Ypsopump and Libre 3

[trophywench]

Went to Diabetes clinic yesterday and DSN got my Libreview results up on his computer, just like I always could on mine, after I downloaded the reader, which I used rather than using my phone cos it saved me having my phone 'to hand' all the while. That not now being a choice, all has to be done via CamAPP on my phone I therefore opened Libreview on my phone but no results from my new pump, so ?????

Rang Ypso Helpline and got a very helpful response. Apparently, the way the Libre 3 communicates with Libreview now is via something called Diasend which yeah could be downloaded to my phone if the hospital have told me what details to tell it which means you see the familiar upright column in pretty colours with the 'time in range ' as a block in the middle with hopefully less above and below the green part Or I can just look at CAMApp, click on the 3 horizontal lines in the top left hand corner, scroll down and click on Statistics, which then asks 'for how long?' so as it's only been 5 days I clicked on 'Week' - and there it was - 81% ! I hardly ever managed much over 70% and definitely haven't for the last couple of years. Impressed? - I ruddy well am so far!

 

[Natalie123]

That's impressive @trophywench Good to hear it's going well and the helpline is actually helpful! I now have a date fixed for mine on 24th February and I have to fill out a form with all my basal rates etc. Unfortunately there are a few parts of the form that don't really make sense so I'll have to ask the nurses about those. I'm trying not to get too overwhelmed and anxious about it but it's difficult. Good to know that it'll be worth it in the end!

 

[SB2015]

Very
Leased that you are already seeing some benefits @trophywench , and hopefully with a lot less effort.

 

[trophywench]

That's impressive @trophywench Good to hear it's going well and the helpline is actually helpful! I now have a date fixed for mine on 24th February and I have to fill out a form with all my basal rates etc. Unfortunately there are a few parts of the form that don't really make sense so I'll have to ask the nurses about those. I'm trying not to get too overwhelmed and anxious about it but it's difficult. Good to know that it'll be worth it in the end!

I really hope it is for you too, Natalie.
The Helpline lady was extremely empathetic to my feeling of wanting to understand EXACTLY how and why is does what it does and was also very truthful saying that they've been victims of their own early success so that ordering extra supplied might currently be slower than they intend it to be. Hence we (ie Ypsomed users whether looping or not) must currently all be patient patients, and we don't at this very moment, have any choice about that. Plus - they rolled out a revised computer system across their offices a couple of weeks ago, so they have internal teething problems with that, too.

 

[trophywench]

Hey Ho - some time last evening my Libre sensor failed at 9 days and a few hours. I didn't know this until after we had our tea, for which I'd had a guess at the carbs - it was stew we'd made on Friday so it's always a guesstimate cos eg no idea of the weight of the 2 onions let alone the parsnips, carrots, swede and leeks - and anyway who weighs ANY veg after they've been peeled and prior to chopping ? Not me anyway. No spuds in stew in this house, should be substantial enough without. So yes it did have flour in it and also a few gravy granules cos it was a bit pale. Totally forgot to look at what BG was doing after tea - too wrapped up watching telly. Hadn't seen any of the latest Masked Singer but the semi final last night and nowt else on we wanted to see - so you have to listen closely to that, followed by the 1% Club ditto. Hence an indeterminately long time until I looked at it again when Oh bugger - telling me it has lost connection. It's told me that it's connecting with the 'roundy roundy' symbol that we see our computers do loads of times since I've had it and since that has shortly after refreshed itself and acted 'normal' I didn't at first take very much notice, just glanced at it again a bit later -still no joy.

Decided I was unlikely to die overnight so went to bed and slept OK (with only the multiple need to empty my bladder 3 or 4 times starting at approx 3 or 3,30am at half hourly intervals. Always hope after 3 I can now sleep but sometimes I'm fooled. 3 last night, so that was OK. (ish, for me) ) Did a FP when I got up this morning and I was 8.9. Didn't react to that really, as yesterday morning I was 9 ish but by lunchtime that had reduced down to the high 5s. OTOH of course the pump was doing its Auto mode thing and today it hasn't been able to as it was not in contact with the sensor. Aaagh.

Husband put a new sensor on my arm but to start it, you open CamApp and click on the '3 horizontal lines' in the top LH corner, which then shows a menu, you scroll that menu up, right to the very last item on it 'Start new sensor', which you click on and follow the instructions on it.

So - husband replaced my Libre sensor and started it by pointing the back top of my phone, with CamApp open on it, over the new sensor, it made a quite nice sound and the instructions said to hold the phone absolutely steady for a bit so he did that, and eventually CamApp told us the Libre had 58minutes to go.

