FUDiabetes

Omnipod trainining tomorrow...suggestions?


#1

Tomorrow I’m getting trained on my Omnipod by my diabetic educator.
I’ve already had formal training on my 630G from Medtronic, so looks very similar.
I’ve already programmed it myself and have been using it for a few weeks or so, and so far I don’t have any questions other than needing help figuring out locations and making sure I’m inserting it right.

I’ve also noticed that the canula seems to be a bit wider/bigger, so it tends to cause sore spots?
I also don’t like that with the amount of insulin I have to take, I have to change it every 2 days.

Any suggestions as to what I should ask her that maybe I’m not thinking of?


#2

Ask when U200 insulin will be approved for use in the pod!

Sounds like you are way ahead of the game. Maybe she will learn stuff from you!
:grinning:


#3

How much difference is there between what you use and the 200 U that fill the pod? Would delivering some of your boluses by pen or injection enable you to get the full three days out of a pod?


#4

@bollina in case you haven’t heard, there is supposed to be a new DASH PDM support U200 insulin (and also U500 insulin) but no dates are known yet.

For me, I use about 180 U for three days when I eat lowish carb. If I eat high carb, I just use an insulin pen for boluses to make sure I have enough insulin in the POD for basal.


#5

Good suggestions! Thank you.

I have plenty of backup pens, so maybe I should start using them for boluses.

I REALLY wanted the dash, but it isn’t due out until sometime Q1 in 2019 per Insulet. The good part is that I can transition immediately once it is available.

So far Out of the 10 I started with, 5 had to be replaced! Not the best track record. Two were occlusions. The one last night the lady said the code said it was from static electricity! I always wear cotton undershirts to bed, so unsure how I can avoid that. So glad they replaced all of them.

Sometimes I think about going back to the 630G as I didn’t have as many problems with it and it lasted 3-6 days with no hard and fast shutoff and easier on my stomach. My wife said to at least go to the training and see if I’m doing anything wrong or can get pointers.

Any other advice as to why I should stay other than that it’s tubeless?


#6

I would have her list the normal topics she covers, and then ask for more information about the one(s) that are of interest.


#7

Also, I would suggest double checking any math/calculations done by a trainer for your basal rate. (Sounds like you’ve done that - but I wanted that entered into the record for anyone in the future who might read this thread.)

I will also add that I really feel like it gets easier over time with less errors, failures, etc. The ramp up to good locations, less failures, learning the ropes was a real thing but worth it.


#8

Really, the only reason I use it is for tubeless.

Otherwise, I think all pumps are pretty much the same thing. Different menus and features.

But if I wasn’t going tubeless, I’d be on MDI. So tubeless is a pretty big deal for me.


#9

I was going to suggest the same thing, since that’s what I do @bpollina . I wondered about how the cannula would affect my delicate skin (with my Animas I use what you MM users call the Sure-T - stainless steel 28 gauge sleekness). I found I had no problems with any skin irritation (even from the large swatch of adhesive that sticks on your skin. Good luck! Keep us posted as you become a member of the Pod People :wink:DELETEinvasionofpod


#10

@bpollina to help with the failed pods, I would make sure that when inserting a pod that you pinch up your skin and push down on the cannula end. I think it helps to place the cannula better. The good thing is that Omnipod replaces pods for whatever reason. I was once placing a pod and the adhesive folded over so I knew it wasn’t going to stick properly for 3 days. I called and they replaced it no problem. I’ve also been told that duct tape helps with the static issue. I have only had that problem once and I was wearing fleece and vacuuming. I don’t wear fleece anymore (I wish I could say I don’t vacuum anymore :stuck_out_tongue_closed_eyes:).


#11

Make sure she shows you the paper clip trick for disabling an alarm that won’t quit! Though a hammer works nicely…


#12

UPDATE:

So I had the training and here is what we did:

  • She took my 630G and compared it to the settings I put in onto my Omnipod myself and declared it was correct. (I read the manual 3x before training and programmed it myself thanks to this wonderful site for encouraging me that I could do it and not wait for training to get started)
  • As we talked, she used an omnipod training checklist to make sure we covered what the company wanted us to cover. From what I understand, my 4 year warranty starts from the date of TRAINING, so I guess this was important.
  • She asked if I was comfortable with the menus so that we didn’t have to go over things I already knew. I told her that was fine.
  • She uploaded my data into gluko and said that my ratio between bolus and basal should be around 50% and it was.
  • She offered to look atmy dexcom data, but told her I was using Xdrip+ and tried to educate her a bit on it. She seemed kind of confused. She said I could fax her the dailys from the last 2 weeks and we could do some basal tweaking. She set my goals at 100-120 fasting and generally ideally under 140 oveall.
  • Since I ran out of insulin in my omnipod the day before, I went back to MDI so she could watch me insert a pod to make sure I was inserting it correct.
  • She said I was too hairy so definitely recommended shaving first. Since she didn’t have a razor, we put it just outside the hair line on the left side of my stomach area almost on my side.
  • She too recommended using skin tack first and pinching. She said that if the canula moves, it could effect absorption so even though it only stays in 2-3 days that I should still use it? (never heard this before)
  • She changed my dose to 75 pods per 90 days as my average was coming out to between 1.5 and 2 days worth vs the standard 3. My insurance is processing a new script as we speak!
  • She kept asking me if I had any questions and took her time. I did not feel rushed.
  • She said to use the wizard and not manually bolus but let it do the math when I put in my current CGM reading and carbs. She said CalorieKing is a good site or I could use OneDrop which I like .
  • She also confirmed that since my C Peptide was .7 and the medicare guideline is .8 that technically I would be considered a Type I vs Type 2.
  • She said I could call her anytime.

