#86 Omnipod 5 Update: Our experience thus far after 2 months

You asked so I answered! So many listeners wanted to know how our experience on Omnipod 5 has been going so I thought it would be nice to put it in one spot.  I talk about why we made the switch, important things to keep in mind, dealing with insurance, what has worked for us in terms of settings, the pros and cons, and how I adjust settings when we are seeing highs or lows.  I think it's a pretty thorough overview. Always keep in mind, I am not a doctor or a diabetes educator... just a mom with a daughter living with type 1 who hopes to help and empower other moms. Nothing you hear on this episode should be considered medical advice... I am just sharing our experience with you all. Enjoy and let me know what you think! What has your experience with the OP5 been so far?

MORE INFO AND RESOURCES FROM THE EPISODE

Juicebox Podcast 3 part series on Omnipod 5 click HERE

For Stacey Simms' (from Diabetes Connections) episode on the Omnipod 5 click HERE

ALL ABOUT DIY LOOP

Loop Docs Website
Looped Facebook Group

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Episode Transcript

Katie (00:00):
All right.
It is time.
This is episode 86 of the sugarmama's podcast.
And today it's just me.
I don't have a guest.
I just wanna talk to you guysabout how our experience with
the Omnipod five system has beengoing so far.
In just a second, you will hearour intro that we do every
single week that has our medicaldisclaimer in it.

(00:22):
But I feel like I need an extramedical disclaimer for this one.
I have had so many people ask mehow it's going.
How do I like it?
Do you have any tips or tricks?
So I thought, instead of tryingto answer everybody's comments
and questions, I would put itall together in one podcast

(00:43):
episode for people to listen to.
I just want to be clear.
I am not a doctor.
I am not a diabetes educator.
I am a mom with a daughter whois living with type one
diabetes.
And we have been on the Omnipodfive system for the past two
months.
So I am in no way giving youmedical advice or telling you
what to do.

(01:04):
I am merely telling you what wehave done and what we have seen
work for us and what we haveseen, not work for us.
So again, not giving you medicaladvice, merely letting you know
how our experience has been sofar.
Of course, something I say mayresonate with you, and you can
take that back to your medicalprovider and talk to them about.

(01:28):
Maybe moving forward with theOmnipod five system or ways to
change your settings, to enhanceyour diabetes management
experience.
Okay.
With that said, let's getstarted.
You're listening to the sugarmamas podcast, a show designed

(01:51):
for moms and caregivers of typeone diabetics here.
You'll find a community oflike-minded people who are
striving daily to keep theirkids safe, happy, and healthy in
the ever-changing world of typeone.
I'm your host and fellow T one Dmom, Katie Roseboro.
Before we get started.

(02:11):
I need you to know that nothingyou hear on the sugar mamas
podcast should be consideredmedical advice.
Please be safe, be smart, andalways consult your physician
before making changes to the wayyou manage type one diabetes.
Thanks.
All right.
Well, how should we start thisepisode about the Omnipod five?

(02:34):
I guess I should start by sayingthat when Sarah was diagnosed on
August 19th, 2020 we of coursewere started on MDI.
So injections with our longacting insulin and then our pins
with short acting insulin.
And we were told about some ofthe different pump systems, not
in great detail because with ourinsurance, we had to be

(02:56):
diagnosed for at least sixmonths before we could get
approved for a pump system.
But they just kind of brieflywent over the different pumps
that were out there.
And when they started talkingabout Omnipod, they mentioned
that coming soon, The Omnipodworld was an automated insulin
delivery system and all abouthow it would connect to the

(03:17):
Dexcom and adjust insulinaccordingly, depending on your
needs.
Then they told me that there wasalso a non FDA approved system
called the DIY loop system andthe Riley link.
that was also an automatedsystem.
So both of those things kind ofperked up my ears.

(03:38):
I don't even think theymentioned the tandem pump at the
time.
They probably did.
Who knows?
I was so overwhelmed.
I think I just really liked theidea of having a tubeless
system, so that one really stuckout in my mind.
No doubt.
They sent me home with abrochure about all the pumps,
but you know, it's a whirlwindwhen you're in the hospital at
diagnosis, but hearing about theautomated insulin delivery
systems or AIGs for short,definitely peaked my interest.

(04:02):
I could already tell a day ortwo into this diagnosis that
this was gonna be life changingand challenging and anything
that could be done to make ourlives easier with this new
diagnosis.
I was all for it.
So I was so excited to hear thatthat was coming up and was on
the horizon.
Well, six months later was Marchof 2021 and Sarah was ready to

(04:23):
get on her first pump.
We had tried and tried and triedto get her on the Omnipod dash
system through priorauthorization after prior
authorization and just continuedto get denied.
I felt like I was getting therun around calling Omnipod and
then calling our insurance,which is Aetna and then calling
our doctor and so on and soforth and around and around we

(04:46):
go that I finally just was like,okay, fine.
We're not gonna get approved forthe Omnipod dash.
Let's go with the classicOmnipod system.
And hopefully in the nearfuture, our insurance will
change and we'll get approvalfor the dash.
So I hadn't completely given uphope, but I just wanted to get
Sarah started on something.
And it looked like it was gonnabe quite a battle to.

(05:07):
Continue to go for the Omnipoddash.
I really wanted the dash becauseof the view app where you could
see her management decisionsthroughout the day while she was
at school.
Especially since her school didnot have a nurse.
So I wanted to be able to seewhat she was doing with her
insulin throughout the day.
That didn't happen.
So we kind of waved the whiteflag at that time and went ahead

(05:27):
and got, got started on theOmnipod Aeros system that has
the big old, clunky PDM, noBluetooth technology, no view
app, nothing like that.
And honestly, it was fine.
It worked great for us.
We had a great experience on it.
Definitely a learning curve aswith all changes to the way you
manage diabetes.
But I would say after a fewmonths, maybe three or four

(05:47):
months, we felt pretty confidentin using the pump and.
Felt like we had really kind ofsettled in, So then another 9,
10, 11 months goes by, we'rehappy with the Omnipod we're on,
but we also hear whisperings ofthe new Omnipod five that's
currently under review for FDAapproval.
So I knew that was cominghopefully very, very soon.

(06:10):
So that's when I really startedto kind of dive in and be like,
okay, getting a denial from ourinsurance company, just isn't
acceptable at this point intime.
So what do we need to do to getthe omnipod five approved.
So that's when I really starteddigging.
Of course, I started callingagain.
I called Omnipod again.
I called our insurance again.
I called our doctor again.

(06:31):
We tried to submit again forapproval and got denied.
So finally I went to my husbandand I said, I feel like I have
done all that I can do on myend, cuz we get our benefits
through his work.
I said, I feel like it's timefor you now to go to somebody in
the HR department who deals withemployee benefits and insurance

(06:52):
and talk to them about what dowe need to do to get this device
approved for our daughter thereason I wanted him to go to HR
is because I kept being told byour insurance company that under
our plan, it was an exclusionthat system, both the dash and
the upcoming Omnipod five wouldnot be covered because it was a

(07:13):
plan exclusion I don't knowexactly what that means or why
that was, but I basically said,what do we need to do to
override that?
And then everything that theysuggested we do just wasn't
working all the priorauthorizations and letters from
doctors and all of that.
So that's again, when I went tomy husband, I said, okay, tag,
you're it, it's your turn.
He started talking with HR longstory short.

