Insulin Resistance on Omnipod

I switched over to Omnipod about a week ago. Using Novolog in the pod, I seem to be more insulin resistant (using ~27% more insulin while still hanging up higher than I like). I find that I’ll bolus for food, wait 15-20 minutes and still spike. Then it’ll take hours to come back down despite several rage boluses :upside_down_face: And once I’m back down, it’ll go right back up. Insulin feels like water. I tried using Fiasp in the pump and suddenly I was much more sensitive (had a ton of lows and really had to back of my basal rates). Only had to prebolus like 5 minutes.

Wondering if anyone else has experienced this? Is it just me? Does my body need to adjust back to novolog after being on Fiasp for a while? Just doesn’t seem to add up.

1 Like

Since you said you just switched, lemme ask - did you let the Insulet pump trainer set your basal settings for you?

2 Likes

When we put a new pod on Liam we anticipate that it will take time for the site to become well saturated so we give more insulin for the first half day or so.

Since we are using the Omniloop - FreeAPS branch we are also getting insulin in small increments regularly if the projected bg is higher than our threshold.

3 Likes

I’ve not used Novolog; I used Humalog with the Omnipod until my insurer suggested I should swap to Novo then I swapped to Fiasp. I wouldn’t notice a 27% change but I can certainly believe that the two different chemistries would result in different dosage requirements, certainly in the short term; a couple of hours after injection.

Yep, me too. I admit I typically don’t wait that long before eating :slight_smile: That darned food; it spikes me. It is, admittedly, anything with concentrated carbs (even starches; bread spikes me). That’s what I eat so I live with it (easier than changing the people around me.) But I get that this is a change for you and you just changed your insulin regime; the easy and possibly the best answer is to go back to what you used before and see if things change back. We are all different so some of us have to experiment.

That is the sales pitch for Fiasp; it includes a chemical which excites the skin and causes more rapid adsorption. That said, and somewhat ironically, it doesn’t do that much for me - I really don’t notice any accelerated adsorption. I have been doing it for a year or so, maybe my skin just got adjusted. I do massive boluses at times too, not rage boluses though I have done a few; I tend to factor out the bolus adjustments and just do the whole thing based on the BG and rounded up to the next unit…

I think rage boluses have their use; so many people have complained about sticky highs and those complaints are not specific to the Omnipod. I find I can manage low BG much easier than high, I just hit the things I’ve wanted to eat all day. That said it really is all experiment; when what you had before worked better go back to that.

5 Likes

She had me set it up a particular way, but I definitely changed them within a day or two. :laughing:

2 Likes

I’ve begun to notice this pattern also - I’ll be higher for the first 3-4 hours (sometimes longer) after a site change but then I at least get a little more responsive to insulin dosing.

I’ve been interested in Looping with Omnipod – does that work with the DASH? Also I heard it doesn’t work with Android phones, correct? (I have Android, not an Apple).

1 Like

It does not work with the DASH and it does require the Apple phone. I was a 100% Android user before Loop, but since I’ve changed over (ONLY for the Loop app), I’ve grown to like it.

3 Likes

Ha, isn’t that the truth. :slight_smile: Yes if i continue to have issues with Omnipod I’m going to try and go back to either MDI or Tandem and see if things go back to normal… I might just have to be patient though (I’m terribly impatient).

Yes yes and yes… I hate dealing with the highs. But then again lows can be kind of debilitating. But I just get so annoyed with the highs. :laughing:

2 Likes

Interesting… Well it’s just my luck that they sent me a Classic before realizing that my insurance actually did cover the DASH, so I guess there’s that. If I hadn’t just gotten a new Android phone I’d maybe consider it :laughing:

1 Like

It was the best decision we ever made. We’ve gone from 7 - 8% A1C’s down to 5.5 - 6.5% A1C’s and that’s all thanks to Loop and especially the FreeAPS (microbolus) branch. We are at only 1% low/severe lows also, so we’re not sacrificing a lot of lows to get the A1C. Actually, less than 1% for lows/severe lows. This, for a 7 year old is pretty phenominal and we couldn’t be happier. He’s been looping for going on 2 years now and we’ve been in the 5.5 - 6.5% A1C most of that time. Before then, we were at or around 7%.

5 Likes

Wow, that’s amazing. My A1c is around there too but I definitely have quite a few lows (normally I range about 5-7% low, more than I would like. Currently I’m sitting around 10% low due to adjusting to new pump). Do you think you’ll stay with Looping once Insulet finally releases their FDA-approved version (which I heard will be coming out this year)?

2 Likes

I live by the motto - “If it ain’t broken, don’t fix it.”

I may be forced one day to no longer be able to use the Eros PODs…until that happens, we’ll be happy with what we have. We stayed with the Dexcom G5 until the very last possible moment that we were forced to switch to the G6’s and we’ll probably do the same with the PODs.

3 Likes

I can’t speak for @ClaudnDaye obviously but I do have a RileyLink sitting somewhere and I do have an unused stock of Eros pods, and, yeah, I even have a Mac I bought for the purpose and the ability to build everything. Yet I do not have the required patience.

I’m on the Dash pods; the Eros ones were, in some way, a backup plan for me in case the ACA was abolished or the FDA taken over by Medtronic (I live in the US). Tidepool is at this moment actively seeking approval from the FDA for a loop program which, I am lead to understand, will work with the Dash pods, but I can’t find any reliable posts to support that.

I live in hope.

4 Likes

@jbowler, if you’re ever interested in completing the process it really is quite easy if you follow the Loopdocs steps and I’d be happy to help in any way that I can. It sounds like you’re comfortable on the Dash PODs now, but if things ever change and you want to get Loop built out, reach out with any questions you have or problems you encounter! They have a great troubleshooting section and most problems/errors are addressed in depth with solutions.

6 Likes

AndroidAPS supports OmniPod now so you can use your Android phone for looping. I use Loop on an iPhone but I, too, was an Android phone user. I’d switch to AndroidAPS but I’m now used to and happy with Loop on iPhone.

4 Likes

Wow, this would be awesome!! I hope so!

1 Like

Oh! I’m definitely going to look into this then. Do I find info on building it all on the Loop Docs website thing? (you can tell I know what I’m talking about right?)

2 Likes

No, you need to go to the AndroidAPS site.

https://androidaps.readthedocs.io/en/latest/index.html
https://androidaps.readthedocs.io/en/latest/Configuration/OmnipodEros.html

https://github.com/MilosKozak/AndroidAPS

2 Likes

@ckimball123
I do an “activation bolus” whenever I put on a new pod. That really helps.

I either put on a pod right before a meal, so I am bolusing anyway. Or I just do a small little 0.25-0.50 unit bolus to get it started, right after I activate it.

5 Likes

I think @docslotnick 's strategy is sound, do a big bolus, then eat a [insert favorite flavor here] donut.

4 Likes