Omnipod 5 and Libre 2+ a few thoughts

[rebrascora]

Using dash I tried FIASP for a few weeks and found it too aggressive, i had trouble stabalising my BG.

i've only been using HCL for a few weeks, but strikes mthat faster acting insulin may suit the system.

I don't use a pump, but I found the change from NovoRapid to Fiasp took a lot of getting used to and in fact it took me 2x 3month (very frustrating) trials with about 6 months in between before I got the hang of using it, as it seems to be quite quirky with my body. It works reasonably fast and effectively when my BG levels are in the 4s or 5s, but above that, it gets progressively slower and above 10, you would think I was injecting water and I need to be much more aggressive with it and stack corrections to get my levels back down. This is just how it works for me but I know other people have had similar problems.
It works really well for me now and I am pleased I persevered but I had to learn a whole new raft of strategies in different scenarios to make it work for my body and that was really challenging.... especially stacking corrections which of course is frowned upon and potentially dangerous. That said, a pump with no "preconceived ideas", may well adapt to it quicker than I did. What I found with Fiasp is that small doses "stacked" works better for me than one large dose, which is essentially what a pump is doing, trickling in fast acting insulin to cover basal needs and also with split doses for meals I believe, so it may just be that you needed to persevere a bit longer with it to make it work.
I am not sure I would swap to it at the same time as starting HCL because that may be too much change at once for you or the pump and if you have to drop back to manual mode for some reason, you may find it tough/overwhelming/frustrating if you have not got used to it beforehand.
Those are just my thoughts .... but very much as a non pump user.
I also think some people experience less quirkiness with it than others, perhaps due to body chemistry.

 

[PattiEvans]

Just on this one, I'm yet to have my pod and CGM on the same side and connection has been fine so far (dexcom g6)

Oops, sorry, I misread the post from Barbara and thought she was talking about Libre having to be on the same side as the pod, not Dexcom.

 

[nonethewiser]

Using dash I tried FIASP for a few weeks and found it too aggressive, i had trouble stabalising my BG.

i've only been using HCL for a few weeks, but strikes mthat faster acting insulin may suit the system.

Guess is you'll find same with hcl then as you still have to bolus for food. Shouldn't make any difference with basal as Smartadjust tech will work out basal needs to keep bg steady.

 

[heathero]

The libre 2 is a cgm it chars away rather happily via Bluetooth to your phone.

It’s the update of of the OMNIPOD with continue glucose monitoring and automatic blouses as needed if BG too High or low . I’m aware of the Libre have used approx 8 years.

 

[heathero]

Has anyone tried Fiasp with their pump? Currently I'm using Humalog, I tried Fiasp a while ago with a dash but found it too aggressive, wondering if it might be better suited to HCL systems.

Yes I use Fiasp didn’t find it aggressive but been using insulin for 59 years now.Still using Fiasp. So quite slow when high BG can take many hours to reduce with multiple bonuses. May be bit better.

 

[heathero]

Hi all I’m still with Omnipod dash and Libre 2 which both work well however more recently had many more Libre 2 faulty.
Now appointment to plan discuss HCL tomorrow. Change of pump / system. Hopefully change of current one to upgrade HCL.

 

[Richard F]

I've been using this system for a month now. After some initial teething problems it's all settled down, much smoother less highs and lows.

TIR now 82% previous 76%
GMI now 6.7% previous 6.9%
CV now 28.6 previous 29.5

Not huge strides but (IMO) worthwhile, I'm hoping my 90 day reads will be even better as its improving week on week.

One thing I've noticed is my bolus/basal has changed, 60/40 instead of 50/50. Overall units similar.

 

[PattiEvans]

Hi Richard

I am on the same as you (Omnipod 5 and Libre 2+). Where do you see the 90day TIR on your PDM please? I am a bit frustrated that I can only go to "Insulin History" and see the % TIR since midnight on any given day.

 

[Richard F]

Glooko on a windows machine shows much more info.

 

[PattiEvans]

Oh, of course. I should have realised! Thank you.

 

[PattiEvans]

So it would appear there's an improvement.

TIR 85%
GMI 6.6
CV 28.8

However 1% at 3.8 whereas previously I'd not gone below 4 for over 90 days.

Can't remember exactly what my TIR was previously but it was always over 70. Last Hba1c was 51 and now predicting 6.6

 

[Lucyr]

So it would appear there's an improvement.

TIR 85%
GMI 6.6
CV 28.8

However 1% at 3.8 whereas previously I'd not gone below 4 for over 90 days.

Can't remember exactly what my TIR was previously but it was always over 70. Last Hba1c was 51 and now predicting 6.6

6.6 is 49 so slightly lower (you may have done the conversion already but just added it for others as I wasn’t sure how they compared)

 

[christine.h]

Hello everyone I'm new to the forum.
Just thought I would share my experience over the last few weeks of adjusting to the Omnipod 5 and Libre 2+ in the hope that it might be useful for someone.

Positives:
My nighttime levels are brilliantly consistent for the first time in years. I go cycling regularly sometimes carrying camping gear up hills and previously this has led to multiple hypos during the ride and more severely and frequently the night after. This in spite of halving basal rates, reducing boluses etc. Recently I did a two day ride and camp in the Peak District following the instructions to use the Acivity setting (which I applied for 48 hours) and reduce boluses by 25%. To my amazement I did not get a hypo in the night at all, and only one or two during the ride itself.
My general levels are less spiky by a long chalk so long as I am careful with carb-counting.
Fewer hypos generally.
Easier to give a quick bolus for a snack.

