL on Tuesday with Omnipod 5 and Dexcom G6. I’ve been listening to the Omnipod 5 Juicebox Podcasts in preparation - there are 3 podcasts and they’ve answered a lot of my questions and given me a better understanding of it all. Have a listen!
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Nice one, will do that! Spend far too much time in my work van so that’s a definite plan!
 
Bloden said:
You can listen to them anywhere LOL.
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Oh you reckon!? I’ve got an absolute head case of a dog wants to jump all over me, a diabetic 7 year old who’s hobbies include wrestling and running round in circles and a missus who has an amazing knack for finding me jobs where there are NONE!! The 4 hours of traffic are a blessing!! :rofl:
 
Something to to note it's not a fit, calibrate, forget kinda deal. I regularly tweak the bolus/carb ratio.

I've emerged from a season of back to back colds and viruses.

Pre season I was using 22-25u per day when active, 25-28 when lazy. During the season I'm 30-33u and this week dropped back to 25-26u with low activity levels. Diet and carbs similar. During the changes and tweaks it's harder to keep stable.
 
@Richard F do you have to make the changes often?

It was going okay for me, it's bad days are worse than the bad days I had on the Dash, and the rest slightly better, so mixed. As good as me based on the data.
But then about 2 weeks ago DP (which I haven't had a problem with in years) seemed to be back after breakfast I would peak 15/16 then 4-5 hours later back in range, spoke with my DSN on Friday and we changed all the settings and now its moved the peak after lunch, and up to 17/18 and lasts longer, then in the evening stubborn hypos and hypos overnight. I am exhausted and the hypers make me feel like a slug.
Now today I woke up with my period so likely that's the reason for the hypos but on my Dash I would just change onto a pre set basal profile and it had less impact on me.
I haven't been told my any "official" professional that the settings will need changing regularly and if this is the case I do wonder how it is better than the Dash.
 
Its certainly a learning curve, I too had problems with DP but it seems to have settled down, (I do pre bolus breakfast whilst still in bed)
It would be good to have easily adjustable carb/bolus ratios at a click of a button. Currently I'm on 11 during the day and 7 for dinner. A week ago I was using 10 during the day and 6 for the evening meal. I didn't have so much disparity between times of day using dash.

During the Autumn I was using 25ish U daily, Dec and most of Jan I was up to 30u now back to 25u. I don't really know why (Xmas and a cold excepted when I was up to 34u) activity and diet very similar. When adjustments become more regular I know I'm going into a new phase and tweak accordingly.
With dash I'd have been adjusting Basal up and down.

It is a different way of thinking the mantra 'Let the bolus do the heavy lifting' keeps popping into my head, and just allow the basal to do its thing for minor adjustments, shutting off when necessary.

A 'sick' button to give a 10-20% increase in bolus would be useful.

I didn't receive any professional advice, a parcel from DPD, websites and advice on here, plus a couple of phone calls when I was coming unstuck (literally and figuratively) I I think the professional advice is just guidelines really.

I've been a user since June it took me 3 months to 'get it' now I have TIR has improved from 79 to 87, Hba1c down from 51 to 48, fewer corrections and sleep (alarms off) immeasurably better!
 
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