Having all kinds of problems with Omnipod 5 and seriously thinking of going back to Loop Dash dev branch. Let’s discuss here.
Ok Here goes. Sorry if this is long:
I started on Loop Eros with Orangelink. When the dev branch came out I tried the Dash and was loving it. But then OM5 came out and promised to learn me and ignore my settings after a few pods and talk directly to each other.
Well, after nearly 2 months of OM5, I don’t like it for several reasons.
- On loop dash, a spike was 150-175 and hardly ever in the 200’s.
- I have high insulin requirements, so I carried a FIASP pen with me and used that for bolusing.
- As a result, I was able to stretch a pod to nearly 48 hours or longer. Under OM5, I’m forced to not use a pen at all and can barely get 24-36 hours of use.
- When I’m out and about like today when I was at the theater, I went to bolus 30 units that I needed, only to hear the <10 units left alarm. Since I had no pen, I was forced to stop the bolus and go high. This wouldn’t happen on my old hybrid system.
- Under loop, my last A1C was 5.8. I’m now creeping into the 6’s.
I asked my endo what he thought he said I’m getting older and he’s more concerned about lows than highs. He said the OM5 is much better at preventing them, landing you softly. He also said that it’s okay to go into the low to mid 200’s so long as you don’t stay there. I’m not sure I agree with that.
Can we have an honest discussion about the pros/cons so that maybe others in the same boat can benefit as well?
If the time you can keep the pod on is limited to the amount of insulin, get a concentrated insulin. Basically doubles the power of the insulin, so like having twice the capacity.
Fiasp isn’t available like this, but Lyumjev is. Not sure if the O5 can accommodate for that or not. But you could adjust you ratios to correct for it if the pump doesn’t.
Why is this? If that were my issue, I’d experiment with taking the meal bolus with the pen without telling the Omnipod that I’m eating. There might be some way to tweak the I:C ratio and pre-bolus time that I use for the pen to make it work.
But I suspect that I wouldn’t be able to stand the Omnipod-5 after using diy LOOP: I gathered from initial reports that the O5 might give me an A1C in the 7’s, and a time-in-range in the 70s, and I’m getting better numbers with LOOP.
(re-edited to mitigate my offensive original statements.)
Yes; this applies to all insulin treatment. With the Omnipod systems it’s just a matter of dividing or multiplying by the relevant factor throughout, once it is done carb boluses and correction boluses will be adjusted appropriately. It has to be done throughout; so if a profile contains lots of different settings each has to be modified, but so far as I know these profiles have to be entered by hand anyway when starting the O5.
The Loop algo requires using autotuneweb, or the corresponding Loop command line program, to update basal information and even then it has to be entered manually. I wouldn’t describe the O5 as “primitive”. In many ways I would reverse the description; loop has umpteen settings that have to be set by hand, requiring either reading reams of documentation written in a Loop-spefiic language (DIA, IC, ISF, BAS, TARG, to give an example of the loop acronyms in the AndroidAPS profile settings). This seems primitive; like the days when you wired the plugs by hand to connect something to the electric.
I’ve commented on TUD about the endo comments, but overall I think the message here is that we’ve still got no information about the real effectiveness of the O5 algos. AndroidAPS only worked for me after I’d done major modifications to my diet. It works now so I’m not going to try to fix it by moving to the O5 (if I even get the opportunity).
I wasn’t all that clear. I meant if the pump had a setting where you told it you were using 200 and not 100 for insulin.
Heck, not sure if any pumps have that?
@bpollina Your comments that the Endo liked the O5 for preventing lows makes me ask: Is your Endo really knowledgeable (practical experience) with the Dash-Loop combo or is he relying on your experiences? Was he your Endo while using Dash-Loop combo? How much experience does he/she have the O5 and it’s algorithm (I thought it was too black box-ish to know). I think you have much more experience than I, particular with the high insulin needs, so you or others with similar higher needs are the better sounding board. I’d say your experience is the best indicator to follow and it sounds like Dash-Loop was working well for you. So if you believe you’ve given the O5 enough time to determine effectiveness, then follow your experiences lead. Perhaps Loop, Tidepool, or similar will work with the O5 eventually and then be a better fit.
@jbowler I think its important to be clear which version of Loop being referred to: Loop_Master (released version), Loop-Dev, OpenAPS, AndroidAPS, and FreeAPS. You can look at: Compare Versions | Loop and Learn for descriptions. I believe AAPS has several more settings than Loop-dev for iPhone (though both use the same base code) and a much more complicated “intro” program to “release” those capabilities/settings. The Dash-Loop_dev combo for iPhone has less settings, a bit less configurability for user intervention without re-programming. Loop-Dev (iPhone) does not require use of Autotune, but it can be used for manual intervention. The Loop&Learn website has instructions and Youtube videos stating how to determine the settings; it does take some time, but I didn’t find it overly complicated.
