I was just doing the legwork myself to look into the O5. Keep me posted. Been up and down all hours of day and night eating cruise ship food all summer and my control has gone downhill a lot. Need something to take some of the workload off
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I’ve been 100% Auto mode since last week, on my third pod since modifying my settings. The one setting I’ve tried to modify but the PDM seems to be reverting back is the “Reverse Correction” under Bolus settings. I want it to be OFF, I have it switched off on settings, but the bolus calculator continues to do the reverse correction in the calcs. It’s that -2.6 units on the calcs. That is the calculated reverse bolus to bring my BG to 110…which I don’t want to do.
Tried to call Insulet but the wait time was 45 minutes so figured I’d see if anybody has successfully turned the reverse correction to OFF.
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This paper covers a lot of the adjustments to settings that might be needed when starting the Omnipod 5. The reverse correction (and why it should be turned OFF on my PDM) is covered on Vignette 3. Still hoping Insulet gets back to me about why mine is still on even though the PDM says it is turned off?
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Maybe I’m being obtuse, but why do you think the reverse correction is on? The screen you show tells us that if the reverse correction were applied it would subtract 2.6u from your meal bolus, which normally would be 6.4u in full. But did they actually try to infuse only 3.8u, or did they really give you the full 6.4u? I can’t tell from the screen how much insulin they actually gave. It could be that they always show the arithmetic, but change the actual bolus given when the reverse correction is on.
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There is a bolus screen that I should have photo’d…yes the bolus calculator offered me 3.8 U. I have usually ignored the reverse correction and entered the bolus amount that I want (in this example I went 6 units). As it turns out, I battled lows all afternoon, I probably should have applied at least a partial reverse correction.
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Well its not only you. I turned off my reverse correction but it still shows up every time I’m under 110 even when there’s no IOB.
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Hi @John58 . . . I’m really starting to understand why you are hovering back and forth between Manual and Automated mode. What I’m finding (probably have done 8-10 pod changes, don’t know exactly how many) is that the basal based on TDI and the Algo is just too low for my needs, like about 25% too low based on my pre-set basal rate that I know is dialed in. Therefore, I’m trying to make up the basal deficit with manual correction boluses and that just isn’t working well. For example, yesterday I was 23% basal and 77% bolus. I’ve read that the algo tries to get you as close to 50/50 as possible so to me that makes no sense.
I’m really hoping some tweaks are made to the algo because I am not going back to a tethered pump, even though based on my limited use of the OP5, the CIQ algo on the Tandem seems to work better for me.
Any thoughts would be appreciated.
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What’s up brother. Based on my experience thus far, I’m not sure if OP5 algo will be good for you as it stands right now. I think the Tandem CIQ algo is much more aggressive for people who want tight control and it works off the basal you input. I’m finding the basal it’s calculating for me is about 25% light and that basal deficit is causing rises that I need to correct with manual boluses. Obviously, this method takes all of the “Automated” part pretty much out of it. Give me a couple more weeks though and I’ll continue to report back.
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I had similar issue with Tandem X2, and impacted the way it cut basal by tweaking my Correction factor (40 to 45). Minor change, but it really helped.
On xDrip, there was noticeable flatter line and lower estimated A1C and average BG.
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@mikep I started in on 100% Auto mode mainly because I felt like I was spending too much time in Manual mode. I went for a few months of using manual mode roughly 25-35% the time. So I am now on pod 3 or 4 of 100% auto and getting better BG control than I had with all the switching back and forth. It has been running about 40/60 % basal/bolus.
Here is my last 24 hours (70-150 range in Clarity):
When I stopped using Manual mode, I upped my ICR by about 15% and dropped duration to 2.5 hours. I was still spiking after breakfast though. So I changed my “Target Glucose” to 130 from 2 am to 5 am, and 110 the rest of the time. This tricks the algorithm into giving me some basal starting at 5 am, helping avoid the spike from breakfast. It was counterintuitive to raise my BG starting at 2 am but this tweak made a huge difference.
Currently I am experimenting with the smart bolus calculator, starting to use the numbers it calcs and see what happens. Ignoring the bolus calculator gave me some lows so I will let it do it’s thing and see what happens. I have been breaking my meal bolus up into a pre bolus of up to 5 units about a half hour before eating and the remainder, usually 2-3 units, closer to meal time.
Anyway I feel a little like the blind squirrel finding nuts with this Auto mode but it seems to be doing it’s thing pretty well right now.
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@John58 very interesting with the overnight tweak. I will try this as I am getting spikes in the morning likely due to DP that I assume my Tslim was covering with CIQ. I does sound counter intuitive but I understand how it could work. I’ll let you know how it goes!!!
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I spent more than a month waking up early to switch into Manual mode, just to start my morning basal. This 2am tweak does not work as reliably well as the manual way but is close…and much easier.
Here’s the dawn graph from last night, the red bar is insulin suspended by Auto mode.
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That looks great. I’m going to try 130 from 2am to 5am as you suggest and tweak from there.
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Got this reply from my insurance plan coordinator re the coverage for OM 5
Hi Sam,
I have contacted our Account Executive at CVS regarding your request and he has advised that the Omnipod 5 is a relatively new product that is under New To Market block. It’s a disposable insulin pump that the manufacturer is only allowing to go through pharmacy and not medical. They are starting to see more clients cover them, or think about covering them even if they don’t currently cover continuous glucose monitors. There is little risk of “abuse” with these products, and can be much more convenient for members. CVS is coming out with an opt-out strategy that they will be sending out to clients soon.
Most clients don’t cover continuous glucose monitors and insulin pumps through Rx, but the manufacturer is almost making it a necessity to cover disposable insulin pumps through Rx because there is no other route for coverage.
I will definitely keep you updated as soon as we receive the strategy CVS will be using.
I’m sorry I couldn’t offer you a better reply, however I will follow-up with CVS to see what we can due to push this along.
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Has anyone tried it with fiasp? Any comments?
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Yes I have been using Fiasp with the Omnipod 5 since I started, no problems at all. I have been limiting meal bolus size to roughly 5 units max. If I am going to have a large meal (my breakfasts are always about 60-65 grams of carbs) I pre-bolus with 5 units about a half hour before meal time and take the rest of my bolus closer to meal time. I tried Novolog for a few pods back in July but decided Fiasp was working better for me.
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Got a very similar response from my insurance as well when the OP5 just came out. For me, it was simply my insurance hadn’t added the OP5 to the prescription coverage yet (I believe they do a review twice a year for new drugs etc). I was told that the next review would be July 1st and magically after that review I was covered. I’m wondering if that’s the same thing going on with you?
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You still have Caremark too right?
I’ve encountered all kinds of weird stuff with them… the previous omnipod and dexcom has always been listed on their master formulary, but apparently by employer is on some kind of budget plan or something that doesn’t cover it— so when I look it up through my specific plan portal it shows both as not covered. This lady who emailed me has override authority (that’s how I got afrezza covered early on) but apparently that doesn’t extend to whatever she’s calling things that have a “new to market block” I guess.
Yes but ended up getting my OP5 through a Pharmacy called Gentry. Never heard of or used before. CVS/Caremark is still my mail order.
Interesting. Cvs Caremark manages my benefits regardless of which pharmacy I go to, so I don’t think it ultimately matters where I’d actually collect the pods as long as someone can convince cvs ti cover them for me. I’m not sure if I could pay cash for them otherwise or what that would cost…