(07:36):
They eventually did get approvalfor the Omnipod five.
We got a letter in the mail andit said that we've been granted
approval.
It did say that it, the approvalwas for one year.
So to be quite honest, I don'tknow what's gonna happen in like
10 months when that year is up.
And I'm hoping that it justkinda rolls right into being

(07:58):
forever approved, but we willhave to wait and see, I'm just
kind of choosing not to worryabout that or stress out about
that.
Right.
At this moment, I'll follow upwith that, like next year in
March or something like that.
So all that to say.
I'm not great with details.
I, I know, I didn't tell youlike every single detail about
how that all happened withinsurance.
Because I don't exactly rememberevery single detail, but I can

(08:20):
tell you this, if there issomething that you want and you
feel like your child needs, andwould make your life with type
one diabetes easier, do not giveup, continue to call, continue
to email, continue to askquestions, you know, just lay it
out there for,'em be like, look,this is what we want.
I feel like this would be bestfor my child.

(08:40):
So what do we need to do to makethat happen?
Okay, so backing up just alittle bit.
We got on the Omnipod fiveofficially in July like the
middle of July.
And now it's about the middle ofSeptember.
So it's been about two wholemonths that we've been on
Omnipod five.
For those of you that have beenfollowing me on social media,
you probably know that we alsodid the DIY loop system and we

(09:03):
switched from just the, theclassic version to doing DIY
loop with that classic Omnipod,that Aeros PODD, we switched to
that back in.
I wanna say late April.
To be quite honest, we had a fewvery challenging diabetes weeks
in a row where Sarah was justrunning high all the time.
It seemed like, and I just gotreally, really fed up and it was

(09:26):
like, that's it, I'm not waitingaround anymore for these
automated systems to be approvedby the FDA or for our insurance
to approve them.
I am going to build this DIYloop thing myself and we are
going to get on an automatedsystem one way or the other.
So that's what I did.
I talked about our decision toswitch to DIY loop and then our

(09:49):
decision to switch from DIY loopto Omnipod five a few weeks ago
in episode 84.
So go back and take a listen tothat.
That was more towards the end ofthat episode that I was talking
about that, But I'll kind of goover it briefly.
Again, we get on the DIY loopsystem.
And for those of you that don'tknow, you have to build this
system on your computer and thentransfer it to your phone, to be

(10:11):
used as an app.
You also have to purchase at themoment.
This is about to change, but atthe moment, you also have to
have either a Riley link or anorange link.
And that's just a small device,about half the size of a deck of
cards that acts as thetranslator between.
The Omnipod pump your Dexcom CGMand an app on your smartphone.

(10:32):
So without that Riley link ororange link, your pod and the
Dexcom cannot communicate witheach other and adjust insulin.
So I would not call myself atechy person.
Sure.
I figured out how to do apodcast, but that's about as far
as it goes and I can say.
First certain that building theDIY loop on a computer was maybe
one of the most stressful thingsI've ever done in my life

(10:54):
because my daughter's diabetesmanagement depended on it.
And I was like, I cannot screwthis up.
And I don't even know what I'mdoing.
Luckily, there's a websitecalled loop docs.
I'll leave a link in the shownotes.
It takes you step by stepthrough the whole process of
what you need to do to get setup and then the steps that you
need to do to build it.
It's confusing.
I'm not gonna lie.
It's kind of hard, but again,I'm not, I don't speak that tech

(11:17):
lingo.
So for somebody that's in thetech world on a regular basis,
you know, it's probably justlike reading a children's book
to you.
You would understand it all.
But for me, it was like readinga complex legal document.
It did not make a whole lot ofsense.
So it was stressful.
DIY loop was created by somepeople who were just tired of
waiting on.
Companies to create and the FDAto approve automated insulin

(11:40):
delivery systems.
in other words, these people aregeniuses.
They also have a Facebook groupon Facebook where it's basically
tech support.
So if you have a tech issue withyour, with your loop system or
something crashes, or you needhelp, you get on that Facebook
group and you ask your questionsand submit pictures to go along
with it and they will try tohelp you troubleshoot and figure

(12:01):
it out.
I'll also leave a link to thatin the show notes.
Okay.
So why did we decide to leaveDIY loop and go to Omnipod five?
Because a lot of people on DIYloop, even when Omnipod came
out, they were like, no way, arewe switching to Omnipod five?
We're sticking with DIY loopbecause it's so much more
customizable.
You can set the target glucoserange anywhere that you want it

(12:23):
basically.
Whereas you're kind of limitedwith Omnipod five because the
lowest you can set the targetglucose value is at 110
milligrams per deciliter.
So I was kind of hesitant too.
I was like, gosh, I just builtthis whole thing.
Do I really wanna switch?
Maybe we should stick it out alittle bit longer.
So what it finally came down towas I just really never had a

(12:44):
piece about the whole technologyside of DIY loop.
My husband to be quite honest, whe was supportive, but he wasn't
super on board.
He didn't love the fact DIY loopwas not an FDA approved product,
which, you know, I get it.
It's.
it's our child.
And we want what's best andsafest for her, but I just never
had a piece about it.
I mean, you, you build this appon your computer and it could

(13:06):
CRA there's the potential for itto crash at any point in time,
which means you would have toscratch everything and start
from scratch and rebuild it.
And then even if that doesn'thappen, you still have to
rebuild it every single year,because with the apple developer
license that you have topurchase, which is about a
hundred dollars, that'srequired, you have to rebuild it
every single year.
So that just kind of stressed meout.

(13:29):
The DIY loop system has a kindof a view like app it's called
night scout.
That is also something you haveto build on your computer.
That's not just something youcan sign up for.
That stressed me out that Iwould have to build yet.
Another thing.
I actually paid somebody to dothat for me.
There's a service called T onepal that will build night scout
for you for about like 10 or$11a month.

(13:50):
And I signed up for that, cuz Ijust, I just couldn't take
having to build one more thingon a computer.
So that's really what it camedown to was just kind of the
stress level of me.
Always having it in the back ofmy mind that I was gonna have to
rebuild it could crash and Icould rebuild.
There's also like your loop.
Can, we were getting a lot ofred loops, which for those of

(14:11):
you that have done DIY loop, youknow what I'm talking about, but
basically it's likecommunication is lost between
the devices.
So the loop system can't work.
I felt like we were dealing witha lot of red loops and we
couldn't figure out why.
And it took a long time for thered loops to turn to green
loops, which means that thesystem's working And we also
just, I mean, we had decentresults with DIY loop, but they

(14:32):
really weren't really any betterthan what we were seeing before
on the classic Aeros Omnipodsystem.
In fact, they might have been alittle bit worse.
Just because I felt like it wassuch a touchy system.
Like you had to have yoursettings perfectly 100% correct.
In order to see good resultsinsulin sensitivity factor or
correction factor was a hugepart of the DIY algorithm.

(14:56):
I don't know.
I just never felt like we couldget it right with that system.
So we decided to make the switchto Omnipod five and we
officially did that in themiddle of July.
So before I made the decision tomake the switch, cuz truly this
was something that I reallywrestled with as to whether or
not to try it and get off theDIY loop.
I read, I probably spent a goodthree weeks every night, just

(15:21):
reading.
Facebook posts some in the juicebox podcast, Facebook group a
lot of them in the Omnipod fiveFacebook group.
There's a really great group outthere for Omnipod five users.
Again, I will put a link to thatin the show notes.
I just read thread after thread,after thread and comment after

(15:41):
comment, after comment, to makesure I really understood from a
user perspective how this systemwas operating.
One of the smaller things that Ireally wrestled with about
whether or not to switch to theOmnipod five was the information
that I had been reading on lineof sight and how the two
devices, the Omnipod and theDexcom had to be in the same

(16:03):
line of sight on the person'sbody.
And I was really worried thatthat was gonna be a problem for
us because.
At the time, Sarah was onlywilling to wear her pods on her
thighs on the front of herthighs and her Dexcoms on the
back of her arm.
So that would not be in the sameline of sight.
Like an example of the same lineof sight would be like Dexcom on

