Once I was recognized 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 previous, I used to be handed a syringe, just a few vials of NPH and R insulin (pork insulin), and was advised to check my blood sugar 10 or extra occasions per day and hope for the most effective. It was brutal.
Many years later, know-how has come a great distance, to say the least.
I can now bolus insulin remotely, examine 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 mechanically adjusting my basal insulin charges for me, in response to what my blood sugar is, all in real-time.
This text will focus on the brand new Omnipod 5 system, my first impressions, and what you’ll be able to anticipate in the event you select this method for your self.
A brief historical past of automated insulin supply (AID)
Automated insulin supply, or AID for brief, has been the holy grail within the diabetes group 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, usually feeling imprisoned by their blood sugar ranges.
AID affords hope to attenuate not solely the highs and lows, however to lighten the psychological burden of a life lived with diabetes.
Individuals with diabetes within the #WeAreNotWaiting motion have been hacking their previous insulin pumps for years to realize hybrid-closed loop methods, however these have been by no means accredited by the Meals and Drug Administration (FDA), and weren’t advisable by physicians, nor had any security ensures.
The primary system to obtain approval from the FDA, Medtronic’s 670g, grew to become out there in the US in late 2016. This technique made automated changes to basal supply primarily based on Medtronic’s personal steady glucose monitoring (CGM) system, The Guardian, and was extraordinarily widespread.
That was shortly adopted by the Tslim Management IQ system from Tandem that grew to become out there 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 (in contrast to 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 modifications each 10 days.
Whereas individuals have been very enthusiastic about these methods, thousands and thousands have been holding out hope for the (then-called) 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 want the Omnipod system because it offers extra freedom to train and really feel extra free, as a result of lack of tubing. One additionally doesn’t have to droop insulin when doing issues like showering or swimming.
The Horizon system, now referred to as Omnipod 5, was slated to be accredited by the FDA in 2020, however the COVID-19 pandemic quickly brought about a serious 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 suitable 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
It’s 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 while you plan on exercising, and there’s an exercise function the place you’ll be able to scale back your insulin wants whilst you’re bodily energetic.
The AID system will, nonetheless, mechanically modify basal insulin charges in response to blood sugar readings twenty 4 hours a day.
The system is just like their earlier variations, the place a pod must be changed and full of insulin each 72 hours, and features with the Dexcom G6 CGM, which must be changed each 10 days.
My first impressions
I used to be fortunate to be a part of the restricted launch group and obtained the Omnipod 5 system on February eleventh, 2022.
My first impressions have been that the private diabetes supervisor (PDM) seems like a smartphone (in all probability as a result of it’s one), and the pods (self-contained insulin reservoirs) look remarkably just like earlier variations of the Omnipod (each the Erros and the DASH use pods).
The pod now “talks” to the Dexcom CGM sensor, so your basal charges will modify mechanically even when your PDM isn’t close by (you solely want it close to you to bolus). Alternatively, in the event you use an Android telephone, there’s a suitable app that you should utilize in your PDM as a substitute, and bolus straight out of your smartphone (how cool is that?!). Since I exploit an iPhone, I opted for the normal PDM.
There may be phrase that an iPhone-compatible app is forthcoming.
I had a two-hour coaching session and shortly jumped into auto mode (why wait?). It’s been improbable.
I’ve solely been on the system for 2 weeks, however I’ve already seen just a few important enhancements to my well being.
Improved sleep high quality
After switching into auto mode, I bolused for a standard dinner, ate, and received prepared for mattress.
Like many individuals with diabetes, I’m used to not at all times getting a lot sleep at night time. Between high and low blood sugars and their accompanying alerts and alarms, I usually get up between 1-4 occasions at night time.
If I’m not woken up by any alarms, I normally am thirsty or have to pee not less than as soon as, so once I awoke the following morning, after a strong 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 seem like this now, and the sensation of being totally rested is unbelievable. It’s a full pleasure to really feel like diabetes isn’t stealing my sleep as a lot because it used to, and sleeping by the night time is certainly one thing that I’m trying ahead to getting used to!
Fewer train disruptions
I’m an avid athlete who workouts between 6-7 occasions per week. I like operating, mountaineering, swimming, biking, and weightlifting, and some of the irritating facets about diabetes is how usually low blood sugars appear to get in my approach.
I additionally dislike having to eat earlier than train, as a result of if I’m attempting to shed pounds, it could possibly typically really feel as if I’m defeating the aim.
I used to go low whereas exercising almost day by day. Effectively, since being on the Omnipod 5, I’ve had one low blood sugar within the two weeks that I’ve been sporting the gadget. One!
The system helps 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 possibly predict you’ll attain that larger quantity.
You’ll be able to set the period of time you’d wish to be within the “exercise function”, anyplace from 1-24 hours, and it’ll mechanically expire, so in the event you overlook to show it off after you’re finished, you don’t have to fret about larger blood sugars in a while.
Every day, I set my exercise function to “on” about 45 minutes earlier than I start my train routine, and it easily will elevate my blood sugar simply sufficient so I don’t crash, after which after I’m finished, will convey it again right down to a traditional vary. That has been superb.
Much less psychological burden
General, being on the Omnipod 5 has lessened my psychological burden of residing with sort 1 diabetes.
One examine has proven that individuals with diabetes make an additional 180 selections almost each single day simply to take correct care of themselves, and having an AID system appears like these selections have been minimize in half.
I don’t have to micromanage my basal charges throughout the day, and I’m not waking as much as low alarms at midnight with a view to pause insulin and have some juice anymore. I’m sleeping higher than ever earlier than.
Train is a breeze (and I can lastly train with out such a worry of going low!).
And whereas dosing insulin for meals feels nearly the identical because it at all times had (you continue to should depend carbohydrates and bolus for meals and snacks), I do know the system will complement with additional basal insulin if I’ve undercounted my carbohydrates to forestall a excessive, or will lower insulin if I’ve taken an excessive amount of by chance, to forestall a low.
Whereas diabetes will at all times be a psychological burden on those that reside with it (and their households!), having an AID system considerably decreases that burden.
Conclusions
Whereas automated insulin supply (AID) methods are nonetheless not a remedy for diabetes, I’ve discovered that the Omnipod 5 system has considerably improved my sleep high quality, my potential to train, and has decreased the psychological burden I expertise as a lady residing with sort 1 diabetes.
It’s, nonetheless, nonetheless an exterior medical gadget: you’ll be able to expertise dangerous 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 in all probability should pee in the course of the night time now and again. CGMs will error out and provides false readings.
You have to actually plug your “pancreas” in nightly (the battery can final a mean of 48 hours), and should run out of battery in the event you’re with out energy for prolonged intervals of time.
Nothing is ideal. However whereas we look forward to the ever-evasive remedy, that is one step nearer to it.
