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At 12 years outdated, I used to be handed a syringe, a number of vials of NPH and R insulin (pork insulin), and was advised to check my blood sugar 10 or extra instances per day and hope for the most effective. It was brutal.
Many years later, expertise has come a good 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 routinely 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 may count on for those who 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, folks with insulin-dependent diabetes are sometimes strolling a tightrope of managing cussed highs and scary lows, typically feeling imprisoned by their blood sugar ranges.
AID provides hope to reduce 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Folks with diabetes within the #WeAreNotWaiting motion have been hacking their outdated insulin pumps for years to realize hybrid-closed loop programs, however these have been by no means permitted by the Meals and Drug Administration (FDA), and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, turned accessible in america in late 2016. This method made automated 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 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 modifications each 10 days.
Whereas folks have been very enthusiastic about these programs, tens of millions have been holding out hope for the (then-called) Omnipod Horizon system by Insulet.
This method can be distinctive in the truth that it could be the primary ever tubeless AID system, all run by Bluetooth.
Many individuals favor 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 have to droop insulin when doing issues like showering or swimming.
The Horizon system, now known as Omnipod 5, was slated to be permitted by the FDA in 2020, however the COVID-19 pandemic quickly triggered 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 folks 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 essential to notice that this can be a hybrid-closed loop system, and customers nonetheless have to rely carbohydrates and bolus insulin for all meals and snacks.
You additionally have to let the system know whenever you plan on exercising, and there’s an exercise characteristic the place you may cut back your insulin wants whilst you’re bodily energetic.
The AID system will, nevertheless, routinely alter 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 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) seems like a smartphone (in all probability 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 alter routinely even when your PDM isn’t close by (you solely want it close to you to bolus). Alternatively, for those who use an Android telephone, there’s a appropriate app that you need to use 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 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 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 bought 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 typically get up between 1-4 instances at night time.
If I’m not woken up by any alarms, I normally am thirsty or have to pee a minimum of as soon as, so once I awoke the subsequent morning, after a stable 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 like this now, and the sensation of being absolutely 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 night time is certainly one thing that I’m trying ahead to getting used to!
Fewer train disruptions
I’m an avid athlete who workout routines between 6-7 instances per week. I really like operating, climbing, swimming, biking, and weightlifting, and one of the irritating features about diabetes is how typically low blood sugars appear to get in my method.
I additionally dislike having to eat earlier than train, as a result of if I’m attempting to shed extra pounds, it may well typically really feel as if I’m defeating the aim.
I used to go low whereas exercising almost each day. Effectively, 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 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 may well predict you’ll attain that greater quantity.
You may set the period of time you’d prefer to be within the “exercise characteristic”, wherever from 1-24 hours, and it’ll routinely expire, so for those who neglect to show it off after you’re executed, you don’t have to fret about greater 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 executed, will carry it again right down to a standard vary. That has been superb.
Much less psychological burden
Total, being on the Omnipod 5 has lessened my psychological burden of residing with kind 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 looks 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 purpose 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 must 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 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) programs are nonetheless not a treatment for diabetes, I’ve discovered that the Omnipod 5 system has considerably improved my sleep high quality, my capability 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 gadget: you may 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 in all probability must pee in the midst of the night time on occasion. 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 will run out of battery for those who’re with out energy for prolonged intervals of time.
Nothing is ideal. However whereas we await the ever-evasive treatment, that is one step nearer to it.
