Dr Ashley Ng

From time to time, I get curious with how many people peruse my blog and what they’ve been reading. I’m always surprised, to the point where I shouldn’t be surprised anymore, that the post on my initial thoughts on the YpsoPump when it furst arrived in Australia is still often frequented. Six years on, a few things have changed and maybe it’s time for an update.

First we finally had the bidirectional update in 2022, which meant remote bolusing – a feature I absolutely loved. Remote bolusing took away an extra step of remembering the insulin dose from the bolus calcuator and actually inputting it into the pump. It also meant not having to fiddle with getting the pump out at all – very discrete. For the loyal fans, we were waiting for the next big announcement…

CamAPS FX – Ypso’s automated insulin delivery system or hybrid closed loop, which was lauched around the end 2022 or start of 2023. CamAPS FX promised an algorithim that learns with you to adjust your background insulin levels in response to your glucose level readings and its trend from your continuous glucose monitor. It features a glucose target that you could adjust yourself, unlike other commercial models where the target range can’t really be altered. You can also tell the system how much carbohydrates you’ve had in response to a hypo and it will monitor the glucose rise and adjust insulin dosing as needed. Amazing for the hypos where you end up inhaling half the pantry.

HOWEVER, the catch was that only the Android app was approved by TGA with the iOS version to come. Initially, the prospect of switching from Apple to Android or purchasing a separate Android phone as a “pump phone” seemed off putting. Yet the more we heard about the responsiveness of the CamAPS FX algorithim, the more people started to take the plunge – and many have sworn by it.

Then there was me. The one who had a million excuses not to use CamAPS FX. ALthough in hindsight, it would’ve really helped me throughout that initial postpartum period. I was nervous to let something else drive the technology that I was so used to managing manually. Although thinking back, I was happy to trust a bolus calculator, which magically calculated the amount of inuslin I needed. But I think since I could see the maths, I felt more comfortable with it.

My biggest barrier was having to carry around a second device that I’d need to purchase and also not being able to see my sugars directly on my Apple Watch without having to set up a million workarounds. However, I had a bit of a wake up call at my recent Endo appointment about my A1c. Thankfully, my sister also happened to have a spare Android on hand, so I decided to take the plunge.

Learning the entire system and its terminology was certainly challenging, but no more than learning how to use a brand new pump anyway. I was surprised at how quickly I got used to carrying around two devices and trusting the algorithm to do its thing. In fact, it was sometimes even nice to just carry around my “pump phone” and leave my personal phone behind to reduce distractions.

Those initial barriers now seemed miniscule compared to the massive improvement I’ve seen with my Time In Range. I’ve gone from 60-75% TIR to about 80-100% in just two weeks of turning Automode on. At the risk of sounding like another Ypso fan, I get the hype now.

Of course there are still things I wish could be improved. These include:

• Not being able to see a summary of daily carb intake
• A very short range I can be away from the pump phone for Automode to keep running
• Lack of direct to smart watch link to see current glucose levels and trend
• Random buzzing alerts for suspension of background insulin etc.
• Pump tubing = pump bungee jumping

Overall though, these are things I’m willing to put up with in exchange for the algorithm putting my mind at ease around my glucose management. I haven’t had to worry about my overnight or morning levels since I started Automode – the two areas where I really struggled with despite multiple adjustments and changes. It’s almost made the 5 year wait from initially promised worthwhile. I’m sure Ypso have more treasures hidden up their sleeves, let’s see what else they can do!