Hi. At 56, I’ve been T2 for almost exactly 9 years - was a decently-controlled pre-diabetic that accidentally/mistakenly had steroids included with my chemo infusions for a week or so. Almost overnight, my BG went from 125 to 396. Unlike with prednisone, when I got off the steroid, my BG never came back down to a pre-diabetic level. I’ve been insulin-dependent ever since. Because I have an ileostomy due to the cancer, I’m unable to tolerate high fiber foods, making it more difficult to eat the way the CDEs & RDs would prefer (and I’ve tried several dietitians/nutritionists who said they understood the juxtaposition, but usually just told me to count carbs & calories, without suggestions for what to replace them with).
Sometimes I’ve been a “good” diabetic and gotten my A1C down in the mid 6s (usually with an Atkins-like diet) and other times, I’ve been frustrated, said screw it and let it get in the 12s. I could blame it on hating fingerpricks or a bad memory, but really I just preferred to enjoy food because life’s too short already.
I started using the 10-day Freestyle Libre almost a year ago and find it a godsend and, particularly, after the change to 14-day with a 1-hour startup. I’m starting with Omnipod soon, so I’m thinking of moving to the Dexcom 6 just for better interoperability with my iPhone and Apple Watch. Though I have to say that some of the stories here about frequent failures concerns me.
As we used to say in my cancer support group, glad to be part of a group that I wish I didn’t have to belong to.
I was just thinking Omnipod should be on the menu, while reading the first part of your post. Your young, still. That will help you eat more normally. You can do a lot with Omnipod, it will just take some experimenting. Figure out a rough dosage for a food, and then extend the delivery - like deliver 85% upfront and the remainder over the next hour or hour and a half. You’ll be able to eat whatever you want.
I’ve been bad talking the G6, but dont let me scare you off it. My tech is different than yours. It might be a better fit for you. Its really hard to say until you try stuff for yourself. If it doesn’t work, you can probably bump down to a G5, or go back on libre.
I love my G6, it is not perfect and they are constantly working on the technology, we need a few more competitors out there I think. And it really varies with some people how well it seems to work. Mine is very accurate most of the time.
I loved my Libre too, but really the Dexcom is better. You can calibrate it and with the alarms it makes having a CGM even better.
i really hope the Omnipod helps. Because of early moderate kidney disease I’m only on half the Metformin I used to be, and my body’s ability to use insulin is decreasing. My ratios have increased to 3:50 & 1:4, along with 60u of Toujeo and that’s only been keeping me at 200 most of the time.
Hello and welcome to TuDiabetes, Russell @The_Burn,
I’ve been using an OmniPod for several years now. My basal rates are between 0.05 and 0.09 units per hour. My insulin to carb ratio ranges between 1:6 to 1:30 depending upon the time of day. My max bolus with the OmniPod is 8 units but I rarely went over a 5 unit bolus (my typical bolus was 2 to 3 units). My total daily dose (basal and bolus) via the OmniPod was in the 25-35 unit range.
Then life happened. I started to have highs I could not control, no matter how much I bolused or increased my basal.
I stumbled on something called “tunneling” with OmniPods. Turns out I was having absorption issues and the insulin was coming back out of the pod (the tunneling problem). I didn’t realize it for a very long time. Once I did, I changed a few things. 1) I changed pod placement from my belly to other areas of my body. 2) I only use the OmniPod for basal and I inject all boluses (meal and correction) with a syringe and vial of insulin. These steps have worked like a charm.
I’ve heard from others in the DOC (Diabetes Online Community) that OmniPod is best delivered in small doses; anything over 4ish units and it begins to tunnel (backup). I’m mentioning this because I’m sensing your insulin needs may cause similar problems for you and I thought it would help if you were aware of them.
Other podders may have different experiences and work-arounds and hopefully they will come around an chime in!
Get a Dexcom if you can. One thing good about the Dexcom. The alerts, at first they were annoying. Then I decided to use them to my advantage, not just as alerts at being too high or too low already. But I used the alerts as a warning that I am approaching numbers I don’t want to be at. Although I guess the miao miao right now can be used to turn the Libre into a CGM with alerts.
I prebolus plus I will not even eat my meal unless I am under 110. maybe I will cave on that if under 120 with a graph arrow saying I am dropping. But maybe try when you are sitting at 200 giving yourself an adjustment and wait to eat until you have dropped to a much lower number? As you know with kidney disease you really need
some lower numbers.
What’s great about an Omnipod (any pump) is the ability to adjust the basal rate as you actually need it. Plus the ability to give small adjustments constantly as you need it. That combined with a CGM can really help with control of BG numbers. Look at your CGM see you are a little high, push a button for an adjustment. It’s great.
@Tapestry has some really good points about high doses on the Omnipod. A lot of people have complained about higher dosing on an Omnipod, Plus sometimes you get site failures with any pump and your numbers will go up. It might be best if you are taking bigger doses to do your bolus for meals still in a shot and save your pump for smaller adjustments and basal rate.
The other thing you will run into is the pod only holds 200 units of insulin by volume. So you will get close to using that up in 3 days by basal rate alone. Your needs of basal usually go down with a pump so you also should have a little more wiggle room for small adjustments in small bolus amounts, You could consider using the double Humalog concentrate , the 200 instead, then the pod will last longer with more actual insulin in it. Trickier to program, but once you understand it, it’s not hard. I use the Humalog 200 in my Omnipod. At first it was thought I would have to change my pod every 2 days so they prescribed it, it turns out I didn’t need it but I liked it so stayed with it.