Negatives:
Not much support after training to answer the questions I didn't think to ask (but I haven't contacted my clinic).
PDM daily losing contact with the sensor (often at the most inconvenient moment eg just before a meal) for an hour or more. After talking to Insulet and Abbott I have replaced the Libre and that seems better so far. (Abbott sent me a new one).
No way of getting alerts/notifiacations on my phone (useful when driving or cycling).
No way of using a reader to give an instant check. This was part of my swimming routine when I would keep the reader at the end of the lane and check my levels every 16 lengths or so. I wasn't sure if the sensor and the pod would talk to each other in the pool and worried about having a hypo as I no longer get the clear warnings as I used to years ago. Somehow dealing with a hypo when you're in the pool seems particularly awkward. I tried putting the PDM at the end of the lane but it lost contact when I was swimming and so I had to wait for some minutes before getting the reassurance I wanted. I am learning to trust the system a bit more and today I left the PDM in the locker and all was fine. I can't resist a little carb pre-loading though, although Insulet say it isn't necessary. Perhaps next week...
I am not sure if the pod will still respond to the sensor when out of the PDM range.

It looks from this as if the negatives outweigh the positives, but although the loss of contact for extended periods is frutrating, I am overall very pleased with the ease of managing my diabetes. I hope this will be reflected in my overall glucose levels, but the big win for me at the moment is the day-to-day convenience.

Cheers
Adrian

Thanks for your post does the libra 2plus stop you having hypos when it is paired to Omnipod 5

 

[Richard F]

Thanks for your post does the libra 2plus stop you having hypos when it is paired to Omnipod 5

My Time in range is much better, instance's of below range much reduced too.
For instance out walking BG dropping, to around 5 or 6 would normally have me reaching for glucose. Now I just keep an eye on it and levels recover.
Activity button when in high risk situations (target around 8) is a great thing too.

 

[aflook]

Thanks for your post does the libra 2plus stop you having hypos when it is paired to Omnipod 5

Hi Christine. Sorry not looked at this forum for a while. My control has always been a bit up-and-down but I am having fewer hypos with the O5/2+. Two big factors for me are activity and carb estimation. I use the Activity feature when I swim, cycle or go walking. I try to follow the rules ie starting the feature 2 hours before exercise and reducing boluses by 25% and mostly that seems to work except when I go for day-long rides up steep hills. Sometimes I get a hypo when not doing that much, such as walking with heavy shopping. (I try to use the Activity feature more.) I very rarely have a hypo at night now, whereas before I would almost always have one on days I had swum or cycled, no matter how I tried to adjust the boluses. So hypos are considerably reduced but not eliminated. It's all definitely worth the irritation of connection problems.

 

[PattiEvans]

Thanks for your post does the libra 2plus stop you having hypos when it is paired to Omnipod 5

If you mean will being on an hybrid closed Loop stop you having hypos then no. When you are going low the Libre 2+ will tell your pod, which will stop giving you basal, but it seems not to ward off hypos as it should. Prior to being on HCL I found that just having a Libre with the low alarm set to 4.1 would allow me to ward off a hypo before it happened as the alarm was very loud. Now I have Libre2+ paired with the Omnipod 5 I am finding that I am having hypos because the low alarm isn't loud enough on the Omnipod 5 PDM. Rather than being a continuous sound it's an intermittent blipping which just sounds like messages arriving on my phone that are not urgent (I keep the PDM and the phone in my handbag when out and about).

Hope this makes sense.

 

[paul2000AD]

If you mean will being on an hybrid closed Loop stop you having hypos then no. When you are going low the Libre 2+ will tell your pod, which will stop giving you basal, but it seems not to ward off hypos as it should. Prior to being on HCL I found that just having a Libre with the low alarm set to 4.1 would allow me to ward off a hypo before it happened as the alarm was very loud. Now I have Libre2+ paired with the Omnipod 5 I am finding that I am having hypos because the low alarm isn't loud enough on the Omnipod 5 PDM. Rather than being a continuous sound it's an intermittent blipping which just sounds like messages arriving on my phone that are not urgent (I keep the PDM and the phone in my handbag when out and about).

Hope this makes sense.

Out of interest, do you get the omnipod on prescription?

 

[PattiEvans]

Out of interest, do you get the omnipod on prescription?

The Omnipod is a pump and as such you have to be agreed for pump funding by the Diabetes Clinic. You are then offered the choice of pumps which that particular clinic supply. I chose Omnipod over the Medtronic 640. From then on you get them via Insulet, the manufacturer, who invoice your clinic. So from your point of view they are funded and you do not pay.

 

[paul2000AD]

The Omnipod is a pump and as such you have to be agreed for pump funding by the Diabetes Clinic. You are then offered the choice of pumps which that particular clinic supply. I chose Omnipod over the Medtronic 640. From then on you get them via Insulet, the manufacturer, who invoice your clinic. So from your point of view they are funded and you do not pay.

Right, yes thanks. As I understand it I dont think I would qualify because I am 47yo and have good control (HbA1c 5.6). Wondering if it will ever be available for everyone....?

 

[rebrascora]

Right, yes thanks. As I understand it I dont think I would qualify because I am 47yo and have good control (HbA1c 5.6). Wondering if it will ever be available for everyone....?

That is a very low HbA1c (38mmols). Could you argue your case on the grounds that you perhaps have too many hypos or have to spend too much time and effort preventing hypos to maintain it and that it is not sustainable or is causing you anxiety? What is your TIR like.... perhaps that gives you grounds to qualify for a pump? HbA1c is not generally considered the best judge of diabetes management these days.