When alone - a safety setting for insulin pumps

Wanted to share this idea as a safety net for when you or your kids are alone and you are worried about sleeping through a low alarm.
(See a-frightening-experience-at-sleepaway-camp )

I am giving an example on how to do it on an OmniPod, but I think most pumps have this same type of functionality. The only difference would be in how you set it up for your pump.

The idea is that when you sleep through a Dexcom low alert, your insulin will be cut off at a certain time. But if you are able to respond to the alarm, you can easily have the basal insulin turned on back to normal.

This has 3 components:

  1. A basal rate customized for the “alone” event with a “safety gap” in it. The length and time of the gap depend on your particular situation.

  2. A temp basal that spans the safety gap, with the same basal rate that you would normally take if there was no problem

  3. An alarm that goes off at the time of the beginning of the safety gap

Setup of the 3 components:

  1. Setup a custom basal for the day/night you or or your child is away. People generally set up basals for when they are alone a bit more conservatively. Pick a time when you think, “If I am having a low that I don’t wake up for, I want to stop my basal insulin during this time, and for this duration as a safety measure”. In my example, I am using 4am to 9am with the lowest possible setting, a 5 hour span. (On the OmniPod, the minimum basal setting, outside of temp basals, is 0.05 units per hour. In the next release, they will allow 0.00 unit settings). Put in the lowest basal value during the time of your safety gap.

  1. Create a temp basal that is the same length of time as the safety gap, and same basal rate that you would otherwise want. In my example, I have a temp basal of 5 hours for 0.60 units. I called it “Night Cover”.

  1. Create an alarm that goes off at the beginning of the safety gap. My alarm is called “Safety Check”, and it goes off at 4:00 am. Pick the time that matches your safety gap.

Here are the scenarios:

  1. Your alarm goes off at 4am. You wake up. You are okay. So you simply turn on your temp basal called “Night Cover”, and it fills in the correct insulin that you have dropped down during the safety gap time. So you basically have a normal basal during this time.

  2. Your alarm goes off at 4am. You DON’T wake up!!! There is a problem. Since you did not wake up, your basal safety gap is going to stay off for 5 hours (or down to the minimum, 0.05 units in the case of OmniPod). While this doesn’t immediately fix your low, at least you have no insulin being continuously pumped into your body while low. So this definitely helps to keep you from being driven lower. It is a bit of a safety net.

Hope this makes sense. I think any pump would allow you to do something like this.

You will have to respond to an alarm that goes off in the middle of the night, but since you have the temp basal already programmed, all you have to do is turn off the alarm and turn on the temp basal, and go back to sleep. No big deal.

For the tykes using OmniPod, like Liam, the 0.05 unit safety gap does not help much, since they aren’t taking more than that usually. But in the next release I think you can have a zero setting programmed. So keep it in mind for the future.

For OmniPod, you will need to setup the temp basal with units/hour rather than % temp basal rate. If you prefer % temp basal rate, simply change to units/hour, create the temp basal, and then change back your setting to % temp basal rate. You only have to do that once during setup!

If you have any questions, or I did not explain it well, please ask me.


The Tandem t:slim has a different approach that likely accomplishes the same end goal.

It has an “Auto-Off Alarm”.

“Your t:slim Pump can stop insulin delivery and alert you (or whoever is with you) if there has been no interaction with the pump within a specified period of time. The default for this alarm is pre-set to 12 hours. You can set it anywhere between 5 and 24 hours, or off. This alarm notifies you that there has been no interaction with the pump in the specified number of hours and the pump will shut down after 30 seconds.”

The OmniPod has the exact same thing, auto-off. You can set it for any time-frame. The problem with the OmniPod version is that it not only stops insulin delivery, it deactivates the pod! :open_mouth:

It is a simpler way of accomplishing the same thing, and I would use this feature all the time, except if I decide to sleep late some morning and don’t interact with the PDM, it would kill the pod, even if I am fine.

It would be a great feature on the OmniPod if it didn’t run the risk of burning through pods…

I have requested that they change auto-off to simply stop insulin delivery instead of deactivating the pod. Anyone else who is a user - feel free to request the same thing next time you are on the phone with Insulet support!

I never used a pod so don’t know the terminology. But do you mean like a permanent kill switch? Like you can’t just activate / turn it back on?

Yes, the pod is DONE. You have to replace it.

The pod is the part that sits on your body that contains the insulin. The PDM is the remote control unit.

So what else does the PDM do? It sounds like more than just a remote?

It has normal pump functionality. It’s really just a remote. A pump that’s not connected.

It has bolus calcs, food library, alarm, IOB, I:C ratio settings, ISF settings, insulin duration, BG meter, insulin history, BG history. Probably some other stuff I’m forgetting.

I basically just use it to take insulin. I don’t really use all the features.