(16:25):
one arm back of one arm.
And then Omnipod on the back ofthe other arm, or maybe Dexcom
on the back of one arm andOmnipod kind of on like the love
handle or upper, but region onthe same side.
Another example would be likeboth devices on the abdomen.
but with Sarah, I was worriedbecause you know, front of the

(16:48):
thigh and back of the arm.
It's not in the same line ofsight, but I read a lot and I
saw several comments fromfamilies that were worried about
the same thing, but they decidedto try it anyway.
And it turned out that theydidn't have any issues.
And it seemed like if the personwearing the devices was on the
smaller side in leaner side,then they had little to no

(17:10):
issues with the line of sight.
It's when it was like an adultthat was maybe a little bit
heftier where.
They started to see issues.
So basically I just decided torisk it and give it a try.
And it turns out we've had noissues with the devices, not
communicating with each otherand connecting.
However, in other exciting news,Sarah, just last week decided

(17:32):
she was gonna try her pod on adifferent spot.
So she actually tried her pod onthe back of her arms and she
tried her Dexcom in a new spottoo.
She tried it on her muffin toparea, which I know muffin top is
like not the PC term for that,but, you know, that's the best
way I know how to describe it.
Sarah is super lean.
So she does not even have muffintops, but you know, the area

(17:53):
that I'm talking about.
And that has been going well,too.
No issues with line of sightthere.
So again, something else to keepin mind.
For the most part, a lot of theposts were very negative.
Lots of people were unhappy withthe system cuz it was super
conservative.
So they were seeing a lot ofhigh blood sugars where as
before they had greatmanagement.

(18:13):
So I think that was frustratingfor a lot of people, but I also
read a lot of comments of peoplesaying like, yes, we saw high
blood sugars, but this is how wemade adjustments.
And now it's really working forus and we really like it.
So based on everything that Iread, I knew that for us,
because I did not wanna have towait out 3, 4, 5 weeks for this

(18:33):
system to learn my daughter.
I didn't wanna have to wait thatlong and suffer through a bunch
of high blood sugars before westarted seeing good results.
So I decided that for us, I wasgonna start off pretty
aggressive with all of thesettings that we programmed into
the pump.
So I kind of picked an arbitraryplace to start for me.

(18:54):
I didn't wanna go too crazy,like change everything by 50%.
So I decided 20% was probably agood place to start.
So we had our basal ratesalready from pumping before.
So I decided I was gonnaincrease all of our basal rates
across the board by 20%.
I was going to strengthen ourinsulin to carb ratios by 20%, I
was going to lower our insulinsensitivity factor, which is

(19:18):
also called a correction factorby about 20% because a lower
ISSF or a lower correctionfactor is a little bit more
aggressive.
So the system would be givingyou more.
So, for example, if your ISF is100, that means that for every
unit of insulin, it's going tobring your blood sugar down by a

(19:38):
hundred points.
If you have your ISF set to 50,that means for every one unit of
insulin, the system is gonnabring your blood sugar down by
50 points.
So if you are at 200, right, andyou wanna get your number down
to 100, if you have an ISF of100, that means you're gonna
need one unit of insulin to gofrom 200 to 100.

(20:01):
you're 200 and you wanna get to100 and your ISF is 50, that
means you're gonna need twounits of insulin to get you from
that 200 down to 100.
So a lower ISF or a lowercorrection factor is a more
aggressive number.
When we were on DIY loop, I hadSarah's set at one 10, so I

(20:21):
lowered that number by 20%.
I set our glucose target to one10, which is the lowest.
It can be set on the Omnipodfive system.
And I set the correct abovenumber at one 20.
So anything above one 20, thesystem would start correcting
for that and take that intoconsideration.

(20:42):
When doing BOS calculations, Ihad the two hour insulin action
time or duration of insulinaction is also called I think
that's what it's called in theactual controller to set up the
Omnipod five duration of insulinaction.
I had that set at two hours.
That's the lowest you can setit.
Again, based on everything I hadread from all these social media

(21:04):
post, that is what seemed to beworking for most people.
I'll come back to that in alittle bit.
Because I think it's importantto remember a few things.
When you have your insulinaction time set at a low number
like that, I did turn thereverse correction off.
I also read that people weregetting better results with that
turned off.
So basically what that does is,you know, if your target is at

(21:25):
one 10, which again is thelowest, you can set it, but
you're currently sitting at 80and you go to Bo bolus for a
meal.
It's going to take intoconsideration that you're
already 30 points under.
Where your target is set.
So it's gonna take away some ofthe insulin that you would
normally give for the carbs inthe meal that you're about to
eat.
So I didn't, I didn't want to dothat.

(21:47):
I, if we were gonna be eatingcarbs, I wanted to give enough
insulin to cover all the carbs.
So I turned the reversecorrection off.
So I went in real strong, right.
Go big or go home.
I was a little bit nervous aboutit, just because it was a lot
more aggressive than what we hadbeen doing previously.
But again, I just had read somany things online how people

(22:09):
were having to make all theirsettings more aggressive.
I just decided I'm gonna go infrom the beginning and make my
settings more aggressive.
We saw fantastic results.
I mean, right from the get go,Sarah was anywhere between 70%
and 95% in range.
I don't think we've had a 100%in range day ever.
Maybe, maybe we've had one, butanyway, not, not on the Omni FOD

(22:33):
five system at least.
And I'm fine with that.
I don't care about that, hertime in range, which to me is
one of the most important thingswas already amazing from the get
go.
And I have her range set on heron her Omnipod five controller
and on the Dexcom clarity appthat we kind of like at all the
CGM data and look at all thetrends.

(22:53):
I have her range set to 70 toone 50.
So that's a little bit lowerthan what most endocrinologists
offices will recommend, which is70 to 180, I just really wanted
to aim for being between 70 andone 50, 70% of the time or more.
That was my goal that I had setfor us.
So even with the range being alittle bit smaller, we were

(23:14):
still seeing good results fromthe beginning.
With those more aggressivesettings, I think the reason why
you have to go into this systemin particular with your settings
set slightly more aggressively.
Or the way that I thought aboutit was that this system is super
conservative and it's reallydesigned first and foremost to

(23:36):
prevent your child from havinglow blood sugars.
So if it thinks there's a chancethat they're going to have
hypoglycemia or fall below theirtarget, the system will turn off
basal insulin.
So if there's a system that'sconstantly turning off basal
insulin, you're most likelygoing to need more Boless
insulin to overcome that andprevent after meal spikes.

(24:01):
And lingering high blood sugars,you know, before we were on any
sort of automated insulindelivery system.
And we were just using theOmnipod Aeros classic system.
Sometimes we would do, what'scalled a super Bowlus and I
haven't read the book sugarsurfing yet, but I think that
comes from.
The guy who wrote sugar surfing,which is Dr.

(24:21):
Ponder, but a super bolus is ifyou're gonna be eating a food,
that's really high on theglycemic index.
And my favorite example isbreakfast cereal.
Then kind of one of the ways hesuggests to get ahead of that
after meal spike is to give apretty hefty pre bolus, right?
Like give the insulin ahead oftime, but also turn off.
And I should probably mentionbefore I go any further that

(24:42):
this is something that only pumpusers can do.
but he suggests turning offbasal insulin for, I think it's
two or three hours.
So you completely turn that offfor two or three hours, but
rather than just not gettingthat insulin at all, you give it
all up front with the bolus, forthe cereal or whatever high GI
food you're gonna be eating.

