The first day was yesterday and seemed great, but while sleeping, my blood sugar dropped below 55. Little helped, so I ate too much sugar, and then corrected the defaults for my bolus and correction. That worked, and I woke up with good numbers that lasted until breakfast, and now I’m running a little high. I’m wondering whether I should fix my bolus or my correction. Any suggestions for this and the future?
3 Likes
It’s still going great, with >90% in range, but again, and overnight low, although not as severe. I have adjusted my bolus calculation, and that seemed to help with the daytime numbers, but the overnight problems might be lingering Tresiba or a facet of my pre-bed snack. The carbs in those might have as strong an effect.
2 Likes
I think the transition from Tresiba to pump is tough for the first few days.
4 Likes
I would think so as well. Tresiba has a much longer half life. For that reason I keep a box of Lantus pens as pump backup. 20 hours and it is mostly gone.
2 Likes
If you keep going low overnight, and it’s in the same time frame, you could try raising your target for that period, so the algorithm backs off a bit.
3 Likes
If I Understand Correctly the O5 does not do anything other than do what it’s told for the first pod. I.e. I don’t think it is doing anything other than what you/your endo told it to do.
The Treshiba point is valid, the same point can be made for Lantus or any other long acting insulin. While it may be pure turtleneck marketing they claim (as if a chemical could claim) that they last for 24 hours, or so, or more.
My approach to the MDI swap is to halve my basal in and out; even if my basal is accurate overlapping with a pump basal is a poker hand that ends at 6. I think I’m just the choirboy.
@James.J.Igoe You’ve gotten some good advice/opinion from a few folks here, first if its your first pod, unless the need is drastic, let it go and let the algorithm do what it needs to do, see if it corrects itself. If it doesn’t or the need is great, then AFTER the next pod make a slight adjustment, i.e. if the algorithm allows, make an adjustment in target or whatever setting affects the need. The key is let the algorithm try to resolve itself, when/if it doesn’t, make a change, just one, and test it for a day or two. We tend to make too large of a change, or too many changes at once, and then either swing too much in one direction or don’t know what worked and what didn’t work. It’s not an easy process. And remember the folks giving the advice (including me) are not experts in O5 or your situation. Give it some time, unless the need is great!
5 Likes
That first day on a new setup can definitely be a bit all over the place I’d be careful about changing too many settings after just one night since things can still be settling in. It might help to review both basal and correction with your endo or pump team so you don’t overcorrect. Hope it smooths out soon!
2 Likes
My first pod went wonderfully, but my next two likely suffered from poor placement. I did everything correctly, but once I switched to the back of my arm for the pod, things went much better. I have tweaked the bolus and correction settings, and that seems to have worked adequately, although I will likely need to tweak further. I see my endo’s PA today as a follow-up.
Up until I lost weight - I changed my diet and lost about 30 pounds over 6 months - my control was good, but with weight loss, I’ve been struggling getting my numbers under control (see left). The numbers are better now (see the right), but since I had 2 days when the pods weren’t working, the results are subpar. Like most, with experience, I imagine the numbers and graphs will head downward and flatten over time.
3 Likes
Sounds like you handled a lot of ups and downs on day one. It can take some time to learn how your settings work in real life. Hopefully others who use the same system can share what helped them during those first few days. Keep us posted on how it goes!
3 Likes
So far, I am almost hitting the short-term target (6.5 A1c, >80% TIR) but hampered by occasional device issues. Although inserted correctly, two pods had to be tossed because I put them where I had too little fat. A third issue was that when I placed a pod of the back of my arm, my sleeping position prevented communication between pod and sensor. With a delayed peak from dinner, my sugars rocketed over 200, and then took a while to bring down.
Long term, I expect to do better, likely keeping it under 6 A1C and (maybe) > 90% in range.
4 Likes
How is it going?
So far, great! I’m hitting the target, and it feels so much better not to have to inject, but I’m hoping that Insulet will eventiually produce devices that last longer than 3 days, maybe with a denser insulin. I’m also getting use to bolusing, incorporating my experience with the glycemic index of foods to keep good numbers. Lovin’ it!
2 Likes
There are infusion sets tha allow for extended use. This would require Insulet to redesign their pumps to use the new infusion technology.
The other issue is that pods hold a maximum of 200iu of u100 insulin. This is determined by the size of the pod. To get around the this they would need to get approval for u200 or u500 insulin and to build an algorithm to be able to use those insulins.
2 Likes
Would they need to tailor the algorithm for U200 or U500? I’m using U200 in pods, and I just had to revise my settings from my U100 ones. The algorithm behaves the same, as far as I can tell.
2 Likes
That’s fine because you are knowledgable. From what I see on the t1 subreddit and the T1s I know many are clueless. Insulet would have to get FDA and other nations equivalent to approve both the extended infusing set and the use of an insulin other than u100.
1 Like
Ideally, the result is what matters, but ultimately, I wish for longer-lasting, smaller pods. One item is the pod itself, much of that electronics, so even with denser insulin either taking up less space or lasting longer, the electronics would need to be designed and tested for extended wear.
As for using U-200, to @CarlosLuis’s point, @Beacher is knowledgeable and, I imagine, also math-savvy. Although not hard math, I was surprised during my Omnipod initiation, both the trainer and a fellow T1 thought converting calories to grams and vice versa was somehow special; it’s sometimes a bone of contention that I think in calories of carbs, rather than grams, but I find it easy to divide by 4. It would be similar to converting from U-100 to U-200, in that the basal, bolus, and correction values would need to change proportionately.
1 Like
So glad to hear that it has been going so well for you.
Personally, I’ve found since they moved away from glass resevoirs that the insulin itself has a 3 to 4 day maximum life.
I knew I had read about insulin efficacity somewhere, @jbowler’s started a thread and it is a discussion about preservatives and intertwined in there also about plastic.
Then @Eric posted a thread discussing how Novolog and Humalog perform differently in a pump.
So let me say that personally I have found that insulin does not seem to be as effective for me now as it did 35 years ago in a different pump. Mind you, I was much younger then and maybe you can blame everything on my advancing age. Only me of course, not anybody else.
1 Like
Get in touch with your nurse educator. Odds are, they’ll dial everything way back, then slowly crank things up once you’re steady at a higher rate. No matter what you do, your body’s not going to just snap to attention overnight. It’s more like steering a cruise ship than flipping a light switch — expect at least a month before the new routine feels normal. When you switch from long-acting to short-acting insulin only, your educator might say, “Let’s let you run a little high for 10 to 14 days, then we’ll see what’s what.”
From my (very humble, possibly clueless) perspective, you’re coming in pretty hot! Also, don’t go changing a hundred things at once. Change one thing, wait, then tweak the next. If you change two things at once and it all goes sideways — congrats, now nobody knows which one did the damage. Give each change 2 or 3 days to see what happens.
And easy on the dramatic adjustments. Big changes can have big consequences — and not always the kind you want. (Says the guy who’s never met a rage bolus he didn’t like.)
Good luck, my friend. You’ve got this.
rick
1 Like
Work with your trainer. Hopefully the understandctgat if you back off making corrections and it may create tgd wind setting that will ni Th match your basal and correction needs, and this will result in the pump struggling to correct the drifting bg. You have to get the TDD to be on the mark during the “learning” period otherwise it may struggle keeping you in target with too much or too little.
It’s almost like you gave trick the learnibgvti Ge Th the right settings, and if you don’t trick it in Th Rd right directions the settings it creates to manage bg constantly be struggling.
2 Likes