Until that hour of 'warmup' had expired, nothing occurred and then, thank goodness, Automode resumed so it resumed telling me my BG and I could then tell it what carbs I was about to eat for my lunch. By which time Libre said my BG was 7.1. Considering my target is 6.5 I think that shows my hourly basal rates are near as damn it is to swearing, correct. Phew.

What I have not discovered is what to do about the failed sensor since there is no info on the Abbott Libre website about failed Libre 3 sensors. Or indeed, how to get any more of them - DSN said they'd be sent to me automatically so OK BUT, hang on, why should the NHS have to pay full price for the failures? And the 6 I was sent upfront won't now last quite as long as they should have. Will ring DSN on Monday to find out what to do about it.

The sensor itself was still stuck to my arm like the industrial glue Amtico use for mega expensive industrial flooring that they have to wear protective clothing, breathing apparatus, time limits, restrict access etc when using - and one of the reasons it's expensive to install - because It Takes Quite A Bit Longer To Put In and It Lasts.

Quite a palaver - but knowing 'how' now hopefully this one and the others will all be OK. Just a thing you can't achieve in a couple of seconds and have to allow time for.

I said, Oooh, Libre, I'm not sure cos they're not all that reliable and though Libre 2 has been more reliable than Libre 1 ever was, a lot of early failures in 2024. No, no, L3 is FAR more reliable, Jen! they said.

 

[dannybgoode]

Right on the Abbott home page is a link to click to fill in a form to report faulty sensors. It's a little lengthy but they usually get a replacement out pretty quickly...

 

[riddler]

Otherwise phone Abbot up about the faulty sensor. They will probably ask for the serial number of the sensor which can be found in CamsAPS. They may ask you to send the faulty sensor back to them (they provide a pre-paid envelope). As stated replacements are sent out quickley.

 

[PattiEvans]

Jen, can I ask a couple of questions about this system please? Do you control it from your phone? Or do you have to get it out of your clothing to bolus? Also you had a Combo pump and I don't know if you remember, but you used to be able to increase/decrease basal by 0.01u. What's the minimum for the Ypsopump? Also what's the minimum target you can set for it to correct to? The system I had (Omnipod 5 and Libre 2+) the minimum I could set it to was 6.1 whereas I'd prefer to set it to 5.5.

At present I'm using Omnipod 5 in manual mode and achieving 90% TIR which is better than the HCL was. I asked to go back to Omnipod dash and DSN said no, but I could have a Ypsopump.

 

[trophywench]

@PattiEvans - Controlled once in use via CamAPP via mobile phone but at the moment must be an Android phone, not licenced for use with Apple, just as Mike has commented. You have to program them all in hour by hour on the pump (same as Combo) and the range starts at 0.00 - my lowest one is 0.26u and I don't officially know how low it can be set but since one of the ladies starting the same day as me was only 4 weeks pregnant and you'll probably recall the first semester is usually Hypo City I would think the lowest could be Nil - but if you have to set some number perhaps you can tell it 0.01. Also, same as Combo, basal is set hour by hour in increments of 0.01u. The minimum it can correct to is definitely under 6 because I said to the trainer setting mine that I'd like 5.5 and she said in her opinion that 6.5 would be safer to begin with so I said Oh, OK then. This closed loop system really is very different to others that people have described and is very fast responding to what Libre tells it, Patti, dropping the basal rate down by the time I've read the alert on my phone telling me my BG has dropped and certainly down as far as Nil if it continues to drop.

So far, despite not yet understanding precisely how it does what when - I'm happy with it.

Not clear to me - are you intending to closed loop with it, or manual?

 

[PattiEvans]

Hi @trophywench I need to ask the DSN a few more questions i.e. would I be able to loop with it etc etc. I mean would they do the training, does the Libre 3 cost the same as the 2? Also need to do more research on the Ypsopump. Ideally I'd like to be on HCL with it, but so far my experience of HCL was very poor. However, I think that might have been the system I was on rather than HCL itself. Someone else on here is also struggling with the Omnipod system. The DSN isn't very approachable when she doesn't want to be, other times she can be great.

Though for some time I've been considering whether to ask if I could go back to a tubed pump. I find the pods rather difficult to find sites for - given my almost 79 year old body is no longer svelt and bits stick out so avoiding siting the pods on those bits is necessary, otherwise clothing catches and can pull them off. Plus I've never liked the 0.05 increments which is all you can do with pods.

There's a lot to consider....

