Omnipod user for 2 years and I've felt unwell since then. Could it be Fiasp?

[Inka]

Following a low carb way of eating may well also be causing a problem for the HCL because there may well be an element of protein release if you are not having significant amounts of carbs. I follow a similar dietary regime and it really suits me and I feel far healthier for it but I do have to inject about 2 hours after meals for protein release. It may be that you are doing enough exercise some of the time for the protein release to be utilised by your muscles.
Personally I wouldn't thank you for a pump in this situation as I don't think they are set up to cope with a low carb way of eating and my consultant is of the opinion that a pump on HCL could not do nearly such a good job as I do manually with Levemir and Fiasp. I don't find my insulin regime particularly onerous and I don't suffer with hypo anxiety, so I don't need a pump from that perspective either.

A pump (without HCL) can deal well with protein release because you can use a dual bolus or an extended bolus 🙂 You can also adjust the basal rate to suit you. I don’t think the pump is the problem here (although I admit to not being a fan of Omnipod at all). I reckon it’s the HCL.

 

[Tennis 4015]

Welcome @Tennis 4015
I moved over from MDI to the Omnipod dash in 2023 and it was life changing actually much better control, less hypos, better sleep and so on.
In December 2024 I moved over to the Omnipod 5 as HCL and I had issues with the libre 2 plus and the connection. Which made it basically on manual mode again but the HCL was just doing random things. I am now on the Dexcom 6 which is much better. So I’m 62% in range the past 30 days which is about the same or little worse than I was before HCL.
Some days are perfect and I hardly think about D at all. Other days it’s really rubbish and it just won’t behave. It’s not better than me and I haven’t made my mind up how I feel about it yet.
Sleep is much better I will say that, which is bug deal. From MDI to pumping was life changing but yes this HCL I don’t know how I feel yet, waiting for my next appointment.
I don’t think it’s for everyone and if you’ve managed to tweak your current treatment to your situation then the change over can be the tricky bit. Those first few weeks I was so disheartened but I’ve been told to give it time, and then changed the sensor so that’s what I am doing and like @PattiEvans I will give it some time and then compare the before and after data and results with the other plus wins and loses and then decide.
Still deciding.
Changing to the pump was great for me though, and I would recommend giving that a go if MDI isn’t working as you would like it. Some people it works

 

[Tennis 4015]

A pump (without HCL) can deal well with protein release because you can use a dual bolus or an extended bolus 🙂 You can also adjust the basal rate to suit you. I don’t think the pump is the problem here (although I admit to not being a fan of Omnipod at all). I reckon it’s the HCL.

Thanks. The diabetic nurse has adjusted the carb ratios, but still no joy. I can manually keep in range between 75-80% and using the omnipod , I was having to intervene regularly. What is the HCL?

 

[Inka]

Thanks. The diabetic nurse has adjusted the carb ratios, but still no joy. I can manually keep in range between 75-80% and using the omnipod , I was having to intervene regularly. What is the HCL?

The HCL is the Hybrid Closed Loop - that is, software that controls the pump so that it responds to a person’s blood sugar readings sent via a CGM. Sometimes it’s just referred to as a loop or looping.

If you’re not eating bread, pasta, rice, etc, then your body will turn protein to glucose in the absence of sufficient carbs. This is less predictable than carbs like bread, etc, and can cause later and persistent rises in blood sugar. I’ve tried a very low carb diet twice and found control harder, as my blood sugar always seemed to be trying to push itself up and I felt I was fighting it. That’s why I made my comment about control being easier with carbs. As you’ve chosen a different diet, then you might well find that normal tweaks and adjustments to ratios, etc, don’t work as they should, and that you require adjustments more suitable for your dietary choices. You might even find you need a different bolus insulin. I did when I tried a similar diet.

 

[PattiEvans]

Hi there

I found the Omnipod Dash very good for 3 years using Apidra fast acting. Prior to that I had a tubed pump for 8 years which was excellent. I transferred to the Omnipod 5 and HCL last June and control went south. I tolerated it for 6 months and hated the lack of control, so switched to Manual. This is better, but nowhere near perfect as the algorithm it uses to calculate boluses is, in my opinion severely flawed as it takes hourly basals into the calculation. In addition it needs to be in a severely limited site. On 1 May I am swapping to a tubed Ypsopump with Libre 3. From my study of CamApps already I can see how much more thought has been put into the algorithms. Good luck but be aware of the limitations.

