As I am writing down my result and units of long and quick acting insulin this morning in my logbook (on my last day of MDI before getting Podded tomorrow!) I realized that I won't have to do that part of my routine anymore either! Right??
Since all my info will be in the PDM I don't see any reason to use a logbook or am I crazy?
I am so freakin' excited for tomorrow!!! It is going to be such a huge change, and I am ready for it.
Your endo may have you log your meals--especially the types of food that you consume. That way you can tell how they impact you bg. You'll be better able to control foods like pizza or mac n cheese which take longer to "hit" your system. You will be able to figure out how to use the "extend" feature. Otherwise...as long as you use your PDM to take your bg (or enter a bg taken with another meter) on a regular basis, you should be all good. Make sure to get the cable to link to your computer and download the co-pilot software.
I continued to use a logbook for the first month or two as we were adapting the settings on the pump. It helps sometimes to just glance down at a piece of paper and see it all on one page. Now I rely on the PDM and the records I download with co-pilot. One thing missing is, when I log manually, I write down *what* I am eating, rather than just the carb count and this helps you see how different foods behave. That's missing with just the PDM records.
Unfortunately, I have never found a good way to log WHAT I eat on a regular basis though I think it would be helpful. I'm still looking for a phone or iPad based program that makes that easy (Anyone one know of any apps or programs they like for that?) Below is a reply that I made that address logging that I have found useful. Also, I have included a system for rotation of pod sites that you might find useful. Wish you the best.
Also, I have recently switched to Novolog from Apidra and have been very happy. See my question regarding that below. You can find the discussion responses under jla Omnipod and Insulin Brands. Apidra, Humalog, or Novolog? Posted by jla on January 10, 2012 at 8:56am in OmniPod Users
It is my observation that while the Omnipod works for 72 hours, it appears that the insulin (Apidra) loses effectiveness during the last 24 hrs and I often run pretty high then. I haven't thoroughly documented this but intend to soon. It has come to my attention in researching this problem that both Apidra & Humalog indicate that the insulin in a pump reservoir should be discarded and replaced every 48 hours. This disconnect creates a problem with insurances and increases the cost of using Omnipod effectively by 1/3. Do you Omnipod users have some feedback about how long the insulin in your "reservoir" is effective? Which insulin seems to get the best overall results? I'm contemplating trying Novolog which appears to have a longer "life span", similar onset rate, peaks faster than Apidra but slower than Humalog. Expected duration for Novolog is 3-5 hours, Humalog 2-4 hours (max <5 hrs), Apidra 3-4 hours. What about "tails" on the three? Thanks for any insight you can give me. Reply by jla on January 14, 2012 at 12:53am to smileandnod in OmniPod Users "Blood Glucose Meter.
1. I am delighted to be able to use the Omnipod PDM as my primary glucose meter. I do, however, carry a backup Freestyle Freedom meter with me because it uses the same newly approved strips. Some supplier sent it to me as a freebie. (I also carry an insulin pen and needles for backup.) When I was using an external meter because I couldn't get "approved" strips for a while I found it was really easy to forget to enter BGs into the PDM when I didn't require any action by the PDM, thus my records were not accurate. I tested the PDM and the FS Freedom side by side for a couple of days using the same "butterfly" strips and found that the PDM was usually a little lower ranging from 4-20 points but usually under 10 points. Note: I haven't seen any direction yet from Insulet about calibrating with the control solutions each new container of strips when you set the code. The new "butterfly strips" (not Lite strips about which I know nothing) carry 3 ranges of results, a low, a normal, a high. I think I'll clarify with Abbott what the deal on those ranges is. Insulet's official word about the FDA approval only came today (1-13-12) and that's one of the details I haven't seen addressed yet.
2- The Freestyle strips are readily available at many pharmacies.
3- I use the Pod disposal program because I'm a recycling queen and I don't want any of the battery stuff not being properly recycled. Yes, it costs me a little money and time but I believe in the principal of recycling.
