Loop and Learn had a great call tonight answering questions about it. It was done by a site nurrse and a few people who were in the study. I guess they must have lifted the NDA. Some things I learned in no particular order:
The goal range is 110-150 in 10 unit increments
If you don’t want to use their controler, you can use a Samsung Galaxy S10 for now.
If you use theirs, data uploads to Gluco and their locked down phone comes with a SIM card in case you don’t have wifi or are not in wifi range. Uploads once an hour.
The Omnipod 5 and the Dex G6 talk directly to each other, so the only thing you need the controler for is bolusing or overrides.
Algorithm is based off of total daily insulin.
It is very good at preventing lows
Basal profile is for the first pod only. On pod #2 and after, it ignores the basal profile completely.
So changing the basal rates etc. does NOTHING after pod # 1
Extended bolus is available in manual mode only but studies showed that it wasn’t necessary
Algorithm looks out over 1 hour and adjusts every 5 minutes
Very user friendly interface
The pod itself is the same size as all the other pods.
Eventually they will open it up to more phones, and iPhones are on the horizon with no time table.
Runs on bluetooth so no rileylink or equivalent needed.
Originally was line of site for the 2 but they tweaked that a bit so is not as much of a big deal. Just don’t put on your stomach and the other on your but or something that far where the signal has to go through your body.
Whatever. A dozen donuts or eating like a jackass or taking insufficient insulin is also good at preventing lows. So what. Preventing lows is easy if you target 150.
Again.
Wow, it can learn all it needs to learn after 1 pod. After that, “Sit down and shut up, user. We don’t care about your basal rates. Our algorithm knows what it’s doing!”
That may be true, and if it doesn’t work well they can come out with a software update after the testing and FDA approval process is followed. But hey, it might work. Not now, but eventually I think the algo’s will be total black boxes that work well, but it does appear a bit early for that. Especially when giving the user the option to take control doesn’t take much work to accomplish.
From the interview, I gather that they start with your basal profile, and do a gradual autotune kind of operation on the basal schedule when they notice they’re doing lots of corrections or suspends that suggest your basal settings have been suboptimal. The tuning is also responsive to changing tdd, as over time this is a signal of changes in insulin sensitivity. But they don’t autotune ICR or ISF. Those knobs remain yours.
To me, that makes some sense as a potential way to reduce the burden without locking you into a starved-for-insulin regime as experienced with the Medtronic closed loops. We’ll see how it works in the field, but to me it’s not an outrageous bozo design choice. And in the trials lots of adults running a target of 110 got TIR in the 80s, so it’s not obviously a bad algorithm.
And they claim that they did a real good job of aggressively dosing to fix highs without causing subsequent lows. Again, we’ll see.
I for one am ready to give it a try despite all the nay saying. I am hoping the algorithm is good enough to reduce BG spikes that occur when I am inattentive to my CGM…sleeping, driving, occupied with a time consuming task. At those times I will be overjoyed to consistently hit a target of 110.
At other times when I am more mentally engaged with my CGM I plan to use manual mode and shoot for lower BG. I have my doubts about exercise mode and will probably stick to my routines of reduced temp basal etc.
That’s what I automatically assumed they meant, seems fairly clear to me. It implies that it changes the basal within a 24 hour time period. Not sure I want that, but if it just gradually drifts it to a fixed number that’s fine, i.e. I don’t what the feedback loop to have a half time of less than 24 hours.
@bpollina Thanks very much for the info! If it works, marvelous! But…and it’s a big “but”…I have to join @Eric (though not quite as stridently) in disliking the black-box approach that I’m supposed to trust my life to. I’d much more prefer an open system that let’s me know how it works just for mental health sake, if not for knowing how to comment or recommend changes. I don’t care for corporations that say “trust us”, I no more trust corporations (large or small) than I do the Sackler family! I had high hopes…time will tell!
Trang Ly said the algorithm adjusts using a time-weighted lookback over several days. I gather that they want to be responsive enough to adapt for things like an illness, a hormonal cycle, or a 4-day camping trip, without over-compensating for any single-day aberration. Anyway, it was clear that they had smart people thinking carefully about how to do it in a sensible way, and they expect to learn and improve as the data come in.
Some of the loopers asked if there was any possibility of some kind of “expert mode” that would enable lower targets and more controls — maybe requiring some kind of demonstration of proficiency before gaining access to these features. Trang Ly fully understood this, but didn’t commit to anything.
So with a normal pump setup, if you know your basal needs are going to be higher or lower, you can adjust it ahead of time. For stuff like what you mentioned, camping trip, hormonal cycle, etc.
If there is no basal profile that you can adjust, how are those things factored in? Does it have to wait until you are high or low and adjust?
As I understand it from her comments, when the BG starts to rise (or fall) unexpectedly, they give insulin corrections or suspends, and they become increasingly aggressive as the BG gets further out of range. So yes, it is purely reactive, but their claim is that this does a pretty decent job.
If you or I were anticipating unusual conditions while wearing this pump, we might choose to switch out of automatic mode and into traditional dumb pump mode, where we have the familiar control over basal and dosing. I don’t know whether manual mode would completely disable the automatic safety suspend for lows, i.e., would it be like going from Control-IQ to Basal-IQ, or would it go all the way back to full-manual only. But the algorithm designers evidently think that most people just want the pump to try to take care of it.
I interpreted her comments to mean…manual mode more or less transforms the Omnipod 5 back to the Dash. Which does not have automatic safety suspend but does have all the manual features needed to adjust basal manually for unusual conditions.
One other tidbit from the youtube was the rollout to customers. She was pretty non committal about timing but mentioned two actions needed to get on the interest list. 1. Start using Dash and 2. Sign up on the interest list at Omnipod website at “Podder Central.”
Well, not purely reactive; corrections performed inform the underlying algorithms of possible need to raise or lower the basal. It’s all reactive however it gets done; a correct bolus calculation will, in the absence of site issues, modified insulin sensitivity, absence of non-regular stress, non-regular exercise, non-regular hormonal changes, vaccinations, illness, non-functioning pods etc, perfectly correct for the imbibed carbs so long as they are calculated correctly, proteins are taken into account, no alcohol is consumed, digestive functioning is perfect, etc.
I guess for people who don’t experience excitement it might work. For me, everything I do is reactive; this is why I wake up two or three times a night to correct by blood sugars. It would be nice not to have to do that. It would be nice not to have to check my BG every thirty minutes or so. It would be nice not to go high, or low, because I don’t want to have my G6 yell at me every 5 minutes because I’m slightly out of range (the only option is to stick a gag in its mouth.)
I’m not a diabetic. I just have diabetes; anything that makes that go away for a few times a day is something I’ll try. I don’t want to be a diabetic.
Wow! What great comments! SO glad to see such lively discussion.
Yeah, I wish they would explain what is going in detail with how it makes decisions.
But the results look great. THey have now 2 YEARS worth of data, and from what I understand, there was not one person who quit the study and extended trial because of the device itself and how it was working. Some just quit because they didn’t like having anything attached to them and came from MDI. Everyone who already had a pump liked it and said that their results were amazing.
I just wish they’d hurry up and get it to the insurance companies so we can try it already! I really want to give it a try. I’m already looping, so it will be very similar except much easier to use.
