Omnipod: the start
As @CatLady did, I am sharing our experience of the first few days on Omnipod. I figure some might find it useful – we were really helped by reading about what others do – and I had plenty of encouragement from @Eric, as always!
The first thing we did was to read the manual several times, then go over some critical parts of it together as a family. In particular, we reviewed multiple times pod insertions and stops, basal profiles, bolus administration, and diagnosing a pod problem (what I am most worried about).
Once we were up to speed on most sections of the manual, we fully programmed the PDM. A few fields I was not 100% sure on – but Omnipod was really good about helping us understand the exact implications (they also have a 24x7 number). Omnipod also assigns you a trainer when you sign up, and that trainer was really helpful and kind!
Once we had programmed the CGM, it was time to decide what levels we would set the PDM at. I entered the same bolus ratios as we had on MDI (ICR and CF i.e. Correction factor). For the basal, I had read in several places that (a) you often end up using less insulin on a pump, and (b), it takes several days for Lantus (or any basal insulin) to flush out, so the first few days are a special basal case. So I programmed a largely flat basal across the day, slightly higher in the very early morning hours (2-7) and slightly lower right after going to bed. I used a total basal number 20% lower than his average basal over the few days before start.
Basal
Then it was time to switch from MDI to pump. The first day, he ran low pretty much all day, so my 20% lower start level was still too high. The second day was mixed, and we started inching up his basal numbers. the third he was too high all day, and we seriously upped his numbers. By the end of the third day, he was roughly back to his MDI numbers on basal (0.5 unit or 2% lower than his weekly average, 2.5 units or 8% lower than the day before he started pumping).
Bolus
We did find that his evening ratios needed to be lowered (? increased? essentially, he needed to use less insulin per carb ingested). But this could have been true before and we did not notice?
Life changes
We had to spend most of the night up for the first 3-4 nights, although some of that was not strictly necessary, but a result of wanting to learn as much as possible about what was happening. Still, it has been a tiring week! I figure that it might take us about 2 weeks to dial in a reasonable set of numbers and go back to the same level of sleep as our regular MDI practice.
I will keep on updating this thread as we progress.