Tip 1: Since the beginning of 2011 I have logged in a dedicated notebook the lot and serial number of every pod I've used along with the time I activated it, a number code where I placed it on my body, and a number that indicates a count up to 50 (to keep track of when I should send a "kit" in for recycling). I started on the Omnipod in October of 2008 and found this record very useful last year. (I also record in the same log when I place a new DexCom CGM sensor or restart a sensor and when I replace batteries.) I record when a pod doesn't "2 beep", won't prime, or occludes all of which I report to Insulet and they have replaced the offending pod at no charge. I also record whether there is a "kink" in the cannula when I remove the pod or blood or "fatty" appearing tissue in the cannula especially if I get an unexplained run of much higher BGs than I would expect. Sometimes, depending on the reference codes for the alarms Insulet wants the pod shipped back. They indicate that when you report it. They do not replace pods with kinks, blood, or "fatty" tissue or occlusions. I think I had a total of 8 of 133 pods I activated or tried to activate in 2011 (12 months) that were replaced by Insulet. They also replaced 3 PDMs. From October of 2008 to January of 2011 (30 months) they replaced 2 PDMs that had issues and I bought a third as an upgrade. I keep the original model around as a backup. I am not OCD about record keeping --I'd probably have better A1c's if I was, but I've never found a method of keeping records thorough enough to be truly useful. I did find this pod log (and CGM sensors and batteries easy to do and useful.)
Tip 2: If the pod doesn't "double beep" when you fill it, try to prime it anyway. Sometimes it still works. If it doesn't you haven't lost much because if you report it, Insulet will replace it.
Tip 3: On occasion, a pod will "squeal" when something goes awry between the PDM and the pod.. The suggestion they'll give you to quiet it is to straighten out a paperclip and stick it "into the manual alarm shut-off port on the top side of the pod. Move the paper clip back and forth until the alarm stops. My experience is that this procedure is often not altogether successful unless you manually continue to hold the paper clip in place. The 2d suggestion that tech support gave me was to throw it in a freezer. I have left pods in the freezer for weeks and still have it start to squeal once more when it warms up. If you can determine that Insulet does NOT want the pod back, I've found that a few firm taps on the pod with a hammer will stop the squeal permanently. If they do want it back, keep talking to Tech Support until you find something that works or they give you permission to hit it with the hammer (I have never been given that permission!).
TECH. SUPPORT IS WONDERFUL They are there 24 hours a day, always kind, understanding, patient and helpful even when you've been a bonehead and not read your manual thoroughly enough. I have been using insulin since September of 1966 and the Omnipod is the best tool I've ever had to administer deliver it. Now that I have it coupled with a CGM it's an even better combination. I was on a Disetronic Pump for 2 years with tubing and I hated it and gave it up to use Lantus and humalog.
I'm working on documenting the frequency with which I need to change pods and am going to try using Novolog which claims to have a longer reservoir life than the Apidra I've been using since 2008. Both Apidra and Humalog indicate that they should not be in a reservoir for longer than 48 hours but the Omnipod is programmed for 72 hours. Changing pods more often, as I might need to do because the BGs seem to go up quite frequently after the first 48 hours, is going to up the cost of using the Omnipod by as much as a 1/3. In 2011 I used 133 pods. Theoretically I should have used 120. Hopefully using Novolog might help with this problem.
So with all that said, I'll bid you all a good night.
Reply by jla on January 14, 2012 at 9:24pm to Thigh Sites Posted by Jeanine S on January 11, 2012 at 4:26pm in OmniPod Users
I use 7 sites on both right and left sides of my hip and buttocks that work best for me. #1 site is on the left right below my waistline on the back where it gets "fleshy". #3 is 2" below that down the buttocks with the cannula end of the pod near a line that goes down the side of my hip, # 5 is 2" below that, and #7 2" below that with the pod still fitting under my panty line #9 is towards the front and directly below my "hip bone" (where you put your hands on your hips). The back end of the pod is on the line that goes down from the hip bone and angled downward. #11, and #13 are each 2" under the one above it. Sites #2, #4, #6, #8, #10, #12, & #14 are in corresponding places on my right hip and buttocks. Theoretically, a site gets used only once every 42 days. Absorption seems ok as long as I don't get too far down my thighs. (I use a similar system for finger sticks: even days on my right hand thumb from 12a-9a, pointer from 9a-1p, middle from 1p-5p, ring from 5p-9p, pinky from 9p to 12a. From Day 1-15 I use the inside of the finger, from Day 16-30/31 I use the outside of the finger. This way I spread the joy fairly equally among my fingers which I've been pricking since 1986 when I got my first glucose meter.)
