First day blues

So, I started my first Omni experience last night. Endo figured it would be best to start at the end of my lantus cycle. Based upon calculation (40 of lantus, and an average of 20 units of Novo daily) we start with a basal of 1.2.

Pod went on without a hitch and going into bed I was at a comfy 82. Ate a banana for a snack, bolused a little bit under for it (was nervous about the pod, and not having the lantus on board). Went to sleep and woke up at around 2:30 with my Dexcom G4 screaming UNDER 70! at me. I checked it and it just said "low". I ran for my Freestyle light and sure enough I checked and got the dreaded 'lo'. Normally when it's that bad, OJ and 2 glucose tabs have me moving up in minutes. Took 8oz and 2 tabs and started the scary wait. 15 minutes later, 32 with a down arrow. More OJ and waiting. It ended up taking me about an hour and 3 glasses of OJ to get above 70.

Finally got to sleep, and was woken back up by the "high" alarm. Checked and I was at 230. Took a correction to cover for all of the juice and to ring me back down. Woke up a few hours later at 120. At this point I adjusted my basal to .80, got ready for work and my son off to school. Halfway to the office, I stopped in for breakfast, checked G4 and I was down to 80 with a down arrow. Ate a munchkin and finished the drive in. Felt kinda shaky at my desk, checked : G4 69, FS : 62. Again, glucose tabs and OJ. It quickly sprang back above 80 and stayed there. I at my wheat bagel and bolused for 6 units (I'm 1 unit per 8g of carb so this was actually a few units lower than I go). About 20 minutes later, I hear my G4 buzzing. 'LOW' again :\ Finger test confirms 'lo' reading. So I suspend the pod, and spend the next 20 minutes waiting for food to kick in at near black out level.

Finally, called my endo and he advised to stop the pod. I go back in later this week to talk to the pump team again. Hopefully round 2 will be better. Sorry this was long :\ It's been a rough day.

I had this same problem for the first 3 days. They for whatever reason started my basal rate too high. I imagine you are experiencing the same. These doctors should always start conservatively! I take .55 units per hour. I take .65 units from midnight to 6 am. Seems I need more when sleeping. Good luck with the omni. Once the adjustments are made you should be fine. After 25 years with diabetes and taking numerous shots per day, I do believe omni is much better than shots. But be patient with yourself. It took me nearly 2 months to get comfortable with it. My last A1c was much better (6.6 down from 7.8). Things are getting better each day!

The first few days are not typical, for whatever reason. My CDE cut my basal *way* back from what I was using on Lantus to prevent this problem. I was upset and worried I would run too fact it was OK, and over the next 2 -3 days I had to crank the basal back up. The Lantus doesn't run out all at once in 24 hours - some may hang around - and absorbtion is different on the pump than on MDI.

Be patient... it may take a month to get all the rates and ratios tuned in. But when it is done you will find your control is much more stable and predictable and in 3 months you will see your A1C coming down.

Spent my entire first week dialing back my basals and shaking and then going high, dialed the basal down a ton and got way better!

Different people will react differently to the initial Omni setup. I believe they (technicans that give you the initial training) calculate the total amout of insulin you are using daily, reduce it by a factor (.85 or 85% in my case) and then halve it for the basal level (so, 20 / 24 hr for me.) What happens is that depending on your activity level, this may not be appropriate. I for example bolus much more than 50% my daily insulin, I excercise and am generally active, but there was no way to account for this prior to the training because i would often skip injecting for small snacks before and just correct at meal-time. So while I knew how much insulin I would need for each of my 3 meals provided I stated at about 100 bg, I could not accout for the corrections.

Setting the right levels for the Omnipod is a process of trial and error, I believe it is a process that works well for me as it has made me check my bg more often and explore for trends and effects of excercise and other activities. I have learned for example that while my basal is usually around 0.6 when I am excercising (if I have excercised within the last day and a half) if I have not hit the pool or ran in more than 3 days my basal is 0.8. It seems a lot, but is something I would never figure out with Lantus. As of late, unless it is in the middle of the night, I always suspend insulin for 30 mins to an hour during lows (which is what a healthy pancreas would do) and try to make note of what I ate last time I bolused. Not all carbs are made equal, Cheerios vs Multi-Grain Cheerios, same portion size, only 2 gr carb difference per portion, about 2 whole insulin units difference for me.

I know this is a long reply, but I just wish you luck and hope that my experience somehow gives you a bit of hope that things will be better.

To track foods I have been using the LoseIt app, helps me go back and check what I have eaten and correlate with lows/highs at a later time.

With any pump, the transition time is rocky. My Endo's office had me call them daily with reports and they made adjustments every day. Plus there's a learning curve that I and I think most have to go through to understand how different pump control is over MDI. It's very different. Personally, I think it's a little bit more work than MDI but the results eventually pay off for that extra effort.

Did you get training by an Omni Pod specialist (CDE)? As others have said, they have specific formulas for figuring your initial basal rate(s) and IC ratio(s); if yours was calculated by an endo who isn't specifically familiar with Omni Pod, it's likely that your basal is too high.
I'm no doctor or CDE, but my injection quantities weren't far from yours when I started OmniPod, but my initial basal rate was a LOT lower than 1.2. Just to give you an idea, my total daily insulin when I started pumping was about 1/3 what I had been taking with injections.

Yeah, I went through the initial training, but my docs office has since replaced the person that did it. She was very hands off and wasn't generally liked by many. I have an appointment with the new nurse/nutritionist Monday. When the did the initial basal, they looked at an average week's worth of data (lantus and novo doses) and just used some basic math calculations to arrive at 1.24 or the 1.2 that I started at. We'll see how it goes on Monday after I go in. Still not feeling great today after yesterdays hellishness.

Thanks all for the replies though :D