Once I was recognized with kind 1 diabetes 22 years in the past, I by no means thought {that a} tubeless, automated insulin supply (AID) system would ever be potential.
At 12 years outdated, I used to be handed a syringe, just a few vials of NPH and R insulin (pork insulin), and was advised to check my blood sugar 10 or extra instances per day and hope for the very best. It was brutal.
A long time later, know-how has come a good 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 latest Omnipod 5 system, not fear a lot about excessive and low blood sugar ranges.
The system is robotically adjusting my basal insulin charges for me, in keeping with 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 possibly can anticipate should you select this technique 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 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, usually feeling imprisoned by their blood sugar ranges.
AID presents hope to attenuate 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Folks with diabetes within the #WeAreNotWaiting motion have been hacking their outdated insulin pumps for years to attain hybrid-closed loop programs, however these have been by no means authorised by the Meals and Drug Administration (FDA), and weren’t really useful 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 USA in late 2016. This technique made computerized changes to basal supply based mostly on Medtronic’s personal steady glucose monitoring (CGM) system, The Guardian, and was extraordinarily standard.
That was rapidly adopted by the Tslim Management IQ system from Tandem that grew to become out there in the USA 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 programs, thousands and thousands have been holding out hope for the (then known as) Omnipod Horizon system by Insulet.
This technique can be distinctive in the truth that it might be the primary ever tubeless AID system, all run by Bluetooth.
Many individuals want the Omnipod system because it provides extra freedom to train and really feel extra free, as a result of lack of tubing. One additionally doesn’t must droop insulin when doing issues like showering or swimming.
The Horizon system, now known as Omnipod 5, was slated to be authorised by the FDA in 2020, however the COVID-19 pandemic quickly induced 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 kind 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 vital to notice that this can be a hybrid-closed loop system, and customers nonetheless must rely carbohydrates and bolus insulin for all meals and snacks.
You additionally must let the system know if you plan on exercising, and there’s an exercise characteristic the place you possibly can cut back your insulin wants whilst you’re bodily energetic.
The AID system will, nevertheless, robotically alter basal insulin charges in keeping with 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 capabilities 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 acquired the Omnipod 5 system on February eleventh, 2022.
My first impressions have been that the non-public diabetes supervisor (PDM) appears like a smartphone (most likely 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 alter robotically even when your PDM isn’t close by (you solely want it close to you to bolus). Alternatively, should you use an Android cellphone, there’s a suitable app that you should use on 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?). It’s been unbelievable.
I’ve solely been on the system for 2 weeks, however I’ve already observed 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 bought 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 instances at night time.
If I’m not woken up by any alarms, I often am thirsty or must pee a minimum of as soon as, so once I awoke the subsequent 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 appear to be 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 unquestionably one thing that I’m trying ahead to getting used to!
Fewer train disruptions
I’m an avid athlete who workouts between 6-7 instances per week. I really like operating, climbing, swimming, biking, and weightlifting, and some of the irritating features about diabetes is how usually low blood sugars appear to get in my means.
I additionally dislike having to eat earlier than train, as a result of if I’m making an attempt to drop some pounds, it could generally really feel as if I’m 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 I’ve been sporting the system. 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 price (or pauses insulin supply) till it could predict you’ll attain that increased quantity.
You possibly can set the period of time you’d wish to be within the “exercise characteristic”, anyplace from 1-24 hours, and it’ll robotically expire, so should you neglect to show it off after you’re achieved, you don’t have to fret about increased blood sugars in a while.
Every day, I set my exercise characteristic 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 achieved, will convey it again right down to a standard vary. That has been superb.
Much less psychological burden
General, being on the Omnipod 5 has lessened my psychological burden of dwelling with kind 1 diabetes.
One examine has proven that folks with diabetes make an additional 180 choices almost each single day simply to take correct care of themselves, and having an AID system seems like these choices have been reduce in half.
I don’t must micromanage my basal charges through the day, and I’m not waking as much as low alarms at midnight in an effort 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 concern of going low!).
And whereas dosing insulin for meals feels nearly the identical because it at all times had (you continue to should rely carbohydrates and bolus for meals and snacks), I do know the system will complement with further basal insulin if I’ve undercounted my carbohydrates to stop a excessive, or will lower insulin if I’ve taken an excessive amount of by chance, to stop a low.
Whereas diabetes will at all times 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 treatment for diabetes, I’ve discovered that the Omnipod 5 system has considerably improved my sleep high quality, my capacity to train, and has decreased the psychological burden I expertise as a girl dwelling with kind 1 diabetes.
It’s, nevertheless, nonetheless an exterior medical system: you possibly can 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 should pee in the course of the night time occasionally. CGMs will error out and provides false readings.
You could actually plug your “pancreas” in nightly (the battery can final a median of 48 hours), and will run out of battery should you’re with out energy for prolonged intervals of time.
Nothing is ideal. However whereas we watch for the ever-evasive treatment, that is one step nearer to it.