(25:02):
So if your basal rate was oneunit an hour and you were gonna
try a super bolus for cereal andyou were gonna turn your basal
off for three hours, you wouldgive those three units of basal
insulin that you would bemissing.
You would give that upfront withthe first bolus.
So that's a, that kind of helpsme to think about how to

(25:23):
approach.
the Omnipod five system, whichis a little bit more on the
conservative side.
It's almost like I'm doing asuper Bowlus because the system,
a lot of the times turns basaloff for a very long time to
prevent low blood sugars.
But I still want my daughter tostay in range.
So I kind of have to give moreinsulin front to allow that to
happen.
You'll hear me talk a little bitmore about this later in the

(25:45):
episode, when I talk about prebolusing with the Omnipod five
system.
Okay.
I will say though, that overtime, like starting, maybe.
Three or four weeks ago.
So maybe like a month in tousing the system, we started
having a lot of lows.
And so I did have to back off alittle bit on some of the
settings, I had to take theinsulin sensitivity factor back

(26:09):
up a few points.
I did not touch the duration ofinsulin action.
I left that at two hours.
I continued to leave off thereverse correction factor.
But I actually, I even had tolike set the target a little bit
higher.
I had to change insulin to carbratios a little bit, so they
weren't quite as aggressive.
And then I didn't do anything tothe basal rates because changing

(26:30):
the basal rates in automatedmode do nothing.
They do not do anything.
If you switch to manual mode,that's when your basal rates
that you put in the systemmatter, but in automated mode,
it will do absolutely nothing tochange the basal rates.
So again, I knew that going intoit, and that is another reason
why I chose to start off alittle bit more aggressive with

(26:52):
our basal rates from the get go.
Cause I knew once I put'em intothe system, I could not go back
and change them.
It would've done.
No good being in automated mode.
So a lot of people have asked meif I still have to do a pre
bolus with the Omnipod five.
And just a reminder, a pre bolusis where you give the insulin a
set amount of time before youactually eat.

(27:14):
I think most endocrinologistsrecommend like 10 to 15 minutes
for us.
We have always had to do ourlongest pre bolus in the
morning.
Usually anything less than a 30minute pre bolus.
And we will see a huge spike.
I mean, even if we wait like 26minutes instead of 30 minutes,
we will still see a huge spike.
It, it does a little bit dependon what we eat though.

(27:36):
I mean, if we're eating like alower car breakfast or something
with a lot of protein and fat,then we might not need as long
of a pre bolus.
Very rarely will I give theinsulin like right before we
eat, but that's kind of just, ifSarah's having like just bacon
and eggs, you know, onlyprotein, which doesn't happen
very often in our house, but youknow, something like breakfast,
cereal, I mean, it has to be a30 minute pre bolus, or we're

(28:00):
gonna see a spike.
Sometimes, I even have to giveSarah a few carbs while she's
waiting that 30 minutes.
So she doesn't crash before sheactually eats the breakfast that
she told me she wanted.
I will say absolutely.
Yes.
We still have to pre bolus withthe Omnipod five.
In fact, I think it's even moreimportant than it was before.
Mostly because this system is soconservative.

(28:22):
I think the main goal of thesystem from what I've read and
listened to is to keep peoplefrom having hypoglycemia or low
blood sugar.
So it's ultra conservative andmany times to keep you from
going below your target.
It will shut off basal insulin,you know, so overnight while
you're sleeping.
Your basal insulin could havebeen shut off for an entire hour

(28:45):
or more before you eatbreakfast.
So keeping that in mind, you'rereally gonna need to give your
insulin extra time to startworking before you eat, to kind
of offset the fact that youdon't have a whole lot of
insulin working in your systemyou wake up in the morning.
So sometimes I'll take a look atthe history in the Omnipod five

(29:06):
controller.
To kind of determine how longI'm gonna pre bolus, or if I
need even need to give acorrection, if my daughter's
blood sugar is high, because thehistory will allow you to see if
you go to auto events, it willallow you to see the micro bolus
that the system has been givingher.
So if I look and see like, oh,it's already been giving her
quite a bit of insulin to bringthis blood sugar down, then I

(29:29):
will know, okay.
Maybe I don't need to give acorrection.
Maybe I just need to wait it outa little bit longer see if it
will bring her down on her own.
So the short answer to thatquestion is, yes, we still have
to pre bolus.
We still have to do about a 30minute pre bolus in the morning.
And for the rest of meals andsnacks during the day, it's
anywhere between like a 10 and20 minute pre bolus.

(29:49):
That kind of depends on theamount of activity she's been
doing beforehand, what her bloodsugar is when she's giving the
bolus, all of those things.
But yes, definitely a pre bolusis important again, unless it's
just one of those super high fatmeals where it's gonna slow down
digestion and those carbs aregonna get later So here's

(30:10):
another thing about pre bolusbefore we move on.
My daughter bless her preciousheart.
I don't wanna throw her underthe bus, but sometimes when
she's not with me, like whenshe's at school, she's not great
about doing a pre bolus for theamount of time that she really
needs to do a pre bolus for.
So I've really been trying totalk to her about how important
the pre Boles is, because thisis what happens if she doesn't

(30:32):
pre Boles.
Okay.
Let's say it's snack time atschool.
And she waits until the lastminute to give herself 30 carbs
for that snack.
So she gave herself the fullamount of insulin that she would
need for the carbs and thatsnack, but she just didn't wait
or give the insulin enough timeto start working before she ate.
Right.
So the carbs are gonna hit a lotquicker than the insulin has

(30:55):
time to start working.
So that's gonna cause a bigspike, which.
When she has a big spike thattells the automated system, the
Omnipod five, that it needs togive her more insulin.
So it starts correcting for thathigh blood sugar number.
And now she has lots of insulinon board, cuz she has all the
insulin for the carbs that werein the snack and all this extra

(31:16):
insulin that the system has beengiving her to try to bring that
blood sugar down.
So that usually leads to a bigcrash.
So I've been trying to reallystress to her like sweetheart,
if you would just wait or giveyour insulin right.
When I text you.
Cause I, I do text her.
I, I try to give her enough timeto do a proper Prebus I'm like

(31:36):
if you would just do it rightthen and there, you wouldn't
have these big spikes.
So the system wouldn't bedumping more insulin into you
and then you wouldn't have thesebig crashes, you know, a couple
hours later.
because you have too muchinsulin on board.
You know, if you, if you justwould do that pre bolus, then
you'd almost have like hardly aspike at all, or just a little

(31:56):
bump up in your number.
And then the system wouldn't begiving you extra insulin that
you didn't need, and you wouldavoid this crash later on.
And you know, of course she'slike, oh, okay, mommy, I know,
I'm sorry.
And I don't, I mean, I reallydon't give her a hard time.
I try not to NA her or get ontoher much about diabetes.
I try to calmly explain why it'sso important in hopes that one

(32:19):
day it will stick and she willrealize, you know, all that
stuff.
My mom was telling me all thoseyears ago, she was right.
Maybe I should pre bolus.
But also along that same vein, Ihave learned that, like, let's
say we get into a situationwhere we can't pre bolus or we
just flat out don't want to prebolus, you know, maybe we're at
a birthday party or cakes comingout right now.

(32:42):
And like, I'm not gonna makeSarah wait around to eat this
cake.
I have learned that in thosesituations, when there's not
enough time for a pre bolus toactually give her less insulin
than what the bolus calculatoris suggesting, because I know
we're gonna have a spike anyway,regardless because we're not pre
bolusing.