 

[trophywench]

I'd be sunk without a trace with such a blunt instrument as the Omnipod then - Good grief ! Using the Insight I had basals to 3 decimal places - and have never in my life needed to increase or reduce a basal rate by a whole 10%, let alone 'half a unit'. I generally go for 5% and round it down, before adding it. My bolus rate has increased from 1u:10g to 1u:12g and mid afternoon onwards basals increase into the 0.4s and 0.5s. You know very well that my frame is smaller than yours so my flabby bits became flabbier several years ago now even though I do weigh more, 62kg. So 9st 12lbs ish in old money. My old fighting weight was around 8 and a half stone and I'm not even trying to get to that now cos I am fairly comfortable where I am and Lor' knows I can't do anywhere near as much physically as I once did, so don't want to get any feebler. In any event I've very long considered the O to be far too large for my body. Takes up too much space on me plus sticks out too far, without any other snags.

I think you really WOULD get on with the Ypsopump quite well, the pump itself is tiny, 3.5ins x 1.5ins x under 0.5ins - but you hardly ever need to touch it unless you're changing a cannula or a reservoir or both. The cannulas are VERY flat and don't even stick above the skin as much as the Roche, very rounded edges so eg knicker elastic doesn't catch on it, just slides across with Swiss efficiency. Applicator for the cannulas, far smoother quieter and gentler than the Roche ones. I think the Libre 3 is most likely the same price as the 2, because my clinic told me I could have any pump I wanted but if I wanted it sooner rather than later the only two they could get easonably quickly were the Omnipod and the Ypsopump for current Libre users. I replied I'd rather fancied the Ypsomed as first choice anyway, so the sooner the better please! They do a silicon cover with a clip and a 'side of the bra' hanger thingy plus some other accessories 'not currently available' but ISTR you were allergic to the Roche ones ? (if not you, sorry. I know someone was!)

 

[trophywench]

Oh PS - when you tell it to administer a bolus it doesn't lob it all in at once - it delivers it gradually. I have yet to discover the details of what it actually does when to achieve this. (ie X percent every Y minutes or what over Z amount of time.) At the moment I don't really need to know this but just not having that sort of detail immediately to hand if I 'just bother to look in the manual' seems alien! 🙄

 

[PattiEvans]

I'd be sunk without a trace with such a blunt instrument as the Omnipod then - Good grief ! Using the Insight I had basals to 3 decimal places - and have never in my life needed to increase or reduce a basal rate by a whole 10%, let alone 'half a unit'.

No, not half a unit. 0.05 of a unit. Whereas the Combo was 0.01 of a unit. I didn't know that about the pod until I got it. Apart from it's size I loved that Combo pump! I used to work out what to increase by percentage of the basal per hour and often it was like 0.02 I needed to add or decrease. I'm seriously considering whether to ask for the Ypsopump. One disadvantage (to me) is that we still go away on hols a lot and if it broke down I'd have to revert to injections. Whereas if it was an Omnipod going wrong I'd just change it... or if it was the control unit (PDM) they lend you one to take on holiday. I still take the pens and needles, but I haven't done an injection for 12 years, or it might be more. I can't recall when I first started pumping. Once the combo handset broke, but I had the one from my old pump with me and set it up with the aid of the online manual.

The bra clip sounds OK. I wasn't allergic, must have been someone else, but I'd have difficulty wearing it under my arm. I've lost a lot of weight since we last met, but it's gone in funny places... like I have no buttocks any more and skinny legs, but carry any weight I do have in front. I do very occasionally wear a dress e.g. we've booked another river cruise and they have one dress up night. Plus I've bought a dress for a wedding in July.

It really does need a lot of thinking about.

This closed loop system really is very different to others that people have described and is very fast responding to what Libre tells it, Patti, dropping the basal rate down by the time I've read the alert on my phone telling me my BG has dropped and certainly down as far as Nil if it continues to drop.

I'm impressed that you're impressed and particularly by how quickly it responds. I was never sure the Omnipod was reacting at all! I dunno what to do Sedge!

 

[trophywench]

You are correct of course - five hundredths of a unit. But you got my gist, a sledgehammer rather than a toffee hammer. in comparison.

Well - you are indeed dependant on the app, so how often do you usually misplace your phone for very long? or omit to charge it? Because I just don't use my phone for very much - or rather, haven't in the past - I've not previously been that bothered one way or t'other whether it has charge in it or not - NOW I have to be bothered, no choice. I can't tell you what happens when you travel elsewhere in the world. But, with the Roche pumps I've always had to revert to MDI anyway - although we've never flown anywhere ever since I've been pumping, was still on MDI anyway when we went to Oz via Kuala Lumpur - so doesn't bother me that much - would just need more than my usual one Flexpen to take with me and enough needles and test strips, although I still have plenty of both at the mo.