I still log, i made my own flow sheet to document so we can see trends, as jacob is probably going to start a growth spurt soon, he is 13, i think it is important to see the trends, it really helps me to look back and see, his blood sugar was this we gave him this much insullin and this is what the result was, i would never get that with looking at the copilot info, although it gives good info, i honestly dont have time to be downloading and reviewing online frequently, i'm a pretty visual person so the log book works for us, and keeps us all up to speed with what is going on.
I use full page sheets that cover one month at a time. Each evening I go into my pda & retrieve the results from that days finger pricks. I bring 3 sheets to my endo every 3 months. I think it helps me see trends by looking at the sheets.
sorry i forgot to say good luck with the transition there will be some tweeking and adjusting to do but it has been mostly a success for my son, good luck and if you have any questions we are all here for you! best of luck, amy
Thank you Amy! I have been pumping for about 19 hours now...I think I still had some NPH in my system cuz I had lows last night and this morning, but we are getting there. I am SO impressed with how easy it is to use!
Thanks!
Yes, when I switched to the Pod, my CDE had me discontinue the Lantus 24 hours before, but still cut back basal and bolus way back from what I was using for MDI. I was concerned it would be too little insulin. But I was wrong...I dropped from using 45 or so units a day on MDI to 35 or so when I first started the Pod. She said some of the long acting insulin seems to hang around and absorption seems to be different on the pump, so she started out very conservatively. Over the next few weeks we got things progressively tuned better. And insulin usage went back up.... so it is not surprising you are seeing a few hiccups or lows as you start.
If you download CoPilot with the Omnipod extension, it kinda does the log book for you, just download the info off of your pod.
When I was using my PDM as a BG meter, it was easy to let Co-Pilot take care of logging and analysis. I just went through way too many batteries taking BG readings and uploading info to my Desktop. The Omnipod system is wasteful enough so I got tired of adding more garbage on top of what was already unavoidable.
I use a Logbook App for Android that takes care of the logging and most analyses. If I need any more processing power, I just use Excel.
jla...
There is a great app for iPad that I use called MyNetDiary http://www.mynetdiary.com/learnMore.html. It does a great job with food and their nutritional makeup as well as weightloss goals and progress. Check it out!
thanks for the tip. I don't have an iPad but I'll see if I can get the app for my Droid.
There actually is a Mobile app for the Droid:
MyNetDiary Mobile Apps
The Ideal Mobile Diet Tools
To make it even easier to keep track of your diet in the modern fast-paced world, we provide mobile apps for the iPhone, Android, BlackBerry® and iPad. All of the apps can work with your MyNetDiary account - use them on the go, and the web site when at home or office.
I still use my logbook. It is easier to see your values that going into the PDM.
I have been logging for 10 years and don't intend to stop.
I highly recommend Medtronic's (even though I DO use Omnipod) Insulin Pump Daily Journal booklet. I won't lie and say I log in it every single day, but find it extremely helpful in recording responses to (not to mention my carb guesses for!) specific meals, exercise, temp basals and site changes. My Endo likes to look over these records to complement the CoPilot downloads, as the entries provide additional detail. There are fields for BG, Carbs, Bolus, Corrections, Basal rates, Exercise notes and site changes. There is also lots of space for meal specifics and other notes - each booklet holds about 30 days of info.
Cheers!
I assume you have excellent control. When my sugar start going up for no apparent reason i start a food diary in a notebook. Your log book sounds very thorough.
Keep up the good work. What is your A1C if you want to tell?
Most recent A1C was 6.3 - so definitely not optimum, but better than the 7.4 from the same time last year before I started detailed logging. :)
I use the logbook to track my experiments/results for getting around the pod change highs (grrr). I still haven't come up with the right algorithm yet for that.
Wow that is wonderful i had 6.5 on Lantus but i am allergic to it.
My most recent was 6.8.