(33:02):
And I know that because of thatspike, the system's gonna dump
more insulin into her.
So I'm trying to like take intoaccount.
That knowing that she's gonna begetting more insulin with a
spike and to prevent a crashlater on.
So that has been helpful to keepthat in mind that if we just
don't have time for a pre bolusor just don't want to, to

(33:22):
actually give her a little bitless insulin to avoid that crash
later on.
So that was just a kind of apattern I kept seeing.
And I'm like, well, let's givethis a try.
And I mean, you're still aredealing with a spike, which is
unfortunate, but you know, ithappens something else that I
think is important to keep inmind is the duration of insulin
action.
Now I have it set to two hoursand I think a lot of people have

(33:44):
it set to two hours on everyother system I've been on.
I've had it set, I believe withthe classic Aeros Omnipod
system, we had it set.
We kind of played around withthree hours.
in four hours kind of switchingback and forth between those two
to see if it would make adifference with the loop system.
You actually have to set insulinaction time at, I wanna say six

(34:06):
hours is what they recommend.
In fact, they might even not letyou set it any lower than that,
but it was a lot longer thanany, any other system I had seen
before or read about before.
Like they wanted it to be at sixhours because of that tail.
That even though there's not aton of that, even though there's
not much insulin at all, workingat that five and six hour mark,

(34:28):
there still is some.
So they wanted to take that intoconsideration.
Huh, but again, mama was notmessing around when she got on
this Omnipod five system.
So I knew to be more aggressive,we would need to set that time
lower.
Now if you're on FIAs, whichwe've never used, I mean, that
might be kind of truthful,right?
Because I think FIAs worksquicker than like Novalog and

(34:49):
Humalog and it's out of thesystem a lot quicker.
So that two, our time might be alittle bit more accurate with
FIAs P which FIAs is notapproved for the Omnipod five
system at this time.
But I do know that people areusing it in their pump and
they're seeing good results, butwe used Novalog and I knew that
Novalog was not gonna be out ofher system in two hours.

(35:11):
I mean, it doesn't matter what Iset it at.
Like Novalog has I'm opening upthink like a pancreas to remind
myself of what Novologs insulinaction profile is according to
think like a pancreas Novalogwill peak between 45 minutes and
an hour and a half.

(35:31):
And then it will last in thesystem for about three to four
hours.
So I would, I would kind of haveto mentally keep track of, okay.
I know after two hours, theOmnipod five is gonna tell me
there's no insulin on board, butin my head, I really know there
is still some insulin on board.
So I would, you know, that wouldcome into play.

(35:52):
Like if Sarah was gonna goswimming or go on a bike ride,
you know, I'd look at theinsulin on board and it would
say zero.
And then I would look at thelast bolus and it was given like
two hours and 15 minutes ago.
Well, according to our pump,our.
Because of the settings that Ientered, it thinks that all the
insulin is out of her system.
Cuz it thinks that after twohours it's gonna be out.

(36:12):
But in my head I know thatthat's not true.
Right.
I know that it's still gonna beanother hour and a half or two
hours before all of that Bolessinsulin from the last meal or
snack is out of her system.
So, you know, in that case,maybe I'll say, Hey Sarah, I
think you're gonna need a snackbefore you go on this bike ride
or hop in the pool or like havea juice box.

(36:33):
Let's put you into activity modeor set the target higher for a
little bit longer to keep youfrom crashing.
Cuz I know that you still haveinsulin board, even though it
says zero on the screen.
So keep that in mind.
So real quick, I just wanna talkto you a little bit about how
the Omnipod five system works.
Listen again, not a doctor, nota diabetes educator, not an
Omnipod rep, just a mom with adaughter living with type one

(36:56):
diabetes who has read theOmnipod five manual, read a lot
of stuff online, listen to somepodcasts.
So the way that it works is itgoes off of total daily insulin.
So it looks at all your basalinsulin that was given all your
Boles insulin that was given.
It looks at the total amount andthen creates kind of an
adjusted, basal rate based onthat total daily insulin.

(37:19):
Every pod learns from the podbefore it.
So, if you had a weekend whereyou took your kid to two or
three birthday parties, and theywere eating cake and pizza, and
you were boing lots and lots forall the carbs and maybe to
correct for some high bloodsugars, then once you changed
that pod, the birthday partypod, you might notice for the

(37:42):
next couple days or for the nextthree days with the new pod that
you're having a lot of lowsbecause that pod was learning
from the birthday party pod andlooking at the total daily
insulin where you're giving likea ton of bolus for all these
carbs that are being eaten.
And it thinks like, oh littleSusie needs more insulin.
So I'm gonna set the adjustedbasal rate higher.

(38:02):
Which, you know, now littleSusie is back in school and
she's not going to birthdayparties all day long.
And so that higher adjusted,basal rate is causing her to
have a lot of lows.
So keep that in mind.
I mean, it could go the oppositeway too.
Maybe you're an adult on theOmnipod five and you decide that
you're gonna do a cleanse.
And so all you eat is lettucefor three days.

(38:23):
So the lettuce pod right.
Is gonna learn and think like,oh, they don't need a whole lot
of insulin.
Look, they hardly gavethemselves any Bo of insulin
throughout the last three days.
So the next pod that you put onis gonna learn from the lettuce
pod that you don't need as muchinsulin cuz your total daily
insulin was less.
So it's gonna set the adjustedbasal rate, lower, which then

(38:44):
after your three day cleanse, ifyou decide you really missed
pizza and ice cream and youstart eating like you did before
your basal rate is probably notgonna be enough because it was
learning from the lettuce pod.
And so now you're probably gonnasee some higher blood sugars.
So a friend of mine, we wererecently talking about this and
she was saying how, you know,they try to keep her daughter's

(39:05):
carb intake to around the sameamount, like on a daily average,
just to kind of keep thingsconsistent from pod to pod with
like the learning of thealgorithm.
Which I just kind of let out abig sigh when we were talking
about that, cuz it's like, ohone more thing to think about,
but it makes sense.
Right?
You don't wanna have these giantswings and fluctuations in your

(39:26):
insulin delivery because you'reconstantly changing what you're
eating.
So overall big picture, try tokeep it consistent.
If nothing else, it gives you alittle insight into why you
might be seeing a lot of lows ora lot of highs with a new pod
that you put on.
So things that I adjust when wesee a lot of low blood sugars I

(39:46):
recently, again, I do not adjustbasal rates at this point.
There has only been one timewhere I have switched.
System back into manual mode.
And that was when we were eatinga big, heavy dinner.
Honestly it didn't work greatfor us when we switched it back
to manual mode and tried to doan extended bolus.
So I decided, well, I'm justgonna leave it in automated mode
then.
And that way it can do all thelearning and we can try to make

(40:10):
the most out of this automatedsystem.
So being in automated mode formost of the time, I know that
adjusting basal rates is gonnado no good.
So when I start to see some lowblood sugars, things that I
adjust to prevent those lows arethe target.
So I have set the target alittle higher.
I had the target set at one 10initially, and then the correct

(40:31):
above I had at one 20.
So with the lows that we areseeing, I decided to set the
target.
A little higher.
I wanna, I think I actually setit up to one 30 while she was at
school.
And then the correct abovenumber I put at one 40 and that
helped a lot.
We hardly dealt with any lowsafter that.
I also did back off on myinsulin decarb ratios a little

(40:54):
bit, but not much.
I wanna say Sarah's breakfastratio was at like six one to
six.
And so I took it to one to 6.5and then actually just this
morning I took it to one toseven.
But that is because Sarah justtried a new spot to put her pod.
She put it on the back of herarm instead of on her thigh,

(41:14):
which is a huge deal for usbecause in the two over a year
and a half that she's beenpumping.
She has refused to wear itanywhere other than her thighs.
So I was very excited that shewas willing to put it in a
different spot, but I will saythat the arm has a much faster
absorption rate than the thigh.
And over the weekend, we wereseeing a lot of lows.

(41:36):
So I decided to, err on the sideof safety for this first Monday
back to school with the pod in anew spot.
And I changed her insulin tocarb ratio, just a tiny bit.
I, for the breakfast one, atleast I, I changed it to one
point to one to seven.
And so far we have not dealtwith one low all day.
So I'm super excited about that.

