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Omnipod Insulin Management System

Omnipod 5 dexcom integration

Omnipod 5 Features

  • Automated Insulin Delivery (AID) pod pump uses Dexcom G6 and G7. The algorithm determines the adaptive basal rate according to TDD from past pods. 
  • Tubeless, waterproof pods adhere to skin, contain the cannula, contain the algorithm, and communicate wirelessly to "Controller" that looks like an Android phone. The Omnipod 5 in Canada does not yet operate from a cell phone. 
  • The Controller contains an Insulet SIM card to automatically upload results to Glooko. (No cell phone plan is required for the Controller to function.)  All programming and pod changes are done via the "app" in the Controller.  
  • The user requires a separate phone to activate each Dexcom glucose sensor from a Dexcom app.  A phone is not needed again until the sensor is deactivated and a new one is inserted. After sensor set-up, the sensor communicates directly with the Pod. The pod communicates directly with the Controller.
  • Glucose targets:  6.1, 6.7, 7.2, 7.8 to 8.3 mmol/L. Users may set set up to 8 different glucose target segments per day.

SmartAdjust Algorithm

  • The following can be adjusted by the user in AID (SmartAdjust) mode:
    • Target glucose
    • Carb Ratio 
    • ISF (corrections are manual via the SmartBolus Calculator) 
    • Other settings: Correct Above, Duration of Insulin Action and Reverse Correction (turn off for most)
  • The algorithm determines the "Adaptive Basal Rate";  it does not use the programmed manual basal rates except as one of the references during the frist 48 hrs.. "Adaptive Basal Rate" is based on TDD for the past 4-5 pods. Optimization could take a few weeks, or less.
  • Pods contain the algorithm. The algorithm is updated every 2-3 days with a pod change.
  • Basal insulin is assessed every 5 minutes based on the current sensor glucose value, trend, predicted value 60 minutes out and the target chosen. The pod then increases, decreases, or pauses basal insulin. 
  • The algorithm may increase the automated basal by up to 4 X the "Adaptive Basal Rate".
  • Only basal modulation is provided based on the algorithm's determination of basal needs. 
  • The bolus calculator uses the following information:
    • Inputted carbohydrate
    • Manually programmed carb ratios
    • Manually programmed ISF (correction factors)
    • Sensor trends
    • Insulin on board (past bolus + any basal delivered "above" the Adaptive Basal Rate)
  • Initial Setup
    • POD #1: For this limited time, the algorithm uses the active manual basal program (and parameter that 50% of total daily insulin is basal) to determine the first "Adaptive Basal Rate". Expect the first 2-3 days' time in range to be lower than desired.
    • POD #2 (at least 48 hrs after pod 1): The algorithm adjusts using total daily insulin from first pod. 
    • With each new pod: The algorithm adjusts according to total daily insulin, with the past 4-5 pods having the greatest impact.
  • More Setup Information
    • More agressive carb ratios may be required compared to multiple daily injections.
    • Most will disable the "Reverse Correction" setting. 
    • Active insulin time often set to 3-4 hour 
  • Features NOT availagble in Automated Mode
    • No extended bolus in "Auto"
    • No temp basal in "Auto"
  • Key Reminder: Pod and sensor need to be in direct line of sight.

 

Adjusting for Hypoglycemia

 

 

Adjusting for Hyperglycemia

 

 

Exercise Options

  • Sets Target Glucose to 8.3 mmol/L for the amount of time chosen (up to 24 hours). 

Training


Reports - Glooko

 

FYI & Misc

  • Omnipod 5 vs Omnipod use in Loop DIY AID (video, Loop & Learn)
  • Pods can only be purchased via Diabetes Express or Richmond Square Pharmacy in Calgary.
  • Advise to change set if notice tunneling or corrections that are not returning glucose to target. Tunneling is the wetting of the material of the pod (insulin travels back up after delivery). It often occurs with movement of the pod (laying on or just day to day movement after a few days) or bigger boluses. Consider extended boluses, different sites, more frequent pod changes, 

     

 

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