It took me a while to figure this out for myself. This was before FUD! I had no idea why sometimes pods seemed to be crappy and other times they were great. I was focusing on the site location, but eventually I figured out that day 3 can be a problem (this can also depend on the insulin you are using).
Another thing that might be at work - endos and CDE’s and pump trainers are so nervous about their jobs! Undoubtedly they gave you lower basal numbers than you actually need! I would absolutely bet they lowered it!
Have you done an increase on your rates from what you started with?
This just takes experience. If you bolus and it fixes it, maybe it is basal. If the same meal bolus you might normally use does not seem to work as well, maybe it is a pod issue or absorption. Check the day. If it is day 3, swap it out!
It just takes experience and practice.
I highly suggest you look at your basal rates and think about if you might need more than you are using. Consider that, and consider the pod day also.
Yes, as @Beacher mentioned, holding down the ? button is like a secret button for screen brightness! I don’t know why they don’t tell you that! It took me a while to learn that little trick too!
My CDE, herself a pod user, recommended having my provider write a prescription for more pods to allow more frequent change-outs because I sometimes stop absorbing very well after 2 days. So I now have the option to order 40 or 50 pods (4 or 5 boxes) every 3 months. Your insulin RX will need to be adjusted accordingly , too. As @Eric says, “when in doubt, change it out”!
Thanks for the heads up everybody! I started out my prescription with 40 pods for 90 days so early pod changes might work out OK. Not sure I had enough insulin with me on my trip so will have to factor that in too…basically wasting 1/3 of my insulin by filling a pod for 3 days but quitting at 2 days?
Insulin is cheap to make and making more has virtually no environmental consequences. Omnipods, on the other hand, are expensive to make and discarding one when it could be used has very significant environment consequences.
If you are concerned about the environment consequences, as I am, then using Omnipods is a big issue. I’m throwing away some expensive bit of electronics every 80 hours, and I don’t know where it goes or who I kill after I stop using it. These are big issues.
On the other hand, I like the freedom and I live in the US, so WTF, I just do it. My feeling, justification after the fact, is that we can’t afford as diabetics to be more sanctimonious than our fellow citizens. Next year I might swap to t:slim and save the world, if I have the choice; at present I can’t because I would be swapping too soon for my insurance company. If insurance companies weren’t part of the picture I could be a better person.
BTW: I spend $6000 per year on medical expenses. I do that in the first two-three months, then my insurance company pays everything, so…
This seemed the most appropriate place. On Monday evening last, I joined the ranks of Podders! Gave up on waiting for the new unit and didn’t want to have to contend with a tube, though that may come. I’ve done well on MDI and know I’m risking a lowered TIR to eval and see what it does, for the convenience of not giving myself multiple daily injections.
My first night was NOT good! The local Omni rep is nice, a T1 himself, but got initial numbers from my new Endo that seemed to come from “old” Endo, i.e. don’t make sense to me, basal is a bit high, acceptable range to wide (high), correction dosage seems way low, etc. I’m sure they’re intended as a careful transition, but a correction 63 correction factor ain’t gonna cut it, 40 is more like it! I went up to 260 after dinner (partly my fault, went to dinner with friends), tried to keep with the Omni calculated basal, boluses, corrections, but took hours to get it down. Then after breakfast this morning went to my lowest level since dx (<50) for God knows why. Yes, I’ve read and listened to the many here and learned from all, but I’m trying to be the “good” student; the Insulet rep made one adjustment. I’ve had a decent relatively level day, but too high (avg around 160) for my liking. I’m hoping for a better night and will give it a decent chance before leaving the reservation (I can say that, I’m part Choctaw!). If it comes to that, I’ll have to re-read a lot or take some T1U classes on Scheiner’s site.
They are definitely over-cautious. Take a poll here of new omnipod users. For those that followed the recommendations, 90% of them were higher than they wanted to be the first few weeks. That’s just their very safe phase of getting it dialed in.
If you get a few weeks of consistent trends you can easily see where you need to adjust. You can adjust everything - target BG, IC ratio, basal rates. And you can add basal rates for different amounts for different times. Start simple and build from there. Make little adjustments over time. Be patient.
Sure, take a class if you want. But nothing compares to the the collective soul of FUD.
@Eric I should have said, “reread a lot of FUD posts/sections.” I’ve found the FUD people and conversations here extremely helpful; especially those with alternative view points…they minimize “group think.” BTW, the Omni rep recommended a book that’s been mentioned here numerous times, “Pumping Insulin”.
Tom, please do give yourself a two week grace period to dial your setting in at a basic level. It is different than injections. If you start having trouble with pump sites, do consider injecting half of your basal, that way when a pump site fails you don’t go straight to infinity on your blood sugar.