@Hammer Good suggestion on the on the double strength insulin for large dosage users! I’ve read several threads on doing that both here on FUD (I think from @Chris or @Eric) and other forums! It takes slightly more math and good understanding of algorithm of the specific pump, but may be a good option for those needing high doses.
Yes. IIRC it has been discussed before; I’m not sure if it was here or TUD and is several years ago. This is from memory, so may be inaccurate. Apparently another highly insulin resistant T2 was using the pod with 500IU/mL insulin and this was, IIRC, a change that her(?) endo made. All the numbers were divided/multiplied by 5 as required.
So far as I know Insulet have never obtained FDA approval for use with anything other than 100IU/mL, I don’t know about other pumps but I suspect approval would require a complete set of tests using the different insulin strength.
I checked the O5 manual; be careful there are now copies of this manual on the web which don’t have all the pages and most likely aren’t kept up-to-date. I just posted a link to the English/mM version, I believe I’ve posted a link to the US/mg/dL version in the past, make sure the link comes from https://www.omnnipod.com/
So far as I can see there is nothing in the UI (it would be in “General Settings”) to change the IU/mL. I guess Insulet may have it as a firmware option on the pod and it will be a value in the PDM software that could be changed, but it apparently isn’t a variable that can be set in the UI.
This is my view, too. I’m hoping to stay with DIY Loop.
I’ll go out on a limb here and reinforce that Omnipod 5 works great for me…I’ve never tried Loop so I have no basis to compare. I have no problem with switching back and forth from Manual to Auto to make the Om5 do what I want it to do. But the thought of overloading my pea brain with more tech needed to run loop and keep it running does not thrill me.
Maybe every one of us could get better (and easier) BG control with Loop maybe not but at this point I am happy with the ease of running the “good enough” Omnipod 5. But that’s just me, YDMV!
I was using freeaps. My doc said I was the first one to do loop and he knew nothing about it so couldn’t advise on dosage but was willing to watch my Dexcom G6 numbers and let that speak for itself. He was really impressed with my numbers on the Loop Dash/Dev branch. I still haven’t decided.
It does take a little bit of effort to get it built and then get the numbers dialed in correctly.
But once you have it set up, it does not really take any work to keep it going.
I’ve asked a few questions because I’m trying to make an improvement to my version. More of a customization. But I’ve been running the same version for about 6 months or so. No changes required.
Thanks for that perspective! Trying Loop is certainly not out of the question for me…some day. I am the opposite of the retired guy with too much time on his hands. It’s crazy how busy I’ve gotten my self.
One piece of the plan is to keep my head above water by putting as little maintenance as possible into the pumping, and Omnipod 5 fits the bill so far. I also like the support from Insulet, even though I have not contacted them much. It feels like if I do run into trouble I will be able to solve pumping issues pretty quickly with the support available from Insulet. I just don’t get that same feel about Loop, probably because it’s all new to me.
Like Eric said, Loop-dev takes some initial effort, but after you have it going, there’s nothing but monitoring the development ZulipChat group to keeping it going; a few people have issues, but for the great majority its straight forward. Like Eric, I’ve been at it right at 6 months, but I’m using it stock (unmodified). In that time, I’ve rebuilt once due to a warning by the coding team of a potential issue. I plan to do another build this week, not because of any problem, just to update. There’s also now a script to do the build of the dev version for you, that’s what I’m going to try. All that said, you still need a Mac, an Apple developer account, Xcode installed, and be comfortable with the potential need to rebuild…even when Loop 3 is released those needs will still exist. Of course, I am the retired guy, not that I have all that much time on my hands…seems tasks always grow to overrun any void!
How long have you been doing it? I’d give it at least two months before I throw in the towel. I found Control IQ to be meh compared to Loop for the first month. Now the ease-of-use makes it way more appealing.
I don’t like the Om5 either. I started it 7/1 and the first night it dropped my sugar to 43! It was giving me micro boluses even though my sugar was in the 70s overnight. I’ve had 3 other incidents of the same thing happening.
The other thing I hate about it is it gives laughably low boluses when my sugar has been elevated overnight. I adjusted different settings many times but I’m tired of the guessing game.
I’m looking into AndroidAPS with my Android phone and Dexcom G6. It’ll take me a while to figure it out, seems complicated but I have to try it
When you were getting micro boluses during the 70s do you know if dexcom and omnipod 5 were still in contact? It will go into automated limited mode when dexcom and omnipod lose contact. If you go onto your history for that day under auto events it will show — instead of a cgm value next to insulin amount.
This happens occasionally to me even though I place both on the same side of my body. Thankfully I’ve never experienced this while low at night. I’m sorry it happened to you it must have been frightening.