My son started on Omnipod a few days ago :-)

I have periodically updated the forum on our progress towards a pump: declined insurance request and final appeal win.

So, for the next step in the saga, my son started on Omnipod a few days ago. On his first day, he proceeded to lose his PDM (but we found it a couple of days later…). We are slowly adapting and learning. As you all know, he withstands high puberty peaks, and the first few days were rather rough (not much sleep at night), but we are starting to tune his numbers, and his BG has become a bit smoother. Last night was the first night with a reasonably flat night curve, and, already, his morning numbers seem to be a bit better than they were on MDI.

Overall, we still are having a harder time than MDI, but we are quickly moving up the learning curve.

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Hang in there, the learning curve is steep, but the results have been worth it to us. But it did take a couple of weeks to get the basics right, and a few months to learn all of the ins and outs of the sets.

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There is definitely more to know, but you’ll find that, once that knowledge base is attained, you’ll be happy you made the transition. Congratulations to you guys! I know that has been a huge hurdle for you and @Kaelan.

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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.

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Thanks for sharing @Michel.

I have only been using the Omnipod for 6 months and just started open looping for the past 4 days or so.

Your comments about adjusting basals reminded me about how I still can’t get them quite right (I mean good enough hut jot perfect.) Today a I am running a bit high on the basals and am am playing a game of chicken… do I run a lower temp or do I ride this out and will I flatline? :grin:

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I’ve been podding since last December and I am still fiddling with basals and insulin:carb ratios. Make one change and it’s sure to throw something else off. It can be incredibly frustrating at times and I’ve been known to pine for the “ignorance is bliss” days of MDI and no CGM, but when it all starts to work together it is truly satisfying.

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@Aaron, this is AWESOME!

You’ve got to start a thread on this! Many of us are looking into it too!

Btw, @dm61 is a looper too.

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Happy to hear you are moving along with it. It takes some time to get it all figured out.

There are so many more ways to do things compared to MDI. For example you can increase basal before you eat, you can drop basal after you eat. Things that you can’t really do with MDI.

It’s not that it is harder, it is just more ways of doing it. So it just takes time to explore all the different things you can do. The only way to get it figured out is with time and trying it.

So hang with it. Keep it simple for the first few weeks. And then you will get comfortable with it and can start exploring all the options.

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Thanks to everyone who’s willing to share! Your experiences are really enlightening. Always good to have a variety of experiences to refer to.

I heard back from EH’s endo, and they’re putting in the request this week for the OmniPod. Hopefully soon we will be joining you all on the sleepless nights (full of learning, which will be a worthwhile frustration) and the learning curve!

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Together we are stronger. I love that everyone here is so giving of their time, resources, energy to help each other.

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Please educate me on open looping, what is this?

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I’m very curious about this also. We use Omnipod, but I’ve never heard of open-loop with regards to this system.

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@Chris and @ClaudnDaye I promise to post a thread later today. :slight_smile:

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Two weeks into Omnipod

Hard to believe it’s already more than two weeks!

My son is now fairly stable with his setup, although we are still fiddling with it to get rid of a couple of creeping lows during the day. We are still encountering midnights lows, although less than before – so this is still a work in progress. Somehow, it seems that his equilibrium with a pump is a bit more brittle than on Lantus, but I hope that it will change.

His # of basal units has stabilized to exactly the same level as it was before pumping. His ratios are also basically unchanged.

What we find:

  • we get too influenced by what the pump suggests: we are less ready to correct hard early on, because the pump suggests much lower numbers than we normally go for. The result is that we have been a bit higher than we want to be.

  • on the other hand, nights appear to be a bit more peaceful than they used to be: we are able to smooth the ride a little better after 2:00am, so the outcome is good: a more rested boy and more rested parents.

  • we have realized that not everything can be entered in such as way that the pump can get it. We essentially need 2 correction factors, one for carb peaks and one for hormone peaks. The hormone CR would be 2x the carb CR.

Swimming season is starting next week. So now we will see what we can do with sports practices. I am excited.

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Congrats on the switch to the Pod. I wore mine for years until I went back to MDI once Tresiba was released.

Good luck!!! In my humble opinion, if you are going to pump, the Pod is the only way to go due to the un-tethered nature of it.

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Yes, it took me a long time to realize this. Or rather, it took me too many nights of not coming down despite mini-correction after mini-correction. Now I customarily add 1 or even 2 units to the suggested correction, and I’m surprised I do not crash.

Also, you will discover to keep an eye on the PDM’s time. [Why do I suddenly sound like English is not my first language?] I find that if I test, say, 1 hour and 59 minutes after the last bolus, it will not suggest a correction. Test a minute after 2 hours, and suddenly it wants to give me 2 units. I enjoy trusting the PDM’s hocus-pocus math, just to take some of the math exam element out of my days, but here is one time I will intervene.

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Last night we had our first night without any wake-ups needed for lows or highs.

I know they will be few and far between for us until puberty is over – but it still is a milestone for us on the pump.

[EDIT] I call them wake-ups, but my son typically does not wake up for most of them. I do :slight_smile:

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Gratz @Michel! A nice nights sleep is great on occasion!

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