After I was identified with sort 1 diabetes 22 years in the past, I by no means thought {that a} tubeless, automated insulin supply (AID) system would ever be doable.
At 12 years outdated, I used to be handed a syringe, just a few vials of NPH and R insulin (pork insulin), and was informed to check my blood sugar 10 or extra occasions per day and hope for one of the best. It was brutal.
A long time later, expertise has come a great distance, to say the least.
I can now bolus insulin remotely, test my blood sugar seamlessly by glancing down at my smartphone, and with the most recent Omnipod 5 system, not fear a lot about excessive and low blood sugar ranges.
The system is routinely adjusting my basal insulin charges for me, in response to what my blood sugar is, all in real-time.
This text will talk about the brand new Omnipod 5 system, my first impressions, and what you’ll be able to anticipate when you select this method for your self.
Desk of Contents
A brief historical past of automated insulin supply (AID)
Automated insulin supply, or AID for brief, has been the holy grail within the diabetes neighborhood for a very long time.
Even with conventional insulin pump remedy, individuals with insulin-dependent diabetes are sometimes strolling a tightrope of managing cussed highs and scary lows, typically feeling imprisoned by their blood sugar ranges.
AID gives hope to reduce not solely the highs and lows, however to lighten the psychological burden of a life lived with diabetes.
Folks with diabetes within the #WeAreNotWaiting motion have been hacking their outdated insulin pumps for years to attain hybrid-closed loop programs, however these have been by no means permitted by the Meals and Drug Administration (FDA), and weren’t really helpful by physicians, nor had any security ensures.
The primary system to obtain approval from the FDA, Medtronicβs 670g, turned obtainable in the US in late 2016. This technique made computerized changes to basal supply primarily based on Medtronicβs personal steady glucose monitoring (CGM) system, The Guardian, and was extraordinarily fashionable.
That was rapidly adopted by the Tslim Management IQ system from Tandem that turned obtainable in the US in early 2020, which was the primary AID system to work with the Dexcom CGM system, and didn’t require fingerstick calibrations (not like the Medtronic system, which requires calibrations each 12 hours).
The Guardian CGM wanted to be modified each 7 days, whereas the Tslim system, utilizing the Dexcom CGM, solely wanted adjustments each 10 days.
Whereas individuals have been very enthusiastic about these programs, hundreds of thousands have been holding out hope for the (then known as) Omnipod Horizon system by Insulet.
This technique could be distinctive in the truth that it will be the primary ever tubeless AID system, all run by Bluetooth.
Many individuals choose the Omnipod system because it offers extra freedom to train and really feel extra free, because of the lack of tubing. One additionally doesn’t have to droop insulin when doing issues like showering or swimming.
The Horizon system, now known as Omnipod 5, was slated to be permitted by the FDA in 2020, however the COVID-19 pandemic quickly induced a significant bottleneck within the approval course of and it was repeatedly delayed, to a lot dismay.
Lastly, on January twenty eighth, 2022, the FDA introduced its approval of the Omnipod 5 system: the primary ever tubeless AID system (hybrid-closed loop). The approval is for individuals with sort 1 diabetes aged 6 years and older, and is appropriate with Android smartphones and the Dexcom G6 CGM system.
Insulet performed a restricted launch in February, with an anticipated market launch in March 2022.
How the Omnipod 5 works
Itβs necessary to notice that this can be a hybrid-closed loop system, and customers nonetheless have to depend carbohydrates and bolus insulin for all meals and snacks.
You additionally have to let the system know once you plan on exercising, and thereβs an exercise function the place you’ll be able to cut back your insulin wants when youβre bodily energetic.
The AID system will, nevertheless, routinely alter basal insulin charges in response to blood sugar readings twenty 4 hours a day.
The system is much like their earlier variations, the place a pod must be changed and full of insulin each 72 hours, and capabilities with the Dexcom G6 CGM, which must be changed each 10 days.
My first impressionsΒ
I used to be fortunate to be a part of the restricted launch group and acquired the Omnipod 5 system on February eleventh, 2022.
My first impressions have been that the private diabetes supervisor (PDM) seems to be like a smartphone (most likely as a result of it’s one), and the pods (self-contained insulin reservoirs) look remarkably much like earlier variations of the Omnipod (each the Erros and the DASH use pods).
The pod now βtalksβ to the Dexcom CGM sensor, so your basal charges will alter routinely even when your PDM isnβt close by (you solely want it close to you to bolus). Alternatively, when you use an Android cellphone, there’s a appropriate app that you should use to your PDM as an alternative, and bolus straight out of your smartphone (how cool is that?!). Since I take advantage of an iPhone, I opted for the standard PDM.
