If you’re not comfortable answering this that’s fine, but no judgement here at all. I am brand new to the omnipod and have been having a lot of trouble with it so far, its mainly figuring out my basal rates and carb to insulin ratio with my trainer. I was wondering if anyone would be willing to share their basal rates. I know my team knows what they’re doing but this is more for peace of mind.
My current basal rates are
12am-8am : 0.65 units
8am-10pm : 0.75 units
10pm-12am: 0.70 units
What issues are you having that show these are not right? Are you basal testing by fasting. Or using amount that is similar to pre-pump basal.
My basal is constant .50 all day. But I do temp basals to adjust for days with different activities. I find that easier than multiple basal patterns, and have used pump for 25+ years.
Occasionally I will do short “extended” bolus without food to do equivalent of temp higher basal, but this does mess up the totals.
I have had very stubborn high blood sugars pretty much since I started the omnipod a few days ago. I have a feeling its more my insulin to carb ratio but I’m not sure. I used to be on 30 units of Tresiba a day when I was on MDI and my trainer now has me on about 16 units total of basal per day. It comes out to .65 over night and .75 during the day. Its still earlier on and there are a lot of factors I’m sure I need to take into consideration.
Question for you as a seasoned pumper: In a situation like Xmas snacking throughout the day, vacations etc., Would it be wise to do a temporary basal of 110% or something during the day? On MDI, We used to use some regular insulin to better cover grazing days to avoid being perpetually high?
Your thoughts?
I mean it comes out to about .75 units during the day and .65 at night. This doesn’t seem too conservative but I guess in comparison to what I was taking it is.
I would use bolus or temp extended bolus. I think this is advantage to temp basal because I can keep eye on IOB to not over compensate. Having CGMS, and using sugar surfing techniques also helpful.
Agree, you are getting less total basal compared to tresiba dose. Some endos do that to avoid lows. Did they instruct you to make adjustments, or for them to give you changes?
Do you have cgms?
I am working with a trainer right now who is helping me adjust the rates.
One thing overlooked by endos is that some women have significant changes in basal related to menses. But that’s a whole new topic!
I adjust my basal rates as needed, sometimes daily if I am having to adjust to a new trend, sometimes not for months.
Right now my DP is quieter than usual. I also added an extra evening boost as my numbers seemed to creep higher early evening. The later morning ones might still be a little high.
But right now my settings are at…
24.15 basal units daily
Usually bolus varies between 20-30 total for the day depending on what I eat.
Average insulin total is about 55 units per day, right now about 50 units per day.
My highest settings are still between 5-12 am and I don’t eat most mornings.
12-5 am .8
5-5:30 am 1.5
5:30-7:30 am 1
7:30-8:30 am 1.5
8:30-12 pm 1.2
12-2 pm 1
2-6 pm .8
6-7 pm 1.5
7-12 pm 1.
You could argue there is very little difference between some of my numbers. But I do 24-36 hour fasting basal testing to refine my settings. I did one about 6 weeks ago. If these new trends keep up I will do another to refine the newer settings. My DP settings can’t be refined well, it’s more what’s the highest dose I can set without dropping too low on the mornings where it’s not as bad.
My experience switching to a pump (MT, not Omni) was that my expectations were way out of whack. No one said, “Hey, it’s going to take at least a couple of weeks, maybe a month or more, until you’re back to where you were on MDI, but don’t worry because it’s worth the effort.” It definitely was worth the effort for me, but up to the day I switched over I’d only been given happy talk and I thought I’d be all set in a few days. NOPE.
Yup. Part of it is just the nature of the beast: my Lantus DD was about 50u, considerably higher than what I seem to need with a pump. I think that’s generally true for everyone. That said, your team does seem to be pretty far out on the conservative side. This was the main reason my adjustment took so long. They are trained to be VERY cautious, rightly so because a pump is a different beast, delivering insulin in a constant flow, which can stack up unexpectedly if you don’t have things set right. So they are much happier letting you run high for a while as you get things dialed in. They are just going to be very low-averse. For me there came a point where I said, “ya know, I understand this thing pretty well,” cut the cord from my trainers and started tweaking my own settings. But that point would have come a lot sooner now because of one thing:
Do you also have a CGM? THIS IS A HUGE QUESTION.
