After I was identified 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 doable.
At 12 years previous, I used to be handed a syringe, a number of 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 very best. It was brutal.
A long time later, expertise 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 most recent 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’ll be able to count on in the event 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 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 reduce 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 attain hybrid-closed loop programs, however these had been by no means authorised by the Meals and Drug Administration (FDA), and weren’t beneficial by physicians, nor had any security ensures.
The primary system to obtain approval from the FDA, Medtronic’s 670g, grew to become accessible in america in late 2016. This technique made computerized changes to basal supply primarily based on Medtronic’s personal steady glucose monitoring (CGM) system, The Guardian, and was extraordinarily common.
That was shortly adopted by the Tslim Management IQ system from Tandem that grew to become accessible in america 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 had been very enthusiastic about these programs, thousands and thousands had been holding out hope for the (then known as) Omnipod Horizon system by Insulet.
This technique could be distinctive in the truth that it could 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, 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 known as Omnipod 5, was slated to be authorised 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 kind 1 diabetes aged 6 years and older, and is appropriate with Android smartphones and the Dexcom G6 CGM system.
Insulet carried out 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 once you plan on exercising, and there’s an exercise characteristic the place you’ll be able to cut back your insulin wants when you’re bodily energetic.
The AID system will, nevertheless, robotically modify basal insulin charges in keeping with 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 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 had been that the private diabetes supervisor (PDM) seems 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 “talks” to the Dexcom CGM sensor, so your basal charges will modify robotically 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 cellphone, there’s a appropriate app that you need to use to 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’s 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 implausible.
I’ve solely been on the system for 2 weeks, however I’ve already observed a number of vital enhancements to my well being.
Improved sleep high quality
After switching into auto mode, I bolused for a traditional dinner, ate, and acquired prepared for mattress.
Like many individuals with diabetes, I’m 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 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 at the least as soon as, so after I awoke the subsequent morning, after a stable 8 hours of sleep UNINTERRUPTED, I used to be ecstatic.
I took a fast take 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 wanting ahead to getting used to!
Fewer train disruptions
I’m an avid athlete who workouts between 6-7 occasions per week. I really like working, mountain climbing, swimming, biking, and weightlifting, and probably the most irritating facets about diabetes is how usually low blood sugars appear to get in my manner.
I additionally dislike having to eat earlier than train, as a result of if I’m attempting to reduce weight, it might probably generally really feel as if I’m defeating the aim.
I used to go low whereas exercising almost day by day. Properly, since being on the Omnipod 5, I’ve had one low blood sugar within the two weeks that I’ve 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 charge (or pauses insulin supply) till it might probably predict you’ll attain that increased quantity.
You possibly can set the period of time you’d prefer to be within the “exercise characteristic”, anyplace from 1-24 hours, and it’ll robotically expire, so in the event you overlook to show it off after you’re completed, 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 completed, will deliver it again all the way 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 kind 1 diabetes.
One examine has proven that folks with diabetes make an additional 180 selections almost each single day simply to take correct care of themselves, and having an AID system looks like these selections have been reduce in half.
I don’t have to micromanage my basal charges in the course of 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 concern of going low!).
And whereas dosing insulin for meals feels nearly the identical because it all the time had (you continue to should depend 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 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 treatment 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 residing with kind 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 should pee in the midst of the night time once in a while. CGMs will error out and provides false readings.
You should actually plug your “pancreas” in nightly (the battery can final a median of 48 hours), and should run out of battery in the event you’re with out energy for prolonged durations of time.
Nothing is ideal. However whereas we await the ever-evasive treatment, that is one step nearer to it.
