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Omnipod DASH

Mirrored from https://wiki.aaps.app/en/latest/CompatiblePumps/OmnipodDASH.html — community documentation, not medical advice.

These instructions are for configuring the Omnipod DASH generation pump (NOT Omnipod Eros) , available in AAPS from version 3.0.

Omnipod DASH specifications

These are the specifications of the Omnipod DASH (‘DASH’) and what differentiates it from the Omnipod EROS (‘EROS’):

Omnipod DASH known AAPS constraints/issues

Hardware/Software Requirements

AAPS will automatically establish a new Bluetooth connection to the Pod every time it needs to send a command (e.g a Bolus), after sending the command the Bluetooth connection is immediately disconnected.

The instructions below explain how to activate a new pod session using AAPS . You should wait for your current Pod to be close expiry, as you will need to activate a new Pod with AAPS . Once a pod is de-activated it cannot be reused/re-activated, the de-activation is final.

Before You Begin

Ensure you have read and understand this whole guide, have read and understand the Before You Begin section, as well as Omnipod and AAPS Constraints and Issues to avoid running into a known problem.

SAFETY FIRST - You SHOULD NOT try to connect AAPS to a pod for the first time without having access to all of the following

Your Omnipod Dash PDM will become redundant after the AAPS Dash driver activates your pod

Your pod WILL NOT stop delivering insulin when it is not connected to AAPS

Default basal rates are programmed on the pod on activation as defined in the current active Profile .

As long as AAPS is operational it will send basal rate adjustment commands that run for a maximum of 120 minutes.

When for some reason the pod does not receive any new commands (for instance because communication was lost due to Pod ➜ phone distance) the pod will automatically fall back to default basal rates as defined in your Profile .

AAPS Profile(s) do not support 30 minute basal rate time frames

If you are new to AAPS and are setting up your basal rate Profile for the first time, please be aware that basal rates starting on a half-hour basis are not supported. For example, on your Omnipod PDM, if you have a basal rate of 1.1 units which starts at 09:30 and has a duration of 2 hours ending at 11:30, it is not possible replicate this exact Basal Profile in AAPS .

You will need to change this 1.1 unit basal rate to a time range of either 9:00-11:00 or 10:00-12:00. Even though the DASH hardware itself supports the 30 minute basal rate Profile increments, AAPS does NOT support this feature.

0U/h Profile basal rates are NOT supported in AAPS

While the DASH does support a zero basal rate, AAPS uses multiples of the user’s Profile basal rate to determine automated treatment; it cannot function with a zero basal rate.

Instead a temporary zero basal rate can be achieved through the “Disconnect pump” function, or through a combination of Disable Loop/Temp Basal Rate or Suspend Loop/Temp Basal Rate.

NOTE: The lowest basal rate allowed by the DASH in AAPS is 0.05U/h.

Selecting Dash in AAPS

There are two available options to configure Omnipod in AAPS :

Option 1: New installations

When installing AAPS for the first time, the Setup Wizard will guide new users through key features and installation requirements for AAPS .

Select “DASH” when you reach Pump selection.

When in doubt you can also select “Virtual Pump” and select “DASH” later, after setting up AAPS (See Option 2).

Option 2: The Config Builder

On an existing installation you can select the DASH pump from the Config builder:

On the top-left hand corner hamburger menu select Config Builder (1) ➜ Pump ➜ Dash ➜ Settings Gear (3) by selecting the radio button (2) titled Dash .

Selecting the checkbox (4) next to the Settings Gear (3) will allow the DASH menu to be displayed as a tab in the AAPS interface titled DASH . Checking this box will facilitate your access to the DASH commands when using AAPS .

NOTE: A faster way to access the Dash settings can be found below in the DASH settings section of this document.

Verification of Omnipod Driver Selection

To verify that you have selected the DASH in AAPS , if you have checked the box (4) , swipe to the left from the Overview tab, where you will now see a DASH tab on AAPS . If this box is left unchecked, you’ll find the DASH tab in the hamburger menu upper left.

Dash Configuration

Swipe left to the DASH tab where you will be able to manage all pod functions (some of these functions are not enabled or visible without an active pod session):

‘Refresh’ pod connectivity and status, be able to silence pod alarms when the pod beeps

‘Pod Management’ (Activate, Deactivate, Play test beep, and Pod history)

Activate Pod

NOTE: When calculating the total amount of insulin you need for 3 days, please take into account that priming the pod will use about 3-10 units.

Ensure that the new pod and the phone running AAPS are within close proximity of each other and click the Next button.

NOTE : if the error message below pops up ‘Could not find an available pod for activation’ (this can happen), do not panic. Click on the Retry button. In most situations activation will continue successfully.