You didn’t mention it and it tends to be assumed these days, but it seems to be something more automatically associated with pumping than MDI, so if you’ve just switched you may not know how crucial it is. I didn’t get one until I’d been pumping for a couple of years and I’m certain it would have made a gigantic difference in how prolonged the initial adjustment period would have been. If you don’t have one, get one now if you possibly can. If they say “one thing at a time let’s not complicate the transition,” the opposite is the case. It has its own learning curve, yes, but the basics are simple enough and it will make a huge difference in getting your pump settings dialed in.
Again thanks for all this feedback! I do have a CGM and it has been a life saver. I can’t live without it at this point. But yeah I definitely know it doesn’t happen over night. Not that I ever had “perfect” numbers but I was just sitting too high the past few days. However I got rid of the ketones last night and my numbers were stable all last night in the normal range which I can assume means at least my overnight basal is correct. I think what really did it the past few days is my insulin to carb ration. I was used to doing 1 unit per 6 carbs but to insure no hypos they had me start with 1 to 10 when I started the omnipod which was way too low. I then tried 1 to 9 and 1 to 8 which still wasn’t enough so now I’m thinking I can just go ahead a go back to my pre-pump carb to insulin ration of 1 to 6.
Letting you run high to avoid hypos, ok; building up ketones: not so much. I’d say that’s evidence of taking the conservative/cautious approach too far, and certainly justifies taking some control, especially since you do have a CGM. Sounds like you’re making good progress.
Plot twist…my blood sugars are normal but I actually still have ketones. I think it might be because I was so afraid of making my blood sugar go up even higher that I haven’t eaten any carb since 1pm yesterday…I just ate some breakfast but not sure how ketones work when they aren’t from high blood sugar. any ideas?
@gsmergss - What kind of ketone levels are you having in the morning?
Regardless of whether or not you’re on a low carb diet, it’s not unusual to have trace levels of ketones in the morning (after all, you’ve been fasting for +/- 12 hours, and low level ketones occur in many individuals).
As far as basal doses, I also started with only 2 basal doses. I split my total MDI basal dose in half and essentially ran 50% of it for 12 waking hours, and the other 50% for night time / sleeping hours.
It didn’t take long to realize that numerous tweaks were needed to that strategy. Most T1D’s have a range of Insulin to Carb ratios. While my I:C ratio is 1:15 later in the day, first thing in the morning when my insulin resistance goes up as a result of dawn phenomenon, it’s much higher (I:C ratio is higher).
Also many of us experience liver dumps of glycogen into our systems (generally dawn or Feet To Floor phenomenon). Adjusting basals during these times insures you maintain a stable BG profile (as close to non diabetic as possible).
Here are my current basal rates (which continue to be subject to change as my rapidly changing metabolism dictates):
I believe they were either trace or small. But it makes sense being that I didn’t eat for about 16 hours that I would have small levels. I have since eaten and blood sugar levels are still normal. I think the problem was my insulin to carb ratio. But I think I have remedied that. I hope it gets easier I really want to like this pump.
Its gonna take a while to figure this out. Feel free to post your data. My basals are:
12AM 1.2 U/hr
3 AM 1.6 U/hr
6 AM 1.8 U/hr
12 PM 1.0 U/hr
5 PM 1.1 U/hr
I average around 30 units of basal per day on MI, as well. I am 5’9", 180 lb female.
When I am doing basal testing, I make an excel spreadsheet like this:
If you can find/get a few hours of data without any correction insulin or food in your system, then that will help evaluate. Have a manual reading at the start and end of that test period (to verify sensor accuracy).
You seem very proactive. Sometimes I just print out this sheet, fold it up, and keep it in my purse. Then, I can easily take data throughout the dat. Dx is a description of what I ate that day.
Thank You! any information I can get is helpful. This whole pump thing has been a shock to my system. I am definitely learning not to compare myself to others as I know everyone is different. Just trying to get a feel for this all. Just for reference I am 5’2" 153 pounds.
