New Here - OmniPod Training Experiences

Tips, Tech & Gear
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Hi everyone, first a little about me as I’m new here. I’m a 38 year old type 1 living in Canada, diagnosed at age 3 and taking daily injections ever since. My drug plan at work recently started covering insulin pumps and the Freestyle Libre so of course I was excited to get set up with both.

The Libre was very easy, here in Canada my pharmacist was able to write the prescription and same day I was using that system.

The move to an insulin pump has been a bit more frustrating and I’m interested to hear others’ experiences getting set up. I was drawn to the OmniPod as I have no interest in tubes etc, just not compatible with my life. I tried the sample pod, found I had no issue with it so decided to go with the OmniPod. The OmniPod staff were great at getting the required paperwork signed by my doctor, getting insurance approvals etc and within 3 weeks or so I was approved and my pump purchase was all set. This is where things start to get frustrating.

Speaking with my doctor, he indicated that in his experience the various pump company trainers would handle my transition from injections, but that he could refer me to a local Diabetes Education Centre if required. After speaking with their training specialist she really tried to push me towards the Diabetes Education Centre rather than use their in-house resources. My concern was lead time to get myself into an education centre since i wasn’t actively working with one so i indicated my preference was to work directly with omnipod.

After some back and forth, she asked if I had ever been trained in carb counting which i hadn’t. Carb counting wasn’t really a thing when I was learning to control my condition. I’m always aware of carb contents, complexity of the carbs etc and use those to inform my dosing, but I’ve never had someone sit down and calculate my carb:insulin ratios, correction ratios etc. I’m very aware of how my body processes things and how to manage my sugar.

At this point she told me her trainers would not work with me until I had some formal training in carb counting. So this meant calling my doctor, asking for a referral to an education centre, and now sitting and waiting for word on when I can go in.

In the meantime my pump starter kit has arrived and it’s just sitting on my kitchen counter useless, burning up warranty period and not doing me any good. My biggest concern is that in our public health system here, referrals can often take months, which is months longer than I’m willing to wait.

So I’m curious if others have run into a similar situation, and what you did about it? I can’t accept that omnipod has a team of diabetes educators and they can’t/won’t do a bit of carb counting 101 with me. Omnipod sure was fast to get my pod purchased and delivered, but seem far less interested in helping me now. I’ve read most of the manual and it’s really not that complicated.

I was on a real emotional high when i got approved, dreaming of taking that last injection before moving to the pump after 35 years of sticking myself. Now I’m dragging low with how this has turned out and the uncertainty of when I’ll be able to start pumping.

Sorry this turned half into a rant as i started typing it but I’m at a high point of frustration…i figure people on a forum like this can understand better than most!

Thanks for any input/advice!

Dave

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Hi @dr1980! I just wanted to leave a quick note saying hello and welcome.

I read your post and can only imagine the frustration. I’m not sure you didn’t already say, but have you started with some basics from the internet?? Just for that basic understanding??

I would be very happy to try to help you with some specifics but doubt I’m the best to do it. I’ve been diabetic for 15 years and really have only been organized enough to know what carbs even are for the last 2. Mostly I blind bolused for everything until I learned some much healthier ways… and now I’m back to not counting. The difference is my a1c is under 6 now— so not carb counting isn’t hurting me. It really may have been the denial that was the problem. :grin:

This is my way of saying I wear a pump and don’t do much in the way of carb counting. It doesn’t mean I don’t think it’s an excellent skill to have, but maybe starting with the basics would suffice. For now.

I’m just holding you over until a better diabetic shows up. :grin:

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So, my son has been using a pump for a few years quite successfully. He can carb count, but actually doesn’t really count anymore, i.e. put 32 carbs into his pump and see what it recommends. Rather he knows that this meal looks like it will take 6 units, then usually pumps in 7, and eats his way out of the low if needed (often it isn’t).

Converting to a pump isn’t rocket science, i.e. you are going to convert your current basal to the pump basal settings (being a bit conservative) and then dial it in over time. Of course the ability to increase it in the early morning to deal with dawn effect will be nice, and the Libre will let you really dial it in quickly.

Some of the topics like basal testing and setting your insulin duration and carb ratio’s are a bit of a foreign concept, so you may want to read something like this book:

Also the concept of a site failure was something we didn’t anticipate needing to learn, but we eventually did through trial and error. I personally wouldn’t wait, I would educate myself then get going. But I am not a conservative person by nature.

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Many of the tools, calculators for insulin and pumps, by John Walsh can be found here.

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I think this is understandable. They sell pumps. They are not diabetes care specialists, and as sellers of pumps they wouldn’t want to get into teaching carb counting or figuring out carb ratios and so on.

You could teach yourself lots, but make sure your province’s involvement in paying for a pump and/or your workplace insurance don’t require training with a pump trainer and regular appointments with an endo or CDE. If I recall correctly, the Ontario ADP grant application form requires this.

Sounds like you’re pretty much up to speed, though, so any education/training would be a formality, and over pretty quickly. But they have to be able to say they did it.

