Once 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At 12 years outdated, I used to be handed a syringe, a number of vials of NPH and R insulin (pork insulin), and was instructed to check my blood sugar 10 or extra occasions per day and hope for the very best. It was brutal.
Many years later, expertise has come a good distance, to say the least.
I can now bolus insulin remotely, verify 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 accordance with 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 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, folks 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Individuals with diabetes within the #WeAreNotWaiting motion have been hacking their outdated insulin pumps for years to attain hybrid-closed loop methods, however these had been by no means accredited by the Meals and Drug Administration (FDA), and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, turned accessible in america in late 2016. This technique made automated changes to basal supply based mostly on Medtronic’s personal steady glucose monitoring (CGM) system, The Guardian, and was extraordinarily well-liked.
That was shortly adopted by the Tslim Management IQ system from Tandem that turned 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 folks had been very enthusiastic about these methods, thousands and thousands had been holding out hope for the (then-called) 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 desire 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 must droop insulin when doing issues like showering or swimming.
The Horizon system, now known as Omnipod 5, was slated to be accredited 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 folks with kind 1 diabetes aged 6 years and older, and is suitable 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 essential 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 once you plan on exercising, and there’s an exercise function the place you’ll be able to cut back your insulin wants when you’re bodily lively.
The AID system will, nonetheless, robotically alter basal insulin charges in accordance 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 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 to be 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 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 telephone, there’s a suitable app that you should utilize in 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’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 unbelievable.
I’ve solely been on the system for 2 weeks, however I’ve already seen a number of important 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 at all times getting a lot sleep at evening. Between high and low blood sugars and their accompanying alerts and alarms, I usually get up between 1-4 occasions at evening.
If I’m not woken up by any alarms, I normally am thirsty or must pee a minimum of 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 evening lengthy, and I had no highs and no lows.
Most of my nights appear like this now, and the sensation of being totally rested is unimaginable. It’s a full pleasure to really feel like diabetes isn’t stealing my sleep as a lot because it used to, and sleeping via the evening 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 really like operating, mountaineering, swimming, biking, and weightlifting, and one of the irritating elements 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 attempting to drop extra pounds, it could actually generally really feel as if I’m defeating the aim.
I used to go low whereas exercising practically each 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 price (or pauses insulin supply) till it could actually predict you’ll attain that increased quantity.
You may set the period of time you’d prefer to be within the “exercise function”, anyplace from 1-24 hours, and it’ll robotically expire, so should you overlook to show it off after you’re executed, you don’t have to fret about increased 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 executed, will convey it again right down to a standard vary. That has been wonderful.
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 choices practically 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 in the course of the day, and I’m not waking as much as low alarms at midnight as a way 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 rely 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 stop a excessive, or will lower insulin if I’ve taken an excessive amount of accidentally, to stop a low.
Whereas diabetes will at all times be a psychological burden on those that stay with it (and their households!), having an AID system considerably decreases that burden.
Conclusions
Whereas automated insulin supply (AID) methods are nonetheless not a treatment for diabetes, I’ve discovered that the Omnipod 5 system has considerably improved my sleep high quality, my means to train, and has decreased the psychological burden I expertise as a lady residing with kind 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 evening once in a while. CGMs will error out and provides false readings.
You might want to actually plug your “pancreas” in nightly (the battery can final a mean 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 look ahead to the ever-evasive treatment, that is one step nearer to it.