 

[Tennis 4015]

The HCL is the Hybrid Closed Loop - that is, software that controls the pump so that it responds to a person’s blood sugar readings sent via a CGM. Sometimes it’s just referred to as a loop or looping.

If you’re not eating bread, pasta, rice, etc, then your body will turn protein to glucose in the absence of sufficient carbs. This is less predictable than carbs like bread, etc, and can cause later and persistent rises in blood sugar. I’ve tried a very low carb diet twice and found control harder, as my blood sugar always seemed to be trying to push itself up and I felt I was fighting it. That’s why I made my comment about control being easier with carbs. As you’ve chosen a different diet, then you might well find that normal tweaks and adjustments to ratios, etc, don’t work as they should, and that you require adjustments more suitable for your dietary choices. You might even find you need a different bolus insulin. I did when I tried a similar diet.

Many thanks. Yes it might need a change of insulin. I’ve been on that diet for a fair few years and my insulin has never ever changed. It’s been absolutely fine however with this Omnipod five the insulin doesn’t seem to be doing the right thing.

Hi there

I found the Omnipod Dash very good for 3 years using Apidra fast acting. Prior to that I had a tubed pump for 8 years which was excellent. I transferred to the Omnipod 5 and HCL last June and control went south. I tolerated it for 6 months and hated the lack of control, so switched to Manual. This is better, but nowhere near perfect as the algorithm it uses to calculate boluses is, in my opinion severely flawed as it takes hourly basals into the calculation. In addition it needs to be in a severely limited site. On 1 May I am swapping to a tubed Ypsopump with Libre 3. From my study of CamApps already I can see how much more thought has been put into the algorithms. Good luck but be aware of the limitations.

Hi Patti and many thanks for your input and advice. For many people the omnipod 5 is fine, but for me I just couldn’t understand how it was going to learn my lifestyle, based on the fact I eat lots of protein salads and fish, no carbs like bread, I am up at 5:45 in the morning walking the dog, I’m in a classroom teaching. I’m on a tennis court coaching and I tutor till 8:30pm on some evenings oh and I also go to the gym. I often miss breakfast and eat late at night. Under my own control with an insulin pen, I have fantastic sugar levels. How will the Omnipod work around that? Also, I’m only 66 kg so very lean and we found out that the pod doesn’t work in certain required places on the body.

 

[nonethewiser]

Additionally, I had some connection issues with the Libre Sensor, to Omnipod, yet my smartphone was unaffected, which makes for issues surrounding reliability a real concern.

Only used Dexcom G6 since changing to Omnipod 5, had no issues whatsoever with them both communicating even when worn on opposite sides.

There's been a few members like @PhoebeC who have had issues when using Libre, so your not alone.

 

[PhoebeC]

Only used Dexcom G6 since changing to Omnipod 5, had no issues whatsoever with them both communicating even when worn on opposite sides.

There's been a few members like @PhoebeC who have had issues when using Libre, so your not alone.

Yeah the libre 2+ and Omnipod 5 connected less than half of the time, I was in manual mode a lot. I was told by insulet they must be worn within inches of each other, and as the libre should only be on the arm that was pretty impossible for me, for site rotation and playing a contact sport it made the main benefit of a small patch pump useless.

As I have said I am still giving it a good go. I really did love the omnipod dash, it wasn't perfect but it was the best control and quality of life I have ever had with T1. This O5 HCL seems about the same level of control and worse quality of life, the pods are a bit shoddy and the algorithm cannot handle my menstrual cycle or match days, which was the same issue I had, but I had worked out the menstrual cycle with trail and error. It seems slow to understand the previous pattern, takes a few days to work it out. Where I could set my manual O-dash onto the right background set up.

I know another T1 who plays rugby with a HCL, but hers is tubed, I don't think that would work for me. We will see. I know my husband thinks O-dash was better, less alarms, less impact on my life so we will see at my next appointment. I can go back to O-dash. I hope they let me keep the Dexcom G6, but again not the end of the world if back to libres.