A green checkmark will be shown upon successful priming, and the Next button will become enabled. Click on the Next button to complete the pod priming initialization and display the Attach Pod screen.

If you get skin irritation from the adhesive consider using a Barrier Wipe or Barrier Spray.

Remove the pod’s blue plastic needle cap. If you see something that sticks out of the pod or it looks unusual, STOP the process and start with a new pod. If everything looks OK , proceed to take off the white paper backing from the adhesive and stick the pod to the selected site on your body.

When finished, click on the Next button.

NOTE: Before the cannula is inserted, it is good practice to pinch the skin near the cannula insertion point. This ensures a smooth insertion of the needle and will decrease your chances of developing occlusions.

Click on the Next button.

Click on the green Finished button.

Congratulations! You have now started a new pod session.

Click on the back button on your phone to return to the DASH tab screen which will now display Pod information for your active pod session, including current basal rate, pod reservoir level, insulin delivered, pod errors and alerts.

NOTE: For more details on the information displayed go to the DASH Tab section of this document.

NOTE: It is good practice to export settings AFTER activating the pod. Settings should be exported after each pod change and once a month, ensure you copy the exported settings file to a cloud storage location (e.g. Google Drive) or somewhere off your phone in case you loose your phone (see Export settings ).

Deactivate Pod

Under normal circumstances, the expected lifetime of a pod is three days (72 hours) and an additional 8 hours after the pod expiration warning for a total of 80 hours of total pod usage.

To deactivate a pod (either from expiration or from a pod failure):

You will receive a confirmation beep from the pod that deactivation was successful.

You may now remove your pod as the active session has been deactivated.

Verify that the Pod status: field displays a No active Pod message.

Resuming Insulin Delivery

NOTE : During Profile Switches , like when using the PDM, AAPS must suspend delivery on the Pod before setting the new basal Profile . If communication fails between the suspend and resume commands, then delivery can stay suspended, Read Delivery suspended in the troubleshooting section for more details.

When insulin delivery is suspended you will need to issue a command to instruct the active, currently suspended pod to resume insulin delivery. After the command is successfully processed, insulin will resume normal delivery using the current basal rate based on the current time from the active basal Profile . The pod will again accept commands for bolus, TBR , and SMB .

Silencing Pod Alerts

The process below will show you how to acknowledge and dismiss pod beeps when the active pod time reaches the warning time limit before the pod expiration of 72 hours (3 days). This warning time limit is defined in the Hours before shutdown Dash alerts setting. The maximum life of a pod is 80 hours (3 days 8 hours), however Insulet recommends not exceeding the 72 hours (3 days) limit.

NOTE : The SILENCE ALERTS (3) button is only available on the DASH tab when the pod expiration or low reservoir alert has been triggered. If the SILENCE ALERTS button is not visible and you hear beep sounds from the pod, try to ‘Refresh pod status’.

You can verify this on the DASH tab, the Pod expires: (1) field will show the exact time the pod will expire (72 hours after activation), and the text will turn red after this time has passed.

Under the Active Pod alerts (2) field the status message Pod will expire soon is displayed. This also will trigger displaying the SILENCE ALERTS (3) button.

View Pod History

This section explains how to review your active pod history and filter by different action categories. The pod history tool allows you to view the actions and results committed to your currently active pod during its three days (72 - 80 hours) life.

This feature is helpful in verifying boluses, TBRs and basal commands that were sent to the pod. The remaining categories are useful for troubleshooting issues and determining the order of events that occurred leading up to a failure.

NOTE: Only the last command can be uncertain . New commands will not be sent until the last ‘uncertain’ command becomes ‘confirmed’ or ‘denied’ . The way to ‘fix’ uncertain commands is to ‘refresh pod status’ .

DASH Tab

Below is an explanation of the layout and meaning of the icons and status fields on the DASH tab in the main AAPS interface.

NOTE: If any message in the DASH tab status fields report (uncertain), then you will need to press the Refresh button to clear it and refresh the pod status.

Fields

Buttons

Sends a refresh command to the active pod to update communication.

Navigates to the Pod management menu.

When pressed this will disable the pod alerts beeps and notifications (expiry, low reservoir..).

Resumes the currently suspended insulin delivery in the active pod.

Pod Management Menu

Below is describes the purpose of each icon on the Pod Management menu, accessed by pressing POD MGMT (1) button from the DASH tab.

The table below describes each button and it’s function:

Button

Function

1

Access the Pod Mgmt settings

2

Activate Pod : Primes and activates a new pod.

3

Deactivate Pod : Deactivates the currently active pod.