(41:57):
You can also increase theinsulin sensitivity factor or
the correction factor.
If you're seeing a lot of lows,I personally would not make a
huge change in there, you know,start by bringing it up by like
five or maybe 10 points andseeing if that makes a
difference.
But again, remember if you makethat number higher, then it's
gonna be less aggressive.
So the system is going to.

(42:18):
Give less insulin.
So that would help to preventsome of those low blood sugars
that you've been seeing.
I already said it before, but Ihave not messed with changing
the duration of insulin action.
At this time to see if thatmight help to prevent low blood
sugars, I've just left it at twohours.
the opposite would be truethings that I do when I see high
blood sugars on the Omnipod fivesystem, again, not adjusting

(42:39):
basal rates, cuz that does nogood, but I might set the target
a little lower along with thecorrect above number might set
that a little bit lower as well.
I would make the insulin to carbratios a little bit more
aggressive.
My rule of thumb and I think theadvice that was given and think
like a pancreas was to start bychanging that about 10% and
seeing.
If that makes a difference andthen you can decrease the

(43:01):
insulin sensitivity factor orthe correction factor.
And that lower number will be alittle bit more aggressive.
So now that we've been onOmnipod five for two months, and
the system has had lots ofopportunities to kind of learn
Sarah, like I said, I, it, itdefinitely has gotten more
aggressive.
It's been giving us highervalues of correction, bolus.

(43:23):
Or higher values of micro boluswhen Sarah has like a spike in
her blood sugar, or if she'srunning a little bit higher.
I mean, we've even seen, I thinkthe highest that I've seen in a
micro bolus and micro boluspotentially could be given every
five minutes is I think thehighest I've seen is 0.35, which
I think most people don't seemmuch above like two.

(43:46):
So I think it's really doing agood job in learning Sarah so
much so that now when she isrunning higher, I really have to
make an effort and go and lookat the history before I will
give a correction, cuz I'll,I'll go to history and I'll look
at auto events.
And if I see that the system hasbeen giving her a good amount of

(44:07):
insulin, you know, if, if it'sbeen giving her like 0.3 and
then another 0.3 and then.
Point three, five, and then 0.2,five, you know, back to back to
back to back every five minutes,then I'll say, Ooh, it's, it's
been giving her quite a bit ofinsulin.
I probably just need to waitthis out.
Cuz if I give her a correctionon top of that, then she's gonna
have a crash.

(44:27):
So that's good.
I feel like it's taken some ofthe burden away from me and I,
and I do feel like it does itpretty quickly.
It can get her back down prettyquickly.
Now, now in the beginning, notso much in the beginning, I had
to give more manual correctionsbecause I wanted the system to
learn like, Hey, when she's upthis high, I don't want her to
be up this high.
I want her to come down quickly,but also safely.

(44:50):
But now that we're a few monthsin, I know that I need to be a
little bit more patient and giveit some time to do its thing and
bring her back down on its own.
And if I do that, typically shewill come back down nice and
safe and smooth and she'll land,you know, somewhere near her
target.
And if I don't and if I getinpatient and I rage bolus, then
that's when we usually see thecrashes.

(45:11):
I actually think the Omnipodfive gets Sarah's blood sugar
under control when it's high, alot faster than what we saw on
DIY loop.
I don't, I really don't know whythat is.
I mean, I could see what the DIYloop was doing in terms of how
it was adjusting her basal.
And it seemed like it was givingher a lot, but it just would
not.
Bring her down quickly when shewas running high.

(45:33):
So I've been very happy with theway in which Omnipod five has
learned Sarah and can now gether number back down pretty
safely.
I think a lot of people werepretty upset to hear that the
lowest target glucose value thatyou could set on the Omnipod
five was 110, cuz I think a lotof people didn't want their kids

(45:53):
sitting at 110 throughout theday.
You know, they would'vepreferred 85 or 90 or whatever
the case may be.
Well, I'm here to tell you thatSarah spends plenty of time
below her target value.
I mean, just this morning shehad yogurt and granola with
berries on top, top like regulargranola.

(46:13):
Not like a low carb version or alow carb granola, like regular
granola and regular yogurt, nota low carb keto version.
Like it was the, the real dealwith berries.
We did a 30 minute pre bolus.
She never got above.
I think 1 25 was the highest.
and then she came back down andshe, I think the lowest she got

(46:35):
was maybe 84, 85, and she kindof coasted around there for a
solid hour or so.
And then the system kind ofslowly started bringing her back
up.
But by the time she went tobolus for her lunch today, she
was sitting at I'm looking atthe screen right now.
She was sitting at 1 0 8 whenshe went to do her lunch bolus.

(46:56):
And her target right now forschool is set at one 30.
So it's definitely possible toget your kid to kind of sit
below their target value for agood chunk of time during the
day.
It might require some tweakingof settings on your part, but it
is possible.
Let me make a quick commentabout activity mode.

(47:17):
The Omnipod five does have afeature called activity mode.
When you put the pump intoactivity mode, you can choose
how long you want it to be inactivity mode.
I think the shortest amount oftime is an hour, and then it
goes up in hour increments afterthat we don't use it a ton every
now and then if Sarah is likerecovering from a low blood

(47:38):
sugar, I will put it in activitymode for an hour, just because I
don't want her to like.
Drink a juice box and have aspike.
And then the system see that andbe like, oh, she needs more
insulin.
I don't wanna have to deal withanother low right after the low
we just fixed.
So every now and then I'll putit in activity mode after we've
treated a low, that has beenhelpful.

(47:59):
What activity mode does is itautomatically sets the target
glucose at 150.
So it te sets that target alittle higher and it also gives
less overall insulin.
I forget what the percentage isof how much less that it's
giving, but it is giving lessinsulin overall.
So that's pretty conservative.

(48:20):
So I have found for Sarah, likeif we're using activity mode
while she's swimming or actuallybeing active sometimes.
She starts to run high, evenwhile she's doing those
activities because of howconservative activity mode is.
Or sometimes it works well forus, but then once she's done
with the activity, because herinsulin has been off for so

(48:42):
long, then we'll see like arebound high.
So I'll still put it in act.
I'll still put it into activitymode every now and then, but
usually like if Sarah's gonnaget in the pool and I know she
still has insulin on board my,the alternative that I prefer
for us is just to like, have herdrink a juice box and maybe just
temporarily set the targethigher, like not set the target

(49:06):
and overall insulin.
Activity mode does two things,right?
It sets the target higher and itgives less insulin overall.
Whereas if I just went in andset the target higher, that
would still be helpful inpreventing low blood sugars, but
not as conservative as activitymode would be.
So that could keep her steadyswimming, but also keep her from

(49:28):
having like a rebound highlater, if that makes sense.
But a lot of times, for us,especially towards the end of
the summer, when her body was soused to swimming all the time, I
found that if she still had aninsulin onboard from a previous
bolus, if I just gave her aPopsicle or juice box, I mean,
who doesn't want that in thesummertime?
That that did better for us tokeep her from crashing during

(49:51):
swimming than like putting herinto activity mode.
Again, I'm not telling y'allwhat to do.
I'm just telling you what we diddo.
I think hearing other people'sexperiences is helpful.
You know, it kind of like makesyou perhaps think in a, allows
you to think about things in away that maybe you didn't
before, and then you can takethat back to your healthcare

(50:13):
provider and kind of talk thingsthrough.
All right.
I wanna talk to you about somethings that we're gonna talk
about the pros and the cons.
I'll start with the cons first,so we can end on a good note.
But there are some things I donot love about the Omnipod five
system.
Personally, I am fine with Sarahhas an iPhone and personally I
am fine with the fact that.

