FUDiabetes

Omnipod takes 6 hours to work on pod change and then delayed insulin


#1

Whenever I do a pod change it seems my first bolus (if under six hours) just doesn’t seem to work.
Last night I had a sub about 60 carbs did my normal bolus shot up to 300 after three hours I did a correction with a pen.

This was around 9:30. By 1:30 I was crashing even though technically I had no IOB.

I ended up having about 70 carbs. It is almost like the bolus from 6:30 kicked in finally.

This has happened a couple times now and I have started just using a pen the first six hours.

Is it possible the insulin finally kicked in?


#2

Sounds like your DIA may be longer than you think? If you ate at 2130 and crashed at 0130 that would put the DIA at 4 hours? Some DIA is as much as 6 hours. Have you tested your DIA (Duration of Insulin Action)? Also, this could be a saturation issue. When a POD is first applied, it takes some time for the site to become saturated and more insulin can be (often is, in our case) required when first applying the POD to a site.


#3

I am pretty certain my DIA is probably 5-6 but I literally ate about 70 carbs at 1:30 where any other time I would need maybe 15 to bring me up.


#4

When I was first podding I often had a noticeable rise with a new pod. But after I started giving a prime bolus of 0.15 units right after activating a new pod, I don’t get this. Your numbers are way more drastic, but I wonder if a small prime would help the site get settled in.


#5

That’s exactly what we do. I always give a .10 to Liam everytime I activate one just to get the site “ready”.


#6

I try to time my pod changes so that they are at least two hours before my next meal so that the site has a chance to saturate. I know some people time their pod changes WITH meals so that the meal bolus helps get the site going, but that always backfires for me.

I’ll apply the new pod, set a +25% temp basal increase for two hours. take a 1.0-1.5 unit saturation bolus, and keep an eye on it. Often I need to run the +25% temp basal even longer than two hours. And if I need to bolus for a meal soon after a pod change, I’ll take it by injection bc my boluses never work right away. I’ll shoot to 325 so easily if the site isn’t saturated. YDMV.


#7

Yep, there are lots of threads about pod change highs on these forums. I haven’t used the OmniPod in a while but had this problem with the old and new pods and had to bolus or set a temp basal increase after changing pods.


#8

so I run fine until I eat, so let’s say I eat 3-4 hours after a pod change it is like my bolus had no impact.


#9

That is highly.unusual.

Possibly unrelated to the pod change?


#10

This is odd. Are you changing your pods at roughly the same time of day each time? If so, maybe the IC ratio for the following meal is wrong?


#11

How long does it take before a pod bolus does work for a meal? Remind me again how long you’ve been podding? Humalog or Novolog?


#12

My current theory for my skin is that if I use a pod for a snack/meal/large correction bolus in the first few hours after application, I’ll induce tunneling. It seems that my skin cannot handle boluses from the pod until it has soaked overnight.

I do pod changes in the evening, usually around 7 or 8PM. Then I’ll skip my snack that night and keep an eye on how the new pod is acclimating. Then the breakfast bolus the next morning works without issue.

My last three pods I applied between breakfast and lunch due to traveling (and trying to make my life easier…HA), and all three failed either from the pod scream of death or due to complete ineffectiveness (tunneling).

Fingers crossed for my current pod that I applied last night. It had an immediate positive effect after its predecessor tunneled some point mid afternoon. Granted, I was getting jostled around all afternoon when I went mudding, but still. The track record is not great right now!


#13

I shall add to the record here. About 1 pod out of 4, we get a pod change high: the first 3 hours we don’t appear to get either any or enough insulin out of the pod for boluses or for basal.

My last hypothesis was that it might be due to poor priming (air?) But my son is convinced I am wrong.


#14

What is his theory?


#15

Is the priming step of getting a new pod ready actually effective at getting insulin all the way through the cannula? For some reason I thought I read somewhere that a half unit bolus is required to actually get it primed. But I could have dreamed that up.


#16

He thinks it is a coincidence, and he does not really have a new pod high problem. He gets about two puberty peaks a day, and, in his opinion, they sometimes coincide with a pod change. But the math of the stats do not really bear this out, or the dynamics of the peaks following the pod change: a slow but unceasing rise (as if you have no basal insulin), and no impact from a bolus.


#17

I definitely think it’s a real thing from my experience when I used the Omnipod. I have not experienced this on my MiniMed pump, a site either works right away or doesn’t work well at all.