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 attainable.
At 12 years previous, I used to be handed a syringe, a couple 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 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 latest 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, based on 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 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 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 techniques, however these have been by no means authorised 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 accessible in the US 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 standard.
That was shortly adopted by the Tslim Management IQ system from Tandem that grew to become accessible 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 modifications each 10 days.
Whereas folks have been very enthusiastic about these techniques, hundreds of 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 could 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, 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 authorised by the FDA in 2020, however the COVID-19 pandemic quickly brought about 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 performed 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 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 characteristic the place you’ll be able to scale back your insulin wants whilst you’re bodily lively.
The AID system will, nevertheless, mechanically alter basal insulin charges based on 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 acquired the Omnipod 5 system on February eleventh, 2022.
My first impressions have been that the private diabetes supervisor (PDM) appears to be like 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 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 need to use to your PDM as a substitute, 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 shortly jumped into auto mode (why wait?). It’s been incredible.
I’ve solely been on the system for 2 weeks, however I’ve already observed a couple of important enhancements to my well being.
Improved sleep high quality
After switching into auto mode, I bolused for a traditional dinner, ate, and bought prepared for mattress.
Like many individuals with diabetes, I’m used to not all the time 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 often am thirsty or have to pee not less than 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 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 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 via the evening is unquestionably one thing that I’m wanting ahead to getting used to!
Fewer train disruptions
I’m an avid athlete who workout routines between 6-7 occasions per week. I really like operating, climbing, swimming, biking, and weightlifting, and some of the irritating elements 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 some pounds, it could actually generally really feel as if I’m defeating the aim.
I used to go low whereas exercising practically each 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 gadget. One!
The system permits 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 could actually predict you’ll attain that larger 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 mechanically expire, so in the event you overlook to show it off after you’re executed, you don’t have to fret about larger blood sugars afterward.
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 executed, will deliver it again all the way 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 research has proven that individuals with diabetes make an additional 180 selections practically each single day simply to take correct care of themselves, and having an AID system appears like these selections have been lower 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 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 all the time had (you continue to need to 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 forestall a excessive, or will lower insulin if I’ve taken an excessive amount of by chance, to forestall a low.
Whereas diabetes will all the time 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) techniques are nonetheless not a treatment 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 kind 1 diabetes.
It’s, nevertheless, 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 most likely need to pee in the course of the evening sometimes. CGMs will error out and provides false readings.
It’s good to actually plug your “pancreas” in nightly (the battery can final a mean of 48 hours), and will run out of battery in the event you’re with out energy for prolonged durations of time.
Nothing is ideal. However whereas we look forward to the ever-evasive treatment, that is one step nearer to it.