(50:34):
It is not compatible with theiPhone at the moment, because I
kind of like having the separatedevices.
I think a con is for a lot ofpeople that it's not compatible
with iOS devices at the moment,but for me, I see it as a pro
because I like Sarah's almost 11years old.
So she's on her phone during theday.

(50:54):
She has little friends that shetexts with.
Some of them are diabetes.
Some of them do not havediabetes.
She plays games on her phonesometimes she'll watch a show on
Disney plus on her phonesometimes.
So I kind of like that I canhold her controller and
manipulate the settings if Ineed to, or give her a bolus
without having to get her phonefrom her, or, you know, say, Hey

(51:16):
Sarah, you need to stop whatyou're doing and, and do this
for your diabetes management.
So personally I kind of likehaving the separate devices.
Sure you have to keep up, keeptrack of another device, but
that's kind of always been whatwe've had to do anyway.
So it's nothing new for us Iwill say that the controller has
been a little glitchy at times,so I don't love that there was

(51:36):
one day when Sarah was at avolleyball camp over the summer
and she was running it like,this is not even funny.
I'm not sure why I'm laughing,but she was running at like 350
and I'm like what is going on?
I'm texting her, I'm callingher.
I even had to call thevolleyball clinic to get in
touch with her.
And the lady on the phone waslike, she says, she's giving
herself insulin.
I'm not sure what's happened.

(51:57):
And at this point in time, itwas like 30 minutes before I had
to go pick her up anyway.
So once I got her in the car, Ilooked at her PDM and I couldn't
even.
Swipe through on the screens.
Like it wa the touch screenwasn't working, it was super
glitchy, nothing was loading.
And I'm like, Sarah, has it beenlike this all day?
I'm she's like, yeah.
And I'm like, sweetie, youdidn't give yourself any insulin
for lunch.

(52:17):
Like you should have called me.
And she's like, I thought it wasgiving me insulin.
It was just so glitchy.
So anyway, lesson learned, Itold Sarah that if this ever
happens again, you need to callme right away.
But we also, I was reallynervous cuz that was only like
two weeks into the Omnipod five.
And I was thinking, oh my gosh,I'm gonna have to call customer
service and get a new controllercuz this one's broken.
But before I did that, I justdecided, okay, let's try to

(52:38):
restart it.
And see if that helps and justrestarting the controller, fix
the problem.
I have had to do that one othertime where it was starting to
look a little glitchy and I waslike, Ooh, I'm gonna restart it
real quick.
So I don't love that.
I don't know why that happens.
But it.
It does.
And for us so far justrestarting, it has helped.
Restarting does not meanresetting.

(53:00):
There is the option tocompletely reset the controller,
but that's like putting it backto like factory default settings
where you have to start fromsquare one.
You lose all the learning thatthe system has done if you reset
the controller.
So I mean, I don't, I don'twanna do that.
so but I did mention to a friendonce that, cuz she was seeing

(53:23):
lots and lots and lots of highblood sugars and I said, you
know, you could reset it andenter more aggressive settings
into the PDM to see if it couldmaybe learn your daughter a
little quicker.
So food for thought.
That's another thing that Idon't love about the Omnipod
five system that eventually, ifthe system does become
compatible with iOS devices andwe decide to switch over to the

(53:46):
phone app, we're gonna have tostart over like the system does
not.
If you have to get set up on adifferent device, there's no way
to like transfer your data over.
You have to start from squareone and you have to start all
over with the automated system,learning your child.
I definitely don't love that.
I'm probably not gonna do that.
Honestly.
Like if it becomes compatiblewith iOS devices, I'm probably

(54:09):
just gonna keep the controllerthat they gave us and just pray
that it keeps working anddoesn't get dropped in our pool
because I don't wanna have torestart.
But with that in mind every nowand then go into the controller
and take pictures of yoursettings.
So you know what they arebecause in the event that you do
have to get a new controller orrestart the learning process,

(54:30):
you will know what your settingsare and you'll know what your
settings were at, where you wereseeing success with the system.
I do that every now and thenmaybe like every three weeks,
I'll just open it up and takepictures of the settings.
So if something should happen,I'll know where we left off
something else I don't loveabout the system is there is no
view app for anybody that was onthe Omnipod dash system.

(54:52):
You will know what I'm talkingabout.
The view app was an app for likea parent or a caregiver to be
able to see the.
Management decisions that theirkid was making throughout the
day.
So like Sarah's at school rightnow.
And if I had a view app for theOmnipod five, I'd be able to go
in and see, okay, good.
She did give herself insulin forher snack and she gave it about

(55:14):
15 minutes before she was goingto eat.
And I would just be able to goin and double check.
And for me that would be sohuge.
Because again, there's no nurseat Sarah's school, so it's
really just me kind ofmonitoring things throughout the
day and texting with her aboutwhat she needs to do.
And it would just be, cuz therehave been some days where she
has forgotten to bolus for lunchor a snack or she's running

(55:38):
really high.
And I would love to see like,okay, did she just forget to
bolus?
Or maybe did somebody bring incupcakes for a birthday?
And I didn't know about it.
Like that would be superhelpful.
I would also love to be able tosee what the system is doing in
terms of the.
Auto events with the microbolusing, because if she is
running high, you know, I couldlook in there and see like,

(55:59):
okay, well she did give herselfher lunch insulin.
Maybe she didn't pre Boles wellenough, but also the system has
been working very hard to gether number back down, and it has
been giving her prettysignificant micro bolus.
So maybe I just need to wait andnot do a rage, bolus and
overcorrect.
Cuz then I don't want her to goout to recess in 30 minutes and

(56:21):
have a crash.
So anyway, again, Omnipod a viewapp would be incredibly helpful.
I really, I just don't.
I love y'all.
I am loyal to your product.
I don't think we will ever go toa non tubeless system.
So you're stuck with us forbetter or worse, but I would
really love a view app.

(56:41):
So anybody that's out therelistening.
That works for Omnipod.
Can you please put that on thetop of your list of priorities
of things to get done?
I just come on y'all.
If I can build the DIY loopsystem on my computer in one
day, your employees can build aview app.
It can happen, you know, it canwhat's the deal.
Come on, Now I will say thereISCO.
So you do have a way to see someof the management decisions that

(57:07):
your kid has been makingthroughout the day, but glucose
is slow.
So you don't really get to seeit until like an hour or two
after your kid has giventhemselves insulin.
And by that time, I mean, it'skind of too late.
There's not a whole lot you cando with it, but if you are on O
P five, definitely go to theOmnipod website and.
Click on all the links to getyourself set up with glucose and

(57:30):
sync your device with theglucose system.
Because that way, when you go tothe endocrinologist, all of your
data is right there for them tosee, and you don't have to
upload anything.
It automatically syncs whenyou're connected to wifi.
SoCo is a handy feature, butit's definitely no view app cuz
you don't get to see decisionsin real time.

(57:51):
There's like an hour or two lag.
Okay.
We are gonna end on a positivenote and I wanna tell you what I
absolutely love about theOmnipod five system.
I love the range that thecontroller has.
Again, if you guys follow me onInstagram, I recently posted a
reel that tested out the rangeand I was sitting on the top
step of some bleachers.

(58:12):
And my daughter was probably, Idon't even know, 80, 90, a
hundred feet away from me, iceskating.
And I was able to deliver abolus from where I was sitting
and it communicated with her podand delivered insulin to her
while she was ice skating.
That is phenomenal.
At night my bedroom is prettyclose to Sarah's.

