I went to my endo for my 3 month (after starting the omnipod-5 months since dx) A1C check and it was 6.3 yay! Anyway, I had mentioned being concerned about highs right after eating and he said to change my insulin action time on my pump to 3.5 hours instead of 4 and that would take care of them. I didn't ask then, so I thought I would ask here why that would work? I changed it, but not sure if it is working yet. Can someone explain why that change would help? Is it just that you would get more bolus insulin delivered? Thanks!
When you change your active insulin, it helps during bolus wizard type actions. Shorter IOB means your insulin is being used up faster. I found I had to shorten my IOB from 4 hours to 3 hours because that last hour was not bringing my BG down to normal levels. It helps with corrections too because then I am less likely to stack insulin. Hope that helps a little.
That is what I thought, so why would he say that should solve my problem of after meal high? Maybe he didn't understand my question? Who knows...Thanks for the input!
I think Alan has given you the key. If you are high after a meal, then when you go to do a correction at 2-3 hours, it will think you have less IOB. He probably thought you were correcting, but your pump wizard subtracted IOB and gave you nothing leaving you high for hours.
Frankly, I'm surprised he didn't drop your I:C ratio if you are high after meals.
You might also try bolusing a little before the meal. Even if it is the right dose of insulin if I bolus directly before the meal i spike to ~200 mg/dl before I come back down. Bolusing 15 minutes before the meal gives me very little spike at all. I agree with BSC: if pre-bolusing doesn't do the trick you need to look at your I:C ratio.
I also want to point out that the OmniPod does not track IOB for carbs. It ONLY tracks IOB for correction insulin. I think this is one of the major shortcomings of Omni. I usually suggest to Omni wearers to not correct until at least 2 hours after the bolus and when I wear it I wait for more like 3 hours before correcting if I do not want to bother to do the math on my own. I have also given my carb and correction bolus all as a correction bolus (so tell Omni you are NOT eating and adding the insulin for the carbs on to what it suggests for the correction bolus) so the machine would track it all for me. It is terribly hard to sort out what happened when you download it and you haven't been putting carb grams into the machine though.
Good point. Makes one wonder even more what the point of modification of duration of action was.
same with me, i have to prebolus before any meal, really, or I'll spike, regardless of what I eat, and I low carb. if I'm high, i'll do a correction and sometimes have to wait a good 50 - 60 minutes to bring me down prior to a meal. everyone, even non diabetics, has an increase in blood sugars when they eat. I was going to switch to Aprida, thinking it works quicker - faster, but..apparently they all (fast acting) work about the same.
Continuing on this subject...do you guys test at the 1 hour mark, I keep doing this and my endo tells me not to..I usually always come back down within range and I like to keep a 'tight' range..but doesn't that one hour spike (when it happens) matter...?