There may be phrase that an iPhone-compatible app is forthcoming.
I had a two-hour coaching session and rapidly jumped into auto mode (why wait?). Itβs been unbelievable.
Iβve solely been on the system for 2 weeks, however Iβve already seen just a few vital enhancements to my well being.
Improved sleep high qualityΒ
After switching into auto mode, I bolused for a standard dinner, ate, and acquired prepared for mattress.
Like many individuals with diabetes, Iβm used to not all the time getting a lot sleep at night time. Between high and low blood sugars and their accompanying alerts and alarms, I typically get up between 1-4 occasions at night time.
If Iβm not woken up by any alarms, I normally am thirsty or have to pee at the least as soon as, so after I awoke the following morning, after a stable 8 hours of sleep UNINTERRUPTED, I used to be ecstatic.
I took a fast have a look at my Dexcom graph and noticed that my blood sugar stayed between 110-130 all night time lengthy, and I had no highs and no lows.
Most of my nights appear like this now, and the sensation of being absolutely rested is unbelievable. It’s a full pleasure to really feel like diabetes isnβt stealing my sleep as a lot because it used to, and sleeping by means of the night time is certainly one thing that Iβm trying ahead to getting used to!
Fewer train disruptionsΒ
I’m an avid athlete who workouts between 6-7 occasions per week. I really like working, climbing, swimming, biking, and weightlifting, and one of the vital irritating elements about diabetes is how typically low blood sugars appear to get in my means.
I additionally dislike having to eat earlier than train, as a result of if Iβm attempting to drop pounds, it could actually generally really feel as if Iβm defeating the aim.
I used to go low whereas exercising almost every day. Properly, since being on the Omnipod 5, I’ve had one low blood sugar within the two weeks that Iβve been carrying the machine. One!
The system enables you to set a goal blood sugar (in my case, I set it to 150 mg/dL), and it decreases your basal fee (or pauses insulin supply) till it could actually predict you’ll attain that increased quantity.
You’ll be able to set the period of time youβd wish to be within the βexercise functionβ, anyplace from 1-24 hours, and it’ll routinely expire, so when you neglect to show it off after youβre performed, you donβt have to fret about increased blood sugars afterward.
Every day, I set my exercise function to βonβ about 45 minutes earlier than I start my train routine, and it easily will elevate my blood sugar simply sufficient so I donβt crash, after which after Iβm performed, will deliver it again all the way down to a traditional vary. That has been wonderful.
Much less psychological burdenΒ
Total, being on the Omnipod 5 has lessened my psychological burden of dwelling with sort 1 diabetes.
One examine has proven that individuals with diabetes make an additional 180 choices almost each single day simply to take correct care of themselves, and having an AID system looks like these choices have been lower in half.
I donβt have to micromanage my basal charges throughout the day, and Iβm not waking as much as low alarms at midnight in an effort to pause insulin and have some juice anymore. Iβm sleeping higher than ever earlier than.
Train is a breeze (and I can lastly train with out such a concern of going low!).
And whereas dosing insulin for meals feels nearly the identical because it all the time had (you continue to must depend carbohydrates and bolus for meals and snacks), I do know the system will complement with further basal insulin if Iβve undercounted my carbohydrates to stop a excessive, or will lower insulin if Iβve taken an excessive amount of accidentally, to stop a low.
Whereas diabetes will all the time be a psychological burden on those that dwell with it (and their households!), having an AID system considerably decreases that burden.
Conclusions
Whereas automated insulin supply (AID) programs are nonetheless not a remedy for diabetes, I’ve discovered that the Omnipod 5 system has considerably improved my sleep high quality, my skill to train, and has decreased the psychological burden I expertise as a girl dwelling with sort 1 diabetes.
It’s, nevertheless, nonetheless an exterior medical machine: you’ll be able to expertise unhealthy pump websites, occlusions, injecting into scar tissue, and failed adhesives.
You’ll nonetheless expertise each excessive and low blood sugar ranges, and whereas sleep high quality could also be considerably improved, you’ll nonetheless most likely must pee in the midst of the night time infrequently. CGMs will error out and provides false readings.
That you must actually plug your βpancreasβ in nightly (the battery can final a mean of 48 hours), and should run out of battery when youβre with out energy for prolonged intervals of time.
Nothing is ideal. However whereas we anticipate the ever-evasive remedy, that is one step nearer to it.