#13

This is textbook and it’s the usual starting point for settings, but know you don’t have to stick with it. Use whatever ratio ends up working for you. My longtime CDE couldn’t care less about the ratio.

It’s great that you got a prescription for pods every 2 days. Once you fine-tune your application technique, though, I wouldn’t be surprised if find yourself getting the full 3 days.


#14

Sounds like you were ahead of the game and ready to go! Nice job! That must’ve felt great!

The wizard is useful if your ratios are right, but I might also suggest using The Force and your knowledge to double check. Sometimes it’s a bit off or doesn’t know how to take into consideration your exercise level, other lifestyle stuff, etc. when making the wizard suggestion.

We have gotten that advice from Omni pod directly as well.

The one thing I will add, is that EH tried it once and got a nasty (probably staph) infection underneath the OmniPod when he did. The problem was that it was uncomfortable but then he ignored it and the adhesive+irritation made things get a bit ugly. It’s fine now. It was probably a one-off and won’t happen to anyone else, but here’s my suggestion of how to do a better job than we did:

  • use clippers/beard trimmer - the skin doesn’t need to be completely bare we’ve found
  • if you must use a razor, use a new blade, shaving cream, and shave the spot the day before and let it grow back a little if possible

Glad you had a good session with the trainer and that you basically had done it right on your own!! Congrats on that!


#15

I always shave before placing pods and have not had the misdortube of a staph infection :grinning:… well at least not from pods.


#16

Great info on Omnipod training, @bpollina! It sounds like you got a very good trainer. I have not heard of bad Omnipod trainers yet, but it seems yours was among the top (except for xdrip).


#17

She really is an excellent trainer. She actually thought I was coming in for Tslim X2 training (I wish!) but then saw the updated note for Omnipod. She takes her time and doesn’t rush things.

I did shave for the next one and it seems to be much better. I used cream but didn’t change the blade. I guess I should have done that. Oh well.

If you guys don’t mind a story, let me tell you how I found this office:

My old endo was an old school Indian (from India) doctor where the staff cowered behind him and never doubted him nor walked in front of him. He set the rules and they were to be followed without explanation. When, foe example, I asked about counting carbs vs sliding scale on my pump, I was told it wasn’t done here. When I asked why, he said he could barely get his patients to do sliding scale. When I asked him about my trying, he told me to just stick with the program and we don’t do things like that here. He insists on only using Medtronic and Dexcom and won’t even entertain other pumps/CGMSs. I fired him.

While googling I found an organization called Taking control of your Diabetes and that they were having a conference in St. Louis. My wife and I went, and an endo in the area gave a great talk that my wife sat in on while I went on one about cooking. He was taking new patients, so I went to interview him. He told me to give him a year, and he’d cut my meds in half. I told him that was fine, but that I was a “why” type of patient and always wanted to know reasoning behind everything he does or recommends. He said that was fine and that his office is very good about explaining everything in as much detail as the patient wants and is open to suggestions. Definitely a team effort.

That has played out and I’m still with him nearly a year later.

The first thing he did was order all antibodies test with my A1C and it turns out my c peptide was 0.6. He also checked my testosterone and finding me very low, gave me Androgel and even doubled that when levels were still not acceptable. He even told me at a later appointment that even though I came in as a T2, he’s treating me as a T1 and if I had problems with insurance he’d be willing to re-code me.

In the year or so since the conference, I’ve learned that I can’t just rely on my MD to spoon feed me things and that I myself need to take control of my own diabetes and do what I can to make myself better and in more control. The MD is to give me suggestions not orders.


#18

Great story! And I am so glad you moved away from the sliding scale!

FYI, I love your concluding line. It is our philosophy also :slight_smile: I think it is true of many of us here.


#19

@bpollina thanks for the story. I think it speaks to the fact that if you feel something is not working well with your endo, there is no harm in trying another.

Your first endo with the “old school” attitude would drive me nuts.

I am one of those lucky people who have awesome endos.


#20

I disagree with that assertion. The basal is whatever it needs to be to keep you level. Then the bolus is whatever it needs to be depending on how many carbs you eat. Both of those amounts are determined by your body, and there’s no reason the ratio needs to be around 50/50.

I’m going to disagree with this too. Type 1 means insulin dependent because of an autoimmune process. It is common in long-time type 2s to have the pancreas “wear out” leading to becoming an insulin-dependent type 2. It’s not type 1 unless there’s the autoimmunity. That said, if calling it type 1 enables you to get the treatment and devices you need and they’re giving you trouble as a type 2, that’s a reasonable strategy. But the actual medicare rules don’t require type 1, they just require a sufficiently low c-peptide (plus some other things.)