@Chris@Eric Thanks for both your comments and encouragement! I’m happy to report my numbers for the last 36+ hours have been much improved with no outrageous long lasting highs, though a couple of unexplained gradual drops to 70 or slightly below, but they didn’t last. The Omni rep has been helpful and we did change a two settings, though I’m not sure how directly they may have been for the better #s. I even used an extended bolus once for a high fat meal. I’ll go through my first pod changeout tomorrow. I’ve found not having to worry about taking Lantus twice a day, just having to enter my BG and carbs to get bolused, and just the BG to get a correction a significant relief. I didn’t realize how many brain cycles I was using with MDI, but it’s good to know I can revert with a solid foundation of MDI to take up the slack when/if needed.
Yep, when I started on Omnipod my endo, or actually my Diabetes Educator, recommended a much lower basal than I needed. .25U/hr, when I should have been at .5U/hr. I was so inexperienced that I did not change the settings much at the beginning. This was way before FUD existed. I knew no one personally with T1 and no one, of course, using a pump, so I was already scared of the pump and a bit skeptical it would work for me. Having FUD whose members share experiences has really been so helpful.
I started on the CGM first, so that sort of got me used to and comfortable using “wearable” devices. Now I’m on Loop software which integrates the CGM BG readings with Omnipod and provides autoboluses as needed. It has made living with T1 a bit less of a full time job.
I also read “Pumping Insulin” and found it very useful! My first introduction to pumping.
Lowered my ICR by 1 this morning in conjunction with the Omni rep. We’ll see how much it helps. Went thru my first pod change early this evening, pretty easy. I’m currently using insulin from Novolog Flexpens, have several on hand. What’s the recommendation from others, continue to keep that supply flowing in case or pod failures or add vials to the mix?
I switched over to vials pretty early after starting pods and now prefer them. I procured some syringes and use vial/syringe instead of the pens when taking a manual dose. I went to a longer needle on the syringes than I had been using with pens and they work great for corrections or when you don’t want to over-bolus your pod site. The pens are squirreled away in the emergency reserve stockpile.
Do other pumpers use the micro-dose capability of pumps to account for even small snacks, i.e. <1 unit’s worth of insulin? When on MDI, I didn’t even try to account for the likes of a Keto Bar (5g, I like the chocolate), a single Lindt dark chocolate truffle (can anyone eat just one?), or a hand-full of nuts (I get I a hankeriin’ at times) as long as it didn’t turn into 3 or 4 “small” servings. I realized this morning, I now have the ability to dose for such things with relative ease (I’m slow, but I get there…) and understand it may be ICR dependent and that you could easily drive yourself nuts obsessing over such things. What do the rest of you “bionic” enabled people do? Use it? Don’t sweat it? Or am I just slow and that’s one of the purposes of the micro-dose ability?
Vials and syringes are fine for me. I have pens too, but I could easily survive off vials and syringes. Either of those would work.
But the key for a pump backup is having a good basal insulin that you are familiar with. I assume that is something you still have. Just make sure to keep some of that, and know the general amount you need.
After having read many posts about replacing a pod, I had to do my first one last night/this morning. Had an issue last night with higher than expected BG (160+) that just didn’t go away (3hrs despite additional 2 units). I chocked it up to a new recipe the wife tried (despite her careful and helpful carb counting), seemed to finally start a down turn so I went to bed. Woke up 2 hrs later at 171, tagged in another 2 units; 1.5 hrs more and BG was 190. A few choice words at 4am and I ripped that pod off, quite a bit of blood soaked a napkin. Can blood pressure stop the pod insulin from coming out? Anyway, changed sites, bolused a couple of units and BG started back down, albeit slowly. Appreciate the advice of those here, “when in doubt, change it out!” Haven’t dealt with Insulet yet on replacements, guess I’ll give them a call.
I’ve not experienced much blood with an Omnipod but certainly blood around the canula will change the adsorption, one way or another. If anything, blood or any fluid, comes out at the canula site it’s a fair bet that some of our insulin is in there too. It is theoretically possible to see what is going on in the viewing window but I’ve never been able to see enough to make any sense of what is going on, however if the adhesive is damp I’m immediately tempted to change the pod.
I find my overnight adsorption of insulin can be unexpectedly low; not always but sometimes a bolus has an apparent effect for a half hour or so then nothing. That might be something to do with Fiasp.
I don’t think so. But in my experience, failing pod sites are prone to having the insulin leak out around the cannula instead of diffusing into the subcutaneous tissue, and that’s why boluses/corrections have stopped working. Your solution of syringe and new pod is what I do too.