I don’t know what province you’re in, but if it covers pumps and/or supplies, take their money first. Private insurance pump coverage can be quite limited, as in $5,000 over your lifetime. Buy one pump and that’s pretty much used up.

In the meantime, put in the batteries and play around with your PDM. Do as much of the set-up as you can at this point, get familiar with the features, and you’ll whiz through your training. Have fun!

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Thanks for all of the responses so far, I’m really happy to have joined this community.

There is part of me that wants to go rogue, but most of me is a rule follower.

To your question Beacher, I’m in Nova Scotia where there is no government coverage for adult insulin pumps so I’m 100% with insurance. They cover up to $10,000 for the pump itself every five years and unlimited for supplies so I’m in a good place there.

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I think carb counting was much more important when there were no CGMs. The game has changed now and will change a lot more once closed loop pumps are standard. There are so many variables carb counting can’t account for, which is why I think so many on this forum stopped bothering with it. If you have a Libre and a pump you can learn to dose, and then make adjustments in real time when your blood sugar is going higher or lower than anticipated.

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I also had to take a carb counting class at my clinic, and also had to wait for an official OmniPod trainer. However, since I already had the pump, and had already done tons of research over the internet and reading several books including the Walsh’s Insulin Pumping already mentioned, I decided to start the pump prior to meeting the trainer. Honestly, it was a good decision since I learned nothing I didn’t already know from the trainer. Yes, I agree, start very conservatively with the basal, maybe no more than 50% of your current basal, and monitor with the cgm.

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Did you get any grief from the trainers or have any issues? I understand their cautious approach, I really do, but at the same time I’m confident I could start on the pump without doing myself any harm through a cautious/conservative approach.

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No, actually the OmniPod nurse was glad that I was already competent with the OmniPod pump. She just asked me to demonstrate my understanding which she confirmed. You could prepare a set of questions before hand, too, but of course, you can ask here, too :smile:

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If there is a set of “rules” for pumping with insulin, it would be different with each person !!

Do you plan to continue calculating bolus for meals as you do now? If yes, carb counting is a mute point (assuming your current method is working well).

Since you have Libre, you likely already have best knowledge of how you respond to how much insulin you need, for your meals. And can adjust accordingly. Pump will have advantage of lowering basal, or extending meal boluses, to give you more flexibility, and potentially better post meal BGs.

You will find lots of help here too.

(I haven’t counted carbs in over 20 years.)

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Actually I had meant rules in terms of following the process to go see the Diabetes Educator rather than doing it myself. It’s great to know that counting carbs isn’t the be all and end all. I feel like that piece I could adjust to, my bigger thing would be figuring out starting basal rates etc, though I’d want to have some decent numbers to enter into the omnipod pump for correction ratios and carb ratios etc.

What about your diabetes educator?

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I didn’t see the CDE (diabetes educator), but I did take the mandatory Carbs Counting class at my clinic before receiving the pump. That was mandatory by my clinic for anyone just thinking to switch to a pump. It was a very basic class that lasted about an hour.

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You could. I could have started up before my training, and I didn’t learn much in my training that I didn’t know from reading the manual and online … except some tips for insertion technique that are unique to pods and aren’t the same as inserting tubed sets. Of course you could also learn those tips from reading this forum …

If you know what you’re doing, training is a nuisance and a formality and insurance for Insulet. You may have learned how to drive by tooling around on back roads and parking lots, but you still have to take your test and get officially approved.

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Thanks everyone, I may give this a shot, still nothing even on an appointment date.

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I’m curious to know, for people that have switched from a long acting insulin to a pump, approximately what percentage of your daily long acting dose did you start with/end up at as your basal dose on the pump? I see one person in this thread at 50%, I’ve Read 20% elsewhere.

Thanks

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First of all welcome to the forum @dr1980!

A good place to start is 50/50 (bolus/basal). Suggest you start your total daily basal dose a couple of units under what you normally take via injection.

Be aware that basal requirements vary significantly during the day. Many of us have higher basal requirements in the dawn hours / just after getting up (known as Dawn Phenomenon).

When I switched to a pump 4 years ago it took me about 6 weeks to tune my basal doses over the entire 24 hour day (I’ve been T1D 55 years).

I’m in Calgary if you need any pump advice - I’d be happy to answer any questions that come up the first few months.

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This makes sense if current MDI is 50/50. But often food bolus total will vary day by day with meal choices and activity.

Conservative start would be basal that is slightly lower than total long acting (lantus, levemir).

If doing meal bolus with fast acting, approximately same dose can be done with pump. Experiment with extended bolus for high fat meals and time to wait for pre-bolus to kick in.

Maybe log your meals + injection doses for a week or so, and then set up pump to replicate. Monitor with Libre and tweak as needed.

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Thanks, with injections on a typical day I’m roughly 60% Humulin N and 40% Humalog so not too far off 50/50.

I could definitely see a higher basal rate in the mornings as i usually have a spike between breakfast and 10am that I can’t seem to solve through humalog alone.

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Does your N cover part of meal times? Do you do multiple N? Does dose vary?
That may be trickier to translate to basal/bolus on pump.

When you eat meals, how do you determine insulin dose?