New Omnipod, corrections and IOB time?

We have been on new omnipod now for two or three weeks and overall doing well, just having some trouble with blood sugars being high for the past 4 days or so... it occurs to me that with the new way IOB is calculated we seem to have trouble with blood sugars coming down with corrections... if it is within several hours of eating, then the Meal IOB gets subtracted out and we are unable to give a " full correction"

Also the Insulin action time is set at three hours, but with out dexcom we can see that the insulin is mostly finished by 2.5 hours, so perhaps we are not coming quite down due to that insulin action time being set too long?

What experiences is everyone having with the new IOB calculator with the new omnipod??

Love to hear from everyone on this??

You can change the duration of action, but you need to understand that most experts suggest that the duration of action of 3 hours is actually too short and it should be more like 5 hours. Before making such a change, you should consult your diabetes team. And you should also question your meal and correction ratios.

hi Natalie, it has been about 2 weeks for us and the same issue we changed his insulin time from 3.5 to 3 ... but will probably try 2.5 I just don't really understand the IOB thing if you bolus for food and a correction the body needs this amount of insulin for that food then if they eat 2 hours later they need the correction and insulin for that food regardless of what was given 2 hours ago I too find insulin peaks out at 2 2.5 hours and then that is it... I like the way it was before even then we would add on some of the insulin on board..Jacob eats a lot and often esp in the afternoon so we have had to add in and really think a lot about his boluses, this is fine when I am around to help him think but when out with friends he is quick draw McGraw with his PDM and just does what it says... so we will try 2.5 and see if things are better.. other than that doing well, only one occlusions numbers overall ok because we have been keeping an eye on the IOB issue... hope kennedy is happy with the smaller size, Jacob was very excited and it definitely feels better for him. hope you are having a good summer! amy

thanks!! yes I read that and was told that by out endo as well, that's whay I was afraid to make it any less, I suppose it's always better to err on corrections being not enough than stacking insulin and having low's I decided to change the correction factor as with her total daily dose it is out of line with my charts I use in my pumping insulin

yes she is thrilled!! the other thing is I got her on the scale and she has grown about 6 pounds to 95!! and she's damn near as tall as me, massive growth spurt!! and dex is really rising starting around four am, so we are going to just crank up tdd and all her settings and see how next 48 hours goes!

kennedy is the same way she is eating tons now and ALWAYS hungry! let me know how that 2.5 tdd works for you!! I use that table in pumping insulin on page 123 to estimate her settings and we usually don't track far off that thing...

We love this new thing!! I was blaming some high blood sugars on it, but I think it was just the diabetes!!

It doesn't tear away from the adhesive or flop at all, she forgets its there even!

We tried to put it on her arm, but she just doesn't like it there, need to find some new sites!

This is a fundamental misunderstanding of how to set the duration of action. The peak may occur at 2-2.5 hours, but the insulin may remain active for upwards of 5 hours. And you don't always observe it's action at the tail. If you basal is properly set, you should be able to precisely count and bolus for a meal and at then end of the duration of action be back to your preprandial blood sugar. If you set the duration of action too low and try to correct a high at 2-3 hours, you may experience hypos. If this occurs, then take heed.

If you are really having problems with meal boluses properly matching meals, then you need to adjust the timing and size of the bolus. You may need to prebolus for meals and adjust your ICR. If your blood sugar is high at 2-2.5 hours, but still comes down to normal at 5 hours, it isn't a problem with your duration of action.

it is a bit hard to test this out with Jacob since he eats sooo frequently but I know if I do what his pump says with the IOB recommendations he will not get enough to cover his carbs he may need some overall tweaking and adjustments for summer sleeping in etc, we are aware of the consequences of insulin stacking but don't seem to see this in practice with him.. all his food choices have some fat and protein which help fend off hypos and spikes with him.. work in progress as usual!

Jacob had a big spurt at this last endo visit, finally he was flat on growth for a few visits and he was concerned! working out and getting muscles! probably still growing I think I might need to tweak some basals im thinking of increasing his earlier morning like 5-9 because he is sleeping till around 9 instead of 6 for school and spiking up after breakfast.... always something but at least the kids are happier with the pods being smaller! which sites does kennedy use? Jacob has been having good success with his thighs he uses these more in the summer, arms are good for him as well and the overused belly, he just got a sunburn and didn't burn in his pod belly areas, he had his pod on his leg with a tegarderm, no prob in the waves, I thought this was a bit odd, but maybe he unconsciously put more sunscreen there. go figure! talk soon. amy

Be aware that while almost all pumps calculate insulin on board, none of them calculate carbs on board. Thus eating frequently will be really complicated. And while shortening the duration of action may work ok during the day when there will be an upcoming snack or meal, corrections at night without an impending snack may have differing results.

are you using the reverse feature as your correction? i turned my reverse feature off. I too don't like the way the Omnipod calculates IOB.

i thought of turning this off a while ago the endo being conservative as they can be advised against it, I do tend to find when he is lowish with a bolus he might not get enough insulin d/t this feature, thanks for reminding me of this, certainly not trying to bring about crazy lows just trying to work around pump features to maximize therapy specifically for our situation... this is a good idea sarah thanks!