Technically, the O5 is supposed to revert back to manual mode settings as well.
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Iām guessing the kind of folks on FU are not the target audience. Itās made for the poorly controlled majority. Kind of like the new ilet pump that only asks for your weight.
The point of the algorithm I think is to take any basal decisions completely away from the patient or provider. This eliminates a lot of errors for the majority.
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I find that it actually does just fine when the Dex values canāt be found for me. It just goes into limited mode. Iāve never experienced a low or major high during this time. The algorithm has some kind of safety feature that takes into account the past values and what it has decided your Total Daily Dose is. I also havenāt had a problem during those wacky first 12 hours of Dexcom startup as well.
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You are correct. We are definitely in the minority of diabetics.
It is a rough experience at times when meeting some T1ās āin the wildā, and see how poorly they manage (if you can call it that,) their diabetes.
My endo always says how different I am than the rest of her patients. She actually likes talking to me about new and different topics for my opinion (she is a T1, and one of her daughters is also a T1, so she has a deep involvement besides just work.)
It feels really odd when the patient gives the Dr advice in their own specialty. That is still something that feels very strange to me.
But this community is why I have this knowledge (and my own inability to NOT take a deep dive into anything new like this and research and learn until my eyes fee like they are bleedingā¦)
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@Hammer Your comment on O5 not being aggressive enough is the most common Iāve read (other than connection issues with G7). Your comment about night time rise seems odd, most reports have been thatās a strong point for O5.
I note your comment about the VA but also insurance. Does your military connection allow use of mil pharmacies? I get my Dash pods thru them at no charge; the mil formulary search tool may āprior authā or ācheck with local pharmā but once the supply is started, they seem to continue the supply chain.
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@Josie and @Hammer You guys are right on the mark: many FUD folks arenāt the target audience. While Iād like to use an automated system (why I use Loop, have interest in iAPS, and had interest in O5, TSlim, iLet) with minimal inputs (certainly not Loop or iAPS), my goals is control of BG and ability to impact my results. The balance is time, brain power, and desired control weāre willing to commit to achieving them while still having a life with spouses, kids, grandkids, and friends.
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I went from pens to the OP 5,but wondered about Looping with OP Dash. Found this panel discussion by those who have used both very informative: Loop vs. Omnipod 5 Panel Discussion - YouTube
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@larry-butler Thanks for that! Very informative to hear these Loop users describe the pros and cons of Omnipod 5. Not sure I agree with everything they said but I have never tried Loop so not sure. For instance, they say Om5 is āBetter at handling highsā and āEasier to correct mistakesā compared to Loopā¦but I find the Om5 to be pretty useless for correcting a high. So I guess YDMV would apply to the comparison.
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All insulins seem to be faster acting in lower doses. I looked at lyumjev recently (6 hours ago) because my endo had suggested I might want to use it in place of Fiasp. Itās Eli Lilleyās take on adding adjuvants (they call them excitants, or something like that) to their existing āfastā acting insulin and it is available in U200 too (though they explicitly say not to use that in a pump).
With lyumjev a āsmallerā dose of 7 units tails out after 4.6 hours, whereas the standard test dose of 15 units takes around 6 hours to tail off. The peak onset is similarly accelerated.
So why? Not a scientific question of course, but could it simply be because the volume of the dose is smaller? Then U200 would be faster acting than U100 for an identical efficacy dose (same number of units, not same volume).
Bernsteinās observation always sticks in my mind; donāt do more than 5IU, or is that 0.05ml?, at a time.
Or maybe donāt bolus for a meal in one shot? Thatās something we lost when we said goodbye to MDI; being about to do a single bolus with multiple injections.
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After only a LITTLE time testing on the Tandem pump. I need to rethink my profile again.
I thought I had it safe enough, but I have not been the simple flat line like I had hoped for. I basically did all my math for the U200 at 2.5x my normal setttings.
Well, in the Tandem pump, where you can still set basal, unlike the omnipo5, I have found that I am still a little too aggressive. I will fine tune a little more.
To your point on bolus size, with U200, I rarely use any bolus over, or near, 5 units.
Still, for the first time using a U200 insulin, let alone a ultra rapid type, and in two different pumps, I think it has gone well, and that I am impressed by it so far.
Now to just find my happy medium on my profiles to work with this insulin. I will work hard on this, so that once I figure it out, I donāt need to worry about it much, if at all (I like to do my work/homework upfront.)
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Or maybe try a mix and change ratio of U100 to U200 ?? Eg 50-50, 30-70.
Are you trying U200 to get more days and/or oomph ??
I started the U200 to get more oomph, mainly with the Omnipod5 I had.
And while it did help, I think it will do even better with the Tandem / Control-IQ setup.
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I have found that exercise is also affected more than I thought it would be.
Nothing horrible, but having IOB and doing any hard labor/exercise, will definitely drop the BG numbers pretty quickly!
I am finding that Control IQ works a little better with the stronger insulin, but I also have not really pushed my basals yet to truly take advantage of this insulin. I wanted to see how well Control IQ could do on itās own, without stronger basal profiles in place, to make adjustments of itās own.
It definitely works better, but I am taking the more cautious route.
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Here is what the Lyumjev website says:
Lyumjev U-200 cannot be given by an insulin pump.
Check your insulin pumpās user manual to see if it can be used with Lyumjev U-100. Follow the instructions in your pumpās user guide when taking Lyumjev.