(58:32):
And so at night I can, I chargeher PDM on my bedside table.
And at night, if she needs acorrection or I need to do
something with the controller,the range is amazing.
I do not even have to get out ofbed, whereas before I would have
to get up, I'd have to walk intoa room and try to tiptoe in and
hold the controller, like rightover the pod in order for it to

(58:53):
Deliver insulin to her orsuspend insulin or whatever it
is we wanted to do.
So the range is amazing.
I absolutely love it might beone of my top three favorite
features.
I love how quickly thecontroller shows Sarah's blood
sugar numbers.
For those of you that don't knowthe controller, if you have the
separate controller or if youhave the app on an Android

(59:13):
device it shows Sarah's Dexcomnumber with the trend arrow, and
it comes up so much quicker thanthe actual number on like the
Dexcom app on a smartphone.
Like if there's a signal lossand you know, you have the
little message that says likesignal loss, please wait 30
minutes.
Well, that might be up foranother 15, 20, 30 minutes.

(59:35):
But if you have the Omnipod fivecontroller right next to Sarah,
that number will come up almostimmediately, which makes things
like checking her number whileshe's swimming so much better.
Because you know, there's alwaysa signal loss when they're
submerged in water and when Ihave her get outta the pool to
check, we literally just standthere for.
Almost no time at all, anywherefrom like 20 seconds to two

(59:59):
minutes and her number will popright up, which is so much
faster than the Dexcom app onher phone.
I really just love that it'stubeless.
I mean, it's always beentubeless, so that's nothing new
that makes life just so mucheasier with the amount of
swimming that we do.
And Sarah's so active.
You know, she doesn't have todisconnect from her pump when

(01:00:19):
she's swimming or taking ashower or riding her bike.
She doesn't have to worry aboutgetting the tube caught on
anything.
So that's always been andcontinues to be an amazing
feature.
Oh, I really love how this isspecific to Omnipod five, but I
really love how the pod and theDexcom communicate with each
other.
Even when the controller and thephone is nowhere near the person

(01:00:44):
wearing the devices.
So Sarah could be down thestreet playing with a friend and
she could have left or forgottenher controller and her phone at
home, which I wouldn't lovebecause then I wouldn't be able
to follow her.
Cuz her phone wasn't near her,but still she could leave those
devices at home, go down thestreet to play and the automated

(01:01:05):
system would still be workingit, they would still because the
algorithm is built into each andevery pod.
It can communicate with theDexcom and make insulin
adjustments without thatcontroller or phone being
anywhere near her.
I think that's phenomenal.
The other day, where do we go?
We went to church the other day.
We went to church and Sarah hadher phone.
So I would still be able to seeher Dexcom numbers on the follow

(01:01:27):
app.
You know, when we dropped heroff and her, her little class at
church but she forgot thecontroller.
I told her, I said, Hey,sweetie, you know, you're just
not gonna be able to giveyourself, or you're just not
gonna be able to have snacktoday at church.
I'm sorry.
Lesson learned.
Hopefully we'll remember it nextweek, but you know, for today
you don't, you're just gonnahave to skip snack, however,
Even though we didn't have thecontroller, the system was still

(01:01:49):
adjusting.
Like she had a little bit of abump up because of breakfast.
And so it did what it needed todo to bring her back down.
And then it helped her to landsafely at a good number that
wasn't a hypoglycemic event.
All with that controller beingnowhere near her, obviously she
would need the controller nearher if she wanted to give
herself a bolus for a snack ormaybe lunch.

(01:02:12):
And then, you know, her phonedoes still need to be near her
for me to be able to see hernumbers, right.
Cuz if her phone's not near her,then the Dexcom app, isn't
picking up the number and thenit's not able to share that with
me, so I wouldn't be able tofollow it, but I just love that
the algorithm still works.
When those devices aren't closeto her.
Okay.
I think that I coveredeverything that I wanted to say.

(01:02:35):
There are some really fabulouspodcast episodes that have been
re recorded about the Omnipodfive system.
I'm gonna link to those in theshow notes.
Juice box did a three partseries with a diabetes educator
who helped people through likethe clinical trial with the
Omnipod five.
So she was a wealth ofinformation.
I'm gonna link to that in theshow notes because she kind of

(01:02:57):
talks about specifics withsettings and some other
features.
I think that would be worth alisten.
Stacey Sims, the host of thediabetes connections podcast.
She also had a really fabulousepisode, all about the Omnipod
five, where she interviewed itwas one teenage girl, like older
teenage girl that had been usingOmnipod five and then two other

(01:03:18):
moms of a type one diabetic theywere using the Omnipod five for
their kid.
So she interviewed those threepeople and then she also
interviewed An Omnipod fiveemployee and not just an
employee, I'm forgetting hisexact title, but it was like
definitely somebody, one of thehigher ups in the Omnipod
insulate world.
So those interviews that she didare combined into one podcast

(01:03:40):
episode, and I really love theway that she, she did that
interview.
So that's for sure, worth alisten.
I got lots of good nuggets ofinformation from that one.
I'm gonna link to both of thosein the show notes, because share
the love.
You know, I'm here to helpparents and caregivers of type
one diabetics, and you canlisten to my podcast, but you
can also listen to these otherawesome podcasts there's room at

(01:04:01):
the table for all of us.
And really my main goal is tomake sure that you are well
informed and.
Feel empowered so you can makegood diabetes management
decisions for yourself or foryour kid.
Whoever is the one living withtype one.
All right.
You guys, that is all I have tosay about Omnipod five.

(01:04:22):
There's so much.
I'm sure, as soon as I'm donerecording, I'll think of 10 more
things that I wanted to tell youthat I didn't.
But feel free to reach out to mewith any of your questions, your
comments.
I'd love to know your thoughtson this episode.
If you've kind of done somesimilar things or.
I would just love to hear theresults that you've had with the
system and how you got there.

(01:04:44):
Personally, we love it.
We're sticking with it.
Like if you wanna know what ourclarity, our Dexcom clarity
numbers show, I can tell youthat everything is for time and
range.
Again, remember I have her rangeset at 70 to one 50.
I'm hoping to actually bump thatdown to one 40 soon.
But this is on like, you know,the Dexcom clarity app.

(01:05:05):
So like for our 90 day range,which remember we've only been
on the Omnipod five for twomonths, so there's a whole month
in there.
In this data that is not takinginto account the Omnipod five
that's when we were still doingthe DIY loop.
But like right now, 90 dayaverage is 1 31 standard
deviation is 52.
I definitely think there's someroom for improvement there.

(01:05:27):
We saw lots of high blood sugarswhen she was on loop.
Anyway her A1C is predicted tobe at 6.4.
I will say that every singletime we've had the prediction in
the clarity app, it's alwaysabout a half of a point lower
than what it actually shows inDCOM clarity.
So with the prediction being at6.4, I'm kind of thinking she'll

(01:05:48):
probably be at like six, rightat six or maybe 5.9 when we go
in for our appointment.
But we'll see.
And her 90 day time and range is70%.
So, but then if you go backearlier, like 30 days would be
probably a little bit betterreflection of what.
The Omnipod five has been doingfor her since, you know, we've

(01:06:09):
only been on that for the pastmonth.
So her average glucose for 30days has been 1 28 standard
deviation is 45.
So that's a little better.
The predicted A1C is still at6.4 and the time and range is a
little bit better.
It's at 73%.
So just to give you a guys, oh,I really like the seven day

(01:06:30):
average.
The average glucose is 1 24standard deviation is 41 and the
time and range is 77%.
I'm I'm gonna choose to look atthat.
I like that.
That makes my heart happy.
all right.
You guys have a fabulous week.
Thanks for listening to me,ramble on about the Omnipod
five.
I hope that I provided you witha good kind of overview and
summary of how it's been goingfor us and what we've

(01:06:52):
experienced.
I will chat with you soon.
But until then stay calm andBoless on.
Bye.