4

Play Test Beep : Plays a single test beep on the pod when pressed.

5

Pod history : Displays the active pod activity history.

Dash Settings

The Dash driver settings are configurable from the top-left hand corner hamburger menu under Config Builder (1) ➜ Pump Dash ➜ Settings Gear (3) by selecting the radio button (2) titled Dash . Selecting the checkbox (4) next to the Settings Gear (3) will allow the Dash menu to be displayed as a tab in the AAPS interface titled DASH .

NOTE: A faster way to access the Dash settings is by accessing the 3 dot menu (1) in the upper right hand corner of the DASH tab and selecting Dash preferences (2) from the dropdown menu.

The settings groups are listed below; you can enable or disable via a toggle switch for most entries described below:

NOTE: An asterisk (*) denotes the default setting is enabled.

Confirmation beeps

Provides confirmation beeps from the pod for bolus, basal, SMB, and TBR delivery and changes.

Bolus beeps enabled: Enable or disable confirmation beeps when a bolus is delivered.

Basal beeps enabled: Enable or disable confirmation beeps when a new basal rate is set, active basal rate is canceled or current basal rate is changed.

SMB beeps enabled: Enable or disable confirmation beeps when a SMB is delivered.

TBR beeps enabled: Enable or disable confirmation beeps when a TBR is set or canceled.

Alerts

Provides AAPS alerts for pod expiration, shutdown, low reservoir based on the defined threshold units.

NOTE: an AAPS notification will ALWAYS be issued for any alert after the initial communication with the pod since the alert was triggered. Dismissing the notification will NOT dismiss the alert UNLESS automatically acknowledge Pod alerts is enabled. To MANUALLY dismiss the alert you must visit the DASH tab and press the Silence ALERTS button .

Expiration reminder enabled: Enable or disable the pod expiration reminder set to trigger when the defined number of hours before shutdown is reached.

Hours before shutdown: Defines the number hours before the active pod shutdown occurs, which will then trigger the expiration reminder alert.

Low reservoir alert enabled: Enable or disable an alert when the pod’s remaining units low reservoir limit is reached as defined in the Number of units field.

Number of units: The number of units at which to trigger the pod low reservoir alert.

Notifications

The Notification section allows the user to select their preferred notifications and audible phone alerts when AAPS is uncertain about the status of TBR, SMB, or bolus, and when delivery suspended events were successful.

NOTE: These are notifications only, no audible beep alerts are made.

Sound for uncertain TBR notifications enabled: Enable or disable this setting to trigger an audible alert and visual notification when AAPS is uncertain if a TBR was successfully set.

Sound for uncertain SMB notifications enabled: Enable or disable this setting to trigger an audible alert and visual notification when AAPS is uncertain if an SMB was successfully delivered.

Sound for uncertain bolus notifications enabled: Enable or disable this setting to trigger an audible alert and visual notification when AAPS is uncertain if a bolus was successfully delivered.

Sound when delivery suspended notifications enabled: Enable or disable this setting to trigger an audible alert and visual notification when suspend delivery was successfully delivered.

Actions (ACT) Tab

This tab is well documented in the main AAPS documentation but there are a few items on this tab that are specific to how the DASH differs from tube based pumps, especially after the processes of applying a new pod.

Level

Insulin Level

Insulin level displayed is the amount reported by DASH. However, the pod only reports the actual insulin reservoir level when it is below 50 units. Until then “Above 50 units” will be displayed. The amount reported is not exact: when the pod reports ‘empty’ in most cases the reservoir will still have some additional units of insulin left.

The DASH overview tab will display as described the below:

Additional note:

Known Issues Workarounds

This section covers common workarounds and settings that need to be changed to enable a feature to work around a community reported issue that has a fix. E.g. the Basal drift enable process is documented here.

Basal Drift Fix Instructions

The Omnipod Dash pump has a limitation that can cause it to deliver less basal insulin than AAPS expects, see Issue #4783 for more technical details.

The Dash uses an internal timer to determine when a basal pulse of 0.05 U is delivered. Once the timer interval elapses, the pulse is delivered. However, this timer is restarted whenever a basal rate change occurs e.g when AAPS sends a new Basal rate.

When used in combination with looping, this leads to under-delivery of basal insulin, as the algorithm updates the basal rate on the pump frequently.

The issue is most apparent during the night. During daytime operation, SMBs often result in a basal rate of 0, which masks the effect. In observed usage, this results in approximately 10% of the expected Total Daily Dose (TDD) not being delivered over a 24-hour period. Additionally, glucose targets are often not reached overnight, particularly after meals with prolonged glucose impact (e.g. pasta).

