Morning routine to get out the door is more involved these days with kids in two different schools. Husband had a job change that has impacted sleep schedules and sleep arrangements throughout the week. I was having afternoon lows on work days and scaled back some basals…but now I’m having afternoon highs so probably need to basal test that all out. I typically only basal test in week 2 of the hormone cycle for consistency. I think my initial basal rates were tested throughout the hormone cycle so there’s variation within the shape of the curve that needs to be standardized.I.E. Certain times of day were set during more resistant weeks vs. other times of day being set during more sensitive weeks. Also, without having little little kids now, I get to sit down more often. I never stopped moving before due to necessity, but now there is more calm to the house (most days).
Just a general observation. For me, a good strong basal amount makes everything much easier.
Basal is the foundation. I think a big solid strong foundation makes mealtime boluses work so much better.
Sure, ideally we would always be perfectly flat when it is mealtime.
But if I had to choose between the two - being on a slight BG decline makes a meal so much easier to negotiate than being on a BG rise.
I know you have a fear of lows. This is a tough thing to deal with. But as long as you are able to check BG regularly, and are not asleep, having a strong basal isn’t too hard to handle. A small snack if needed - a couple of crackers or whatever - prevents the low. And then the mealtime spikes are not as prominent. At least, that’s been my experience.
And of course, I am talking only about a “strong” basal, not a crazy basal that drops you through the floor!
Keep in mind that bolus size probably isn’t the cause of tunneling; the tunnel is already there by the time you notice leaking insulin. And one thing that can cause the tunneling is movement of the cannula. Therefore putting the pod in a place where the cannula doesn’t get moved around as much (abdomen rather than arms?), or keeping it more firmly in place with some type of tension belt, can help prevent tunneling.
Since reducing my bolus size some months ago I have had only one leak. I put a brand-new pod on the back of my arm and a few hours later scrubbed the bathtub, with that arm jostling back and forth. I remember thinking, “This can’t be good for my pod.” Sure enough, as soon as I started my next bolus I could feel the leak.
Why does this problem seem to be more common with Omnipods? Maybe because they have a larger profile on the body, so they’re more inclined to be inadvertently bumped about, by daily activity, in sleep, etc.? For me, even pressure can lead to leaking, so I have to be careful not to lie on my pod while I’m sleeping.
Also part of it can be the lack of cannula options. The 6.5 mm cannula goes in at an angle of about 45 degrees, so the depth is only about 4.5 mm, which doesn’t give a big margin of error for moving around.
According to the picture at http://www.mylife-diabetescare.com/mylife-omnipod-the-pod.html, the depth (not length) is 6.5 mm. I think the length is closer to 9 mm.
So it looks like odds are decent that my body was developing an allergy to Humalog. My numbers are so much more predictable (knock on wood) with getting my sites straightened out on Novolog. This possibility freaks me out.
The OmniPod user guide is incorrect. They mention the insertions depth, but they are really giving the length instead of the depth.
Every measurement I have ever done never comes close to 6.5mm depth, only 6.5mm length.
You can measure the depth against the pod yourself.
Here are pictures
Depth
Depth (this is a different pod, BTW)
Or you can cut some cannulas and try it. Cut it at the point where it comes out of the pod, not the part that is inside the pod which doesn’t matter for insertion depth.
Length
Cool! But why haven’t they corrected the error by now? I hunted all over and could not find any official reference to cannula length. Curious.
They haven’t acknowledged it as an error.
I am basing my statement on having cut and measured a bunch of pod cannulas that I have removed…
Try it yourself the next time you pull out a pod.
My measurements are not exact, but those pictures are legit. It would be nice if someone else verified it. See what numbers you come up with.
This is brilliant! I’ve never heard of the sandwich bag trick!
I heard about Flonase from a T1 9 year old girl cheerleader I chatted up about diabetes in a hotel restaurant one day when EH was at a conference. She was very knowledgeable! I wish I’d known about FUD at the time. She’d have fit right in!
Thanks for clearly outlining your steps! I’m sure it’ll be helpful to many!
EH has had similar problems, generally with arm movements (rock climbing, pull up from a door frame, etc.).
@Eric your measurements are really interesting and I’m not surprised Insulet hasn’t corrected it. I’m guessing they’ve not admitted it’s an issue because most users don’t look that closely. 
So this is weird. Granted I’m using an old-fashioned ruler and not digital calipers, but I do get approx. 6 mm depth:
and roughly 6.5 mm length (the gap before the measurements start is 2 mm):
What I noticed - kinda from looking at the picture, hard to tell exactly - is that the angle I have on mine is not as big. Just a shallower angle, and that might be part of the difference.
Can you tell a difference on the angle in my pics?
What if you cut the cannula off right at the base of the pod and measure it? What do you get there?
Since I’ve started using Flonase under my pods, and limiting my bolusing to 4 units at a time, I’ve had much better success with pods working as advertised (both in effectively delivering insulin and in lasting three full days).
Last night was an exception. I did a pod change at 5PM and then struggled mightily for the next 5 hours with slowly climbing and then absolutely stuck bg’s. I decided the insulin was pooling or leaking and changed my pod. And then the next pod worked really, really effectively and it was a three-juice-box kind of night. My hormones are contributing factors to those lows…but slingshotting from stuck high’s to stubborn moderate lows when I’m supposed to be sleeping is not ideal. I.E. I’m a zombie at work today.
One of those most frustrating things about pumping to me has always been the variation from site to site. I found it was even worse using the OmniPod, and I would often get highs after changing pods, but my results are variable with Medtronic too so not here to bash any particular pump. I wish pump companies would focus more on improving infusion technology which hasn’t changed since the early 90s.
A while back Medtronic came up with a cannula that had several openings in it. I think it was kind of like a garden sprinkler hose. I can’t remember the name of it, but the idea was something like this:
Not really sure what happened to that idea. Anybody know?
They put it on the market, it had lots of site failures in practice, and they took it off the market.
For those who use Unisolve to remove pods, do you soak the pod while it’s still attached to you to remove it? I haven’t used Unisolve in a long time and maybe I used it wrong the last time I tried it. I’m looking for a less messy alternative to soaking my pod in baby oil for 30-60 minutes prior to removal. Not schedule friendly with a full family life when I’m trying not to ruin my clothes!
We soak a cotton ball and run it along the sides of the pod. Then we find a loose corner and slide that cotton ball around that corner until it can get under the pod. Once it’s under the pod just go back and forth until it comes off.
We can usually remove a pod in five to ten seconds.
We don’t use the pads… Those were worthless for us… Strictly a saturated cotton ball from the the 8oz bottle of unisolve.
Also after the pod has been removed we scrub that spot a little more just to be sure the adhesive is off of the skin.