Omnipod 5: Snoop, Termites, and Otis Redding

A Top 5 is in order now that we have been using Omnipod 5 for a full month. Read on for the highlights.

1. Zoolander: "There must be an ON button somewhere"

You know the feeling… banging on our technology thinking that it works like the candy bar stuck in the vending machine. This clip from Zoolander perfectly explains my night with the O5 controller.

The controller failed at 1:30 in the morning. I did the usual reboot (x 20) before calling Omnipod. Their customer service was great and only took about 30 minutes to have a replacement controller setup to be shipped with next day delivery on a Saturday.

This does bring up a very important topic of your backup plan. I have an older compatible Samsung with Dexcom and Omnipod 5 apps pre-installed and ready to use and I would suggest you do the same to either buy a second controller or have a backup phone that you know is compatible.

So why does a failed controller make it in my Top 5 list? I could tell by the BG readings that the pod was still running in automated mode. So there was no need to wake her to change pods and switch the Dexcom to a new device. All of that could happen anytime prior to the next meal. I have spent many sleepless nights rebuilding Loop over the years and quite a few have required a new pod to be able to stay Looping through the night. If this happens again, we'll just turn off the controller (to silence its screams) and go back to sleep to deal with it in the morning.

2. Florida Georgia Line

The simplicity of Omnipod 5 is astounding. Based on what I see in some of the Facebook groups, I think some people are overcomplicating things though. So here are some tips:

• If you are high, dose what you think you need based on your own learnings over the years. This is especially true if you haven't adequately or accurately tested your Correction Factor recently because the calculator might not be an accurate dose. So keep in mind that you aren't required to use the calculated value for a correction dose.
• While we usually use the calculator for carbs, we don't enter fat and protein. This greatly simplifies things to be more similar to how we sugar surfed when MDI. Our strategy has been to just dose on the rise based on what we have learned is needed. Omnipod 5 does not track carbs for the algorithm, so there is no need to enter carbs for fat and protein once you learn what your body needs for various meal types.
• Dose enough to stay in range. If you allow BG to remain high either by only accepting the calculated corrections or using only automated mode, the learning seems like it takes longer. It seems to me that this is because automated mode has safety limits based on your TDD. So unless you forcibly increase TDD when high by doing extra doses, it may take a significantly longer time to learn. 

3. The Orkin Man

What 17 year old doesn't love one million texts from her parents every day? With Loop, our dia-texting could be overhwelming at times... add x carbs, set an override, turn off the override, change the carb duration, what does it say for absorbed carbs, etc. This has dropped to basically 2 things 1) did you dose? 2) did you have carbs? In simple terms: We are no longer pests to our 17 year old.

4. Where is Snoop D O Double G?

I read that Snoop pays his blunt roller $50,000 per year. I don't know how many joints a full time roller can make in a year, but that sounds like an insane amount of time being high!

We had a recurring theme with Loop of Snoop-Syndrome "stuck on high". It was usually overnight when Gluconeogenesis would kick in. When you rely on carbs for the algorithm, it has the unfortunate effect of predicting a low BG when there is IOB and no "carbs". So the algorithm in Loop would suspend basal while high with the slightest drop in BG, resulting in prolonged highs. In this case, it is not actual carbs but rather carb-equivalents for fat and protein that kicks into a high-gear conversion process overnight.

This chart shows: 1) last 30 days of Loop 2) first 30 days of O5 3) last 2 weeks of O5. Not only are the highs being reduced substantially, but it is also 99% automated while the extra 5% of highs with Loop still required a lot of manual interventions.

5. Dock of the Bay

The last in my top 5 has been the most profound. Burnout with T1D management is a serious issue that can have severe consequences. For us, Loop was a system that helped reduce the physical burden of management with immediately more and better sleep. But the tradeoff was a lot of mental work to keep up with settings and data analysis. One month in, Omnipod 5 has taken that further by reducing the physical AND mental burden of management. If I think back to the days before we had children, I wonder what we wasted so much time on. How did we magically find all this extra time to raise kids, keep them alive, and drive them to a million activities? Omnipod 5 feels similar to that. Our physical and mental time spent on diabetes is a fraction of what it was just a month ago. I didn't track my time with a punch clock, but the difference has probably been a drop of 80-90%.