Do You Still Pre-Bolus on a Closed-Loop Pump? | Control-IQ, Omnipod 5

If you're on a closed-loop system, Control-IQ, Omnipod 5, or Loop, you've probably wondered whether the algorithm means you're off the hook for pre-bolusing. Neil has to be the one to tell you: you still do it. These systems are an incredible co-pilot, but they're not a self-driving car you can nap in.

Here's the reason, with a real number. In Omnipod 5 data, when people skipped the meal bolus, the algorithm poured in about 16% of their total daily insulin over the four hours after the meal trying to catch up, and it still couldn't stop the spike. These hybrid closed-loop, or automated insulin delivery (AID), systems are reactive, they respond after glucose rises. The guidance to bolus 10 to 15 minutes early is published, not opinion.

In this episode:

Why closed-loop pumps still need you to pre-bolus your meals
The Omnipod data: the algorithm used ~16% of daily insulin and still spiked
Why AID systems are reactive, not predictive
Why bolusing TOO early can backfire on a closed loop

This Week's Challenge: If you're on a closed-loop system, give your meal dose about 10 to 15 minutes before dinner and watch how your system rides along. Compare it to dosing at your first bite.

Helpful resources and newsletter: https://yourbestt1dyear.com

Connect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.com

Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1

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