Insulin Increments for Little People

I have been on my Omnipod for about a week, and have noticed that even the .05 increments (in my basal) make a difference. I am putting my five year old on his Omnipod next week, and I am worried about not being able to make smaller increments for his little body. (the Ping and now the Medtronic have .025 increments). For those of you with little people on this pump, how do you deal with this? I was thinking perhaps if a .05 increment is too much for him, that I could divide the hour with two basals (say .2 one half hour and .25 the next half hour). Any other suggestions?

Thanks much! jen

(oh yes, on my third pod I had an occlusion (the pod started beeping, so that was good!) My question - Insulet does not replace pods that have an occlusion, correct??)

I do not have any children on the Pod, but I, too, and very sensitive to insulin changes. Your theory of dividing the hour into two basal doses sounds logical, but I would run that past your endocrinologist just to make sure. Also realize that even though he is small, his sensitivity to insulin may be different than your sensitivity. A .05 dose may be just what he needs. As you know, the first month or two are an adjustment period, so you may have to make several small changes just as you are doing for yourself.

You are correct that Insulet will not replace an occluded Pod. I had a Pod that failed to prime last Sunday, so I called them today about it. They told me I should have called within 48 hours of the Pod not working correctly, but the customer service rep also told me since the Pod did not prime correctly, that they would replace it with my next shipment.

Good luck to you as you and your son adjust to the OmniPod. I wish this had been an option when I was a child. You and your son will lead healthier lives because of it once you adjust it to your needs.

I have heard both things about the occluded pods - so far if my son’s pod occludes, and it is relatively newly on, we have always had them replaced. He also had a pod occlude on Christmas, which was preceded by consistently really high readings, so even though he had worn it longer than 24 hours, since he was high the whole time they replaced that one too.

As far as the .05 increments, I have often wondered that about little kids - what is your son’s total basal per day? I wouldn’t think you would want to switch every half hour or if that’s even possible . . . my son started when he was 9, so we were okay with the rates - but I know there are other parents on here that have kids who started earlier.

You have a good idea for the basal increments. Caleb has been using the Pod for three and a half years and was 4 when he started with a TDD of less than 2 units, so I understand the concern.

Rather than use 1/2 hour increments however, I would suggest alternating basals in hour increments. So if you want to achieve 0.225 over two hours, you would do that as 0.2 for one hours and 0.25 for the next.

The reason I suggest this, is because the insulin delivery is in 0.05 pulses on a conservative basis based upon 60 minute intervals. If you split it to 30 minute intervals, although mathematically it should work, I think you might lose a pulse here and there and deliver less insulin than you want.

For example, if you want to deliver 0.20 in an hour, the Pod will begin that hour and deliver insulin on the 15 minute, 30 minute, 45 minute and 60 minute intervals - the latest possible, not the earliest. If you do that for a half hour, you would get it at 15 and 30. If the next half hour is at 0.25, you will get a pulse in 12 minute intervals or at 42 minutes and 56 minutes and at the 60 minute mark it will start all over. You will end up with only 4 pulses in that hour when you wanted 5.

It’s actually a little more complicated than that because the 60 minutes don’t start counting at the start of the hour, but at the minute you activate a Pod. So unless you know that minute and can track this all out, I would suggest sticking with full 60 minute intervals to ensure you get all the pulses in the hour you want.

Did I explain that well, or just make matters worse? :slight_smile:

Thank you so much! Is this the Caleb that is on youtube? :slight_smile:

lol. Yes. This Caleb is on YouTube. :slight_smile:

Thanks so much for posting your videos! I actually watched them myself before I put on my first pod, and I send them to people before I am going to train them! (school nurse, babysitter, etc).

Hi Lorraine,
You probably already know this, but just in case… The OmniPod system keeps track of “fractions of a pulse”. It does not discard them. So, if after a few basal intervals, these “fractions” add up to a pulse, it will deliver it.
Cheers,
Gil

Hi Gil,

Actually this is news to me.

My experience has been different than that, but maybe I need to pay closer attention. For example, if I set a temp basal as a percentage for Caleb and it calculates for something like 0.58 (resulting in a fraction of a pulse). I have found that what is delivered is 0.55 and I have never noticed that it’s made up. I have had trouble using percentages for this reason.

I thought basal intervals could only be schedules in 0.05 increments, so I’m wondering where else a fraction would come up. Or am I completely misunderstanding what you mean by “fraction of a pulse”? :slight_smile:

Lorraine

Oh, ok, it doesn’t keep track of the extra 0.03, that’s not what a mean.
Here’s what I mean:
It keeps track of “tenths of a pulse” (.005 U each). The system calculates the number of pulses for a 30 min (or 60 min, can’t remember anymore), so if you run a rate that is not equally divisible by the 30(or 60) min x 60 sec (and one pulse at every 2 secs max), it will deliver a certain number of (integer) pulses during that period and remember the remainder. For the next periods of 30(or 60) min it will add the remainder to the number of pulses and again divide by the period, so it might change the frequency of pulse delivery to make up for the remainder. And keeps doing that for each 30(or 60) min interval…
Darn, it’s hard to explain these things on text… is it clear or not?

Gil

I think I get it. I think you are saying that in my example above, it may in fact remember the rate of the first 30 minutes and not start over in the second 30 minutes and actual work the way that Jen wants it to and thus I have provided poor advice.

That certainly is interesting. :slight_smile:

I must confess, that I have never experimented with the 30 minute intervals. I do know that it delivers the pulses in the most conservative way (I’ve tested this through a couple of hours checking to see exactly when the pulses are recorded in “My Records”) and I do know that when I “mess” with temp basals not “on the hour” things do not work as I wish because of the conservative method of the insulin delivery.

I’m impressed that the OmniPod is that smart. I think I’m gonna test this too. (I’m an auditor - I can’t help it. :))