It also has the ability to record carbs eaten to treat or stave off too low BG as exactly that, so that the pump doesn't immediately decide to increase the insulin it's giving you when your BG starts to increase cos it thinks you've mis calculated your carbs at the last meal. In the same part of the App there's also the option to choose 'Slowly absorbed meal' - dunno yet but presumably that's an extended bolus. As I'm not due to speak to clinic for another week and I'll most likely want to eat eg fish and chips sometime in between now and then, might ring the Helpline tomorrow and if I get someone as lovely as the last time may also ask what you have, about holidays. Will have to play it by ear.

 

[trophywench]

I eventually worked up the momentum to ring Abbott this morning. Told the (foreign, as per usual) lady that I was using Libre 3 in combination with an Ypsopump and as that was all new to me this was the first time I'd needed to ring them with a Libre 3 failure. She told me to open the L3 App and she'd talk me through the troubleshooting. I can't said I, the Ypsopump doesn't communicate with Libre via the Abbott app, it uses its own App to do so. She could not fathom how it could possibly do that or why I could not instantly tell her either the sensor serial number or exactly what the error message was at the time. Yes I know it's written on the box - left at the hospital to go in their recycling bin rather than bringing it home to put in ours - same as the other detritus was. Such a temptation to reply because their computer programers don't trust yours and they are not going to risk compromising what they legally guarantee with third party things that they have no control of themselves. or maybe because their programers are evidently better than yours.

I managed to zip my lip and only think it, without becoming noticeably impatient with her - so I reckon I did really well, for me, there!

Just tedious needing to repeat your own personal info of full name and full address with Postcode and email address and telephone number at the end of the conversation as well as right at the beginning. Presume the logic is if I didn't immediately remember it all (again) then maybe I'm not really who I said I was, a few minutes ago?

 

[PattiEvans]

Drives me mad that English isn't their first language, but they gabble their version of it really fast. So I always begin the discussion with "Please speak slowly and clearly, or I will not be able to understand you as I am hard of hearing". Not an entire lie as I do wear hearing aids these days! FWIW the serial number is printed round the side of the sensors - or it has been on every other version of the Libre BUT you need a magnifying glass to see it! We inherited one from Julian's dad. Anyway the serial number still won't give you the error message. Ho hum!

However the Insulet (Omnipod) customer services people are even worse! Plus I am very unsure that their software is fit for purpose. If someone's control was blooming awful then they might think the Omnipod HCL is good, but I am vastly disappointed in it (due to what I think is poorly conceived software that doesn't truly address the issues and is a blunt instrument). I'm going to do more looking into the Ypsopump. I know that the head pump DSN didn't like all the combo pump users she inherited as she thinks that the idea of having a different basal for umpteen periods of the day is ridiculous, but she's not diabetic and I know darn well I need a lot of different finely tuned basals to get the best out of pumping. That, of course could well change with a well written HCL.

Oh and my phone is nearly glued to my side as I use it for all sorts... and carry on lots of conversations on WhatsApp with friends every day.

Take care lovely!

 

[trophywench]

Someone helpfully (they thought) told me the serial number is available on the CAMApp - but I can only find the current one that I replaced it with!

The L3 sensor is smaller than the L2s.

And - the 'slowly absorbed meal' bit lets me enter the carbs and calculates the bolus great but has no option to deliver the bolus - instead gave me a warning that delivering it all upfront might send me hypo before enough of the carbs get there. I do believe I already know that one! So back to the drawing board on that one.

 

[curlygirl]

I use the libre 3 and have claimed replacement sensors a few times using the same form on the abbott website as when using libre 2. There is a drop down option on the form for which sensor. The serial number is not on the sensor and the camapps fx shows current serial number but not others...as far as I am aware. The serial number is on the box and on the plastic cap from the inserter. This does not help claim a replacement if you have not got serial no, but if you have, the form on the website is a lot easier than ringing them.

 

[trophywench]

Online form - There were three options you could tick to explain what had happened to the sensor, one was it had fallen off and I can't remember the other, or a 3rd option 'Other' - well mine was 'other', it was still there and firmly stuck but just completely stopped working in the middle of the night. Pressed Submit. Immediate response - Sorry you'll have to telephone us blah blah.

 

[Natalie123]

@trophywench can I ask if you had to fill out a form with target glucose levels, bolus values etc before your pump appointment? I have one to fill in but I'm a bit confused! There's some things that I can't fill in yet like pump and sensor serial numbers. I can do my basal, correction and carb ratios but then it asks for a personal glucose target and a bolus calculator meal glucose target, do you know what these mean? Is the meal one a post meal target, like the highest you want to go or 2 hour post meal target or a pre meal target? No worries if you don't know, I'll call the DSN but thought I'd ask first!