Thanks for the welcome and to the insight on tunneling. My first pods came today, so I’ll be scheduling my intro session with the Endo soon. So much to think about
Getting the Dexcom shouldn’t be an issue. While it’s a bummer that as T2 my OmniPod is a pharmacy product on Medicare (with price changing throughout the year), CGMs are DME and with my Supplemental insurance, I pay nothing. I think I’ve got 2 more months worth of Libres (they started shipping 3 month supplies when it became a 14-day product), so I just have to wait until those are done.
The CKD is what prompted this re-evaluation and the decision to pump. It literally came out of nowhere at the beginning of the year and we’ve been modifying variables to verify that it was true. Nephrologist did say that if I could control my diabetes, there’s no reason I’ll ever progress past Stage 3.
Yeah, I questioned the Omnipod rep (they have been great) about why she only wanted me to order 10 for the first month, as I didn’t think I would get 3 days out of them. While my endo prescribed a change every 2-3 days (and so I could get 15), apparently the dosing she wrote (I haven’t seen it yet) will work. We’ll see.
Lots to think about here. My endo’s great, but as someone said on another thread - unless they’re diabetic and on a pump, dealing with these micro changes and complications is not something they’ll probably be all that educated about.
On the other hand, they DO know how to prescribe enough Omnipods and insulin. Don’t run on the boundary with that. They don’t need to be running you that thin. There’s no reason for that. It will cause you heartache, don the road, if you need to ration supplies. Trust me. They do this to everybody upfront. You just gotta tell them to go f*ck themselves when they try to do that. Thats them being b4stards.
My endo did prescribe a 2-3 day change, and Walgreens was ready to send 15. it was my Omnipod rep who said to get only 10. She may have been trying to save me a few dollars until I make sure I like the pods (or make sure I wouldn’t balk at the higher $ amount). With Medicare in the catastrophic phase, it was the difference between $25 and $38. Assuming this starts smoothly, I’ll do 90-day orders of 45. I tend to knock off several Libres a year from the back of the arm (even with SkinTac), so I know it’s good to have spares anyway.
The pod actually will keep working for about 8 hours after it expires. This can be useful for timing of pod changing. However after about 8 hours or 8 and a half hours after expiration it will shut down and start shrieking at you.
Hi. I’m Devin. I’m new to diabetes and don’t really know what type I am. I’m 41 and I was diagnosed in dka in September with a bg of 473 and an a1c of 12.1. I tested negative for gad antibodies but my cpeptide was low. My diagnosis says t1d and my first appointment they said t1d but my appointment the other day they said type 2 but i don’t make insulin anymore. Either way I’m fairly confused by that but im not sure it really matters. I was told in 2019 i may be prediabetic and needed to lose weight (im 5’11 and i weighed 209). That was the first er visit in 2 weeks. They thought i may be having a heart attack. 2 weeks later i was back for a panic attack. 12 hours after that i was back vomiting blood and diagnosed with gallstones. 24 hours later i was back with acute cholysystitis and obstruction and had to have surgery. Within a year and half of the surgery i lost 50 pounds. I also started having issues with dizziness and nausea if i didn’t eat. In August i started to feel thirsty often. It got worse and worse and my hair started to fall out and i lost 10 pounds in a few days. After about a week and a half of barely being able to get out of bed and almost passing out i went to the er and was in dka. And now here I am.
There are a few type 1’s that don’t test positive for antibodies, they don’t know why. My DE is one of those, she makes no insulin but doesn’t have the antibodies.
Don’t let them label you a type 2. Type 1 if you test positive for the antibodies that’s a definitive yes. But if you have low c peptide that is also a yes. A type 1 especially a LADA/type 1 slowly loses the ability to make insulin and their c-peptide will be low normal or low and that can vary some as you lose the ability over time to make insulin. Eventually it lands at zero or close to zero. But your pancreas will keep trying sometimes up to 8 years plus. But a type 2 will test high or high normal because they have a different issue, they are insulin resistant, so they make enough insulin and usually more than normal as their body tries to make up for it.
If you are low on the c peptide, you do not fit a type 2. Unfortunately too many doctors still misdiagnose type 1. I still hear about it. The knowledge is really lacking sometimes in GP’s.
DKA is generally a type 1 issue unless you are on certain diabetic medications. DKA isn’t caused by high blood sugars, it is caused by lack of insulin.
It does matter what you are labeled for most people. Insurance and proper treatment. If you are labeled a type 1 it is easier to get tools we use okayed by insurance. Plus they are more likely to set up the proper treatment needed, insulin, which is critical, pumps, cgm’s which can be helpful etc.
Hopefully someone just glanced at the chart and saw no antibodies and said type 2. Hopefully they did not change the original diagnosis. Sometimes a nurse or doctor or something will not really read the chart???
But you also should get a copy of the results and see what tests they ran. They commonly just test for the one most common antibody test which is Gad, but there are a few other antibody tests. But there are several type 1 types of diabetes that just don’t fit the common molds. There is also one that is caused by steroid use or panceas trauma, sometimes in those cases insulin production can return.
I looked at mychart. He didnt change anything in it. In the hospital discharge notes it says dka type 1 not at goal and my first follow up appt notes he wrote type 1. He didn’t add anything new to the notes other than we changed my sliding scale and basal amount to what i was giving myself anyway. I know at my original diagnosis they thought maybe the gall bladder stuff caused it because i had pancreatitis. Their cpeptide range is different than the internet. The normal range at this lab is 1.1-4.4 and mine was at .6. The doctor said that is little to no insulin production at all. And it was only gad antibodies test. He also made a comment about maybe needing medicine for insulin resistance then said i seem to be very insulin sensitive. They sent me home in 66, 12 units 3 times a day and 30 at bedtime. That got lowered immediately. I now take 8 basal and anywhere from 2-10 at meals, usually between 2 and 6.
