Hello everyone after 17 years of mdi, I finally got on a pump and dexcom. I literally started the pump today and the dexcom I've been wearing for about 3 weeks. I love the Dexcom, I have been wearing the pump with saline to get used to the functions but I feel I have a big learning curve to get over.
If anyone is on omnipod and dexcom together and can give any tips I would appreciate it. I have a diabetes educator I can call and the pod rep but I know that I need to really understand how it all works and reacts with my body.
I am probably 40 pounds overweight and my a1c's have been in the 8 range, so I have work to do. Funny thing is I skip so many meals and I think that is my problem with slow metabolism and erratic bg. Well I signed up here about 2 weeks ago but I've been lurking around just reading as much as I can. Look forward to hearing from people going through the same challenges.
The biggest thing that I am concerned with is basal rates and just getting them under control, trial and error I know. My mdi way of treating my dm was not working well the last 2 years. I guess age catches up quick if you let it. Take care all
I've been on the pod for 4 years. You will have a learning curve with it as well as your endo will need to dial in your various basal rates. It could take 6 months before that happens. When I started my a1c was 11, but now I hang right around 7.0.
I'm taking 1.6 for a basal and that seem's low compared to the 50 lantus I used to take but I understand it's a different thing all together. I just want to know how to use the pdm like the rep did from Insulet, man she knew everything on it, and fast.
Generally, your basal rate will be about 10-20% less than the basal long-acting you used to take. So, if you were taking 50U of Lantus, the right place to start on the pump is 80-90% of 50U/24h, which is right in line with your 1.6U/hr.
I'm not on the Omnipod but I do use the Dex G4 with my Animas pump. One of the easiest mistakes to make is to use the G4 number to either treat a low or add insulin for a high. Now, I know that we've all done this, and I admit to doing it from time to time. If my G4 is tracking well, I have little insulin onboard, and no active food, then using the Dex number is probably safe.
However, I've been bitten more times than I care to admit by continuing to treat a low BG for 15 minutes too long. The Dex lags actual BG by about 15 minutes. I've discovered many times that following my first or second effort to treat a low BG, the actual (fingerstick) BG will start to rise but the Dex lags. I've been suckered into adding more glucose during that lag period and then suffer a rebound high. This is a rookie mistake that is avoidable!
Good luck with your pump and CGM adoption. Take the time to learn as much as you can, Read both manuals cover to cover. TuD is a great resource. Learn how to search and read from the archives. It is an underutilized gold mine. If you take and maintain an active learning posture, you will reap big rewards later. Diabetes is a damn-hard disease to manage. Persistence, focus, a good attitude, and a never-ending interest in learning are the keys to a good life with D. Be well!
Thanks all I appreciate the comments. Yes I have figured out myself about the Dexcom being a little behind sometimes. Either way I always use meter to treat low's or when eating. Maybe cause i'm new to it i don't know, but I have noticed the dexcom can track well and other times it could say I'm 134 and I'm 200, I've seen it happen. Not often but it has. Most of the time it's pretty spot on though.
Good reference to use as you work to fine tune your numbers is Pumping Insulin. It has a lot of info for pumpers and has a good section on CGM patterns and how to use them to adjust your basal ,C.F.,I:C and duration of insulin activity.
Is available for e-reader, or in hard copy and you can download all the work sheets.
One of the easiest mistakes to make is to use the G4 number to either treat a low or add insulin for a high. Now, I know that we've all done this, and I admit to doing it from time to time. If my G4 is tracking well, I have little insulin onboard, and no active food, then using the Dex number is probably safe.
I take issue with referring to this strategy as a "mistake". As with all things diabetes, "it depends".
I treat my high's and lows based on G4 readings routinely. Like, all the time.
I only do this because my own personal experience with the G4, how it reacts to my blood chemistry, etc. For me -- and I must emphasize that this is ONLY for me, I can't speak for anyone else -- the G4 is incredibly accurate and reliable during the "period of accuracy" I have learned works for me.
Generally days 3-21 after I put the sensor on.
Since I am verifying the accuracy at least 5x a day with strip testing, and consistently find it always to be where I expect it to be, I have complete confidence in relying on my G4 for making treatment decisions.
All that said, keep in mind that I'M LUCKY. Most people don't get the kind of performance I do with the G4 (some do). Some can't even use it at all, it's so inaccurate for them, for some reason.
Also the 15 minute lag is the Dexcom "drawer statement" about performance. Real-world measurements, and my own direct experience, is more like 5 minutes. Search the internet -- there have been a study or two measuring this. And again, like many things, this is highly variable. One of the biggest factors is placement. Abdomen has one of the longer latencies, back of upper arm one of the shortest. Since the abdomen is the only officially "approved" site, it's not surprising Dexcom's specs say 15 minutes.
Hint: The more perfusion at the site, the shorter the latency. Arms and thighs are good spots for lots of blood flow. Anywhere covering large muscle will have a lot of blood flow.
I didn't realize that the lag time differed at sites other than the abdomen. Thanks for making that point. Maybe I should try the back of my arm again. The last time I tried it I had to remove the sensor at 7 days due to pain. Are your sensors placed into muscle?
If my experience with the 15-20 minute lag is typical for abdomen use then my advice about over-treating lows due to depending on Dex data only is still valid.
Congrats! Though I haven't been a diabetic nearly as long (I just got to 8 months on Saturday) I'm working on getting a pump now, no idea if I'll get one but I'm hoping I can. I mostly need it because my lifestyle is kinda making mdi hard and I need the ability to do better dosing because I'm having trouble with that.
Good luck though! Hopefully it brings you better control and peace of mind!
I use back of arms, alternate sides. Get around three weeks before it quits. Just need to be careful when I pull shirt over head. Get better numbers then on abdomen.
