# To Diluent or Not to Diluent

#21

yes everything would be double – bolus and basal both, if you’re using diluted insulin by 50% in the pod.

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#22

Yeah, after more than 2 years, Liam still hates his Fred (POD) and Bob (CGM) changes…he’s getting better…now it’s more of a …“You’re still killing me, but at least it’s not by a thousand daggers.” lol

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#23

I think she means multiply your bolus and corrections by 2, and also the daytime basal.

They nighttime basal would not be multiplied, since you are trying to reduce. But if you want to keep the daytime basal the same, you would multiply it.

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#24

I’m still confused as to how you all use 2 pods.

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#25

I mean the other basal rates, if they work for you, you’d double. the night you might keep the same but youll be delivering half the insulin all night.

And maybe you’d wind up (if you did this a lot) using not quite double for some other stuff. Like if you bolus 0.2 units of undiluted insulin as a correction, for instance, you could bolus 0.3 units of diluted insulin and the net result would be 0.15 units of undiluted insulin – so a little less than you normally bolus but not by much. And if you wanted a slight bump in the bolus amount, you could bolus 0.5 units of diluted insulin to get a 0.25 unit bolus of undiluted insulin. So just finer increments for boluses. Because we have openAPS I never really feel the need for these fine-grade increments – but you might?

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#26

Imagine that you have one pod – it has undiluted insulin.
You use that during the days and do everything as usual.

Then at night, you have both pods on. i believe right now you have something like
12am -4am 0.05 units
4am - 8 am 0 units
or something like that, right? (may be reversed).

Well, in this instance, you’d have your undiluted pod and it would deliver:
12 am - 3am -.05 units
3 am - 8 am 0 units

THEN meanwhile you’d have your diluted pod and maybe from
3am -8 am it would deliver 0.05 units of diluted insulin – which would be the equivalent of 0.025 units per hour.

If your son went high you’d still bolus from his undiluted pod corrections, so you’d know for sure that the insulin was working…

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#27

10PM - literally 6AM we SUSPEND all basal and we still go low some nights.

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#28

The two pod issue is not applicable to this. It is unnecessarily adding a level of complexity here that is not needed.

I can post on the reasons somebody might want to do it and how to do it on a different thread.

For what you are wanting to try, I would suggest posting the basal amounts you want to do, and then we can go over every single thing that would need to be changed. I have spare PDM’s so I can run through the PDM setup over and over to make sure all the pieces are covered.

If you post the basal amounts you have now, and what you want, as well as IC and correction, and then we go over all the numbers and changes, you can have a few hundred eyes looking at it and a discussion that verifies all the numbers are correct.

Any mistakes will be caught, anything that does not make sense can be brought to light.

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#29

But this is exactly the theory I was thinking about if it’s possible to have 2 pods on…I just don’t know how that process would work. I can envision using one pod for straight (regular) insulin, and the other POD JUST for nighttime basal rates?

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#30

oh wow… that’s really crazy!
Samson gets 0.075 or 0.05 all night long…often goes high even with that.

Liam must be making some endogenous insulin then, which is good news. Or I guess his muscles could be refueling at night?

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#31

This is simple. We want LESS than the minimum .05 that the POD affords us, during the nights. All other times we want the POD to function as it usually does with the normal undiluted insulin.

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#32

yeah that’s what I was imagining. But if you’re going low all night I can’t imagine you’d need to use that second diluted pod very often.

How much is Liam’s TDD?

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#33

It’s been something that’s confused the heck out of me for a few weeks now. It’s been happening for only the past month or maybe less.

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#34

Between 5 and 8 units TDD

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#35

wow, that’s low…pretty much what Samson got when he was first diagnosed. We use between 6/7 and 14 or 15. Lately it’s been closer to 11 or 12.

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#36

Yes…but as with anything, it’s not every night. 3 nights out of the week he may need nothing for a majority of the night and other nights of the week he may need some, but not .05, else he goes high.

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#37

If he’s honeymooning, I’m not going to complain…the longer he has functionality, as you said, the better. But it’s not so great on figuring out what needs done with dosing. Because, one day his pancreas may decide it’s going to work extra hard (i guess?), and other days, it’s like…nah, I’m sitting on the couch eating potato chips today…I’m sitting this one out.

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#38

Getting 0.025 units per hour at night is easy. Or 0.02, or whatever you want.

And you can make the daytime basal amounts whatever you want also.

But with bolusing and corrections, using the diluted insulin means you have to make adjustments to the amounts (more liquid volume to get the same amount of insulin from the diluted mix). This is also not too difficult, as long as you have setup your PDM to do it, and you don’t forget when you do a bolus that your insulin is diluted.

Two pods could possibly do this for you also, but wearing two pods, and also going through your pod stash at double the rate, is not ideal since Liam is not too keen on getting the pods put on. And because you can only turn off the basal for 12 hours at a time, you would have to always do this every night. If you forgot, it would be a problem.

So for what you are trying, I would stick with 1 pod and diluting it.

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#39

Yeah, this sounds easy, but in practice it’s going to be a LOT to remember…even if I set up different profiles, I can’t program everything that’s required so it would require remembering that EVERYTHING (except nights) would require double…so if I had planned on “bumping” him .30 for a snack he was unbolused for, but now his sugars are rising, I would need to remember to always do .60 instead.

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#40

Yep.

If you use the bolus calcs and pump recommendations for everything you do, it is easier than if you are manually doing it.

In theory, every single thing you could do on the pump could be programmed for the diluted amount - corrections, different BG targets for different times of day, different IC’s for different times of day. But in practicality, I know most people are adjusting anything the pump tells them to do. So you’d need to be aware of it at all times if you make any adjustments.

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