NOTE: This issue is especially important to understand for people on very small dosages of insulin, Children for example.

Enable Basal Drift Fix in AAPS

You must be running AAPS Version 3.4.2.3 or later for this feature.

The Basal Drift Fix is not enabled by default on AAPS.

To enable it:

NOTE: Ensure you check in the AAPS settings where your AAPS Directory is, and that you placed the file in the correct one, a number of several have been caught out putting the file into the wrong folder.

Troubleshooting

This section covers common known issues and solutions for Omnipod DASH use with AAPS. There is also General Troubleshooting section in the documentation that should be reviewed as it covers relevant topics for some Pod issues too.

---## Bluetooth related issues

For known issues with Bluetooth connections, dropouts of pump/pods, or activation and connection issues Bluetooth Troubleshooting

---### Delivery suspended

NOTE: When you hear beeps from the pod, do not assume that delivery will continue without checking the phone, delivery might stay suspended, so you need to check !

---### Pod Failures

---### Preventing error 49 pod failures

This failure is related to an incorrect pod state for a command or an error during an insulin delivery command. This is when the driver and Pod disagree on the actual state. The Pod (out of a built-in safety measure) then reacts with an unrecoverable error code 49 (0x31) ending up with what is know as a “screamer”: the long irritating beep that can only be stopped by punching a hole at the appropriate location at the back of the Pod. The exact origin of a “49 pod failure” often is hard to trace. In situations that are suspected for this failure to occur (for instance on application crashes, running a development version or re-installation).

---### Pump Unreachable Alerts

When no communication can be established with the pod for a pre-configured time a “Pump unreachable” alert will be raised. Pump unreachable alerts can be configured by going to the top right-hand side three-dot menu, selecting Preferences ➜ Local Alerts ➜ Pump unreachable threshold [min] . Recommended value is alerting after 120 minutes.

---### Export Settings

Exporting AAPS settings enables you to restore all your settings, and maybe more importantly, all your Objectives. You may need to restore settings to the “last known working situation” or after uninstalling/reinstalling AAPS or in case of phone loss, reinstalling on the new phone.

NOTE: The active pod information is included in the exported settings. If you import an “old” exported file, your actual pod will “die”. There is no other alternative. In some cases (like a programmed phone change), you may need to use the exported file to restore AAPS’ settings while keeping the current active Pod . In this case it is important to only use the recently exported settings file containing the pod currently active.

It is good practice to do an export immediately after activating a pod . This way you will always be able to restore the current active pod in case of a problem. For instance when moving to another backup phone.

Regularly (after each export preferably) copy your exported settings to a safe place (a cloud drive e.g. Google Drive) that is accessible by any phone when needed. This allows you to restore to a phone from anywhere in case of a phone loss or factory reset of your phone while you are not at home.

---### Import Settings

WARNING : Please note that importing settings will possibly import an outdated Pod status (depending when you made the last export/backup).

As a result, there is a risk of losing the active Pod! (see Exporting Settings ).

Importing while on an active Pod: (you risk losing the Pod!)

Importing (no active Pod session)

---### Importing settings that contain Pod state from an inactive Pod

When importing settings containing data for a Pod that is no longer active, AAPS will try to connect with it, which will obviously fail. You can not activate a new Pod in this situation.

To remove the old pod session:

Generic error: java.lan.illegalStateException: Trying to set a Bluetooth Address to , but it is already set to

If you receive this error when attempting to Initialize a new pod AAPS fails as it still has settings for an old pod stored in configuration.

This can happen if you restore from a backup, or a pod deactivation fails.

To resolve keep clicking on RETRY until a Discard option is shown, then discard. This procedure should work for De-Activating a pod too.

You should now be able to Activate a new pod.

---### Reinstalling AAPS

When uninstalling AAPS you will lose all your settings, objectives and the current Pod session. To restore them make sure you have a recent exported settings file available!

When on an active Pod, make sure that you have an export for the current pod session or you will lose the currently active pod when importing older settings.

---### Updating AAPS to a newer version

In most cases there is no need to uninstall. You can do an “in-place” install by starting the installation for the new version. This is also possible when on an active Pod session.

---### Omnipod driver alerts

The Omnipod Dash driver presents a variety of unique alerts on the Overview tab , most of them are informational and can be dismissed while some provide the user with an action requiring their input to resolve the cause of the triggered alert.

A summary of the main alerts that you may encounter is listed below:

Where to get help for DASH

All of the development work for the DASH is done by the community on a volunteer basis; please keep this in mind and use the following guidelines before requesting assistance:

When requesting help come prepared with the following information to help those in the community with your specific questions and problems: