Hey guys, Ive been on the Omnipod for 5 days. How long might it usually take before a rep gets the basic basal and meal bolus dosages worked out? Trying to be patient because I know this can be tricky, but I feel horrible. It might help if I had a plan for how much longer I can expect to be ‘in transition.’ Thanks
When I transitioned my son to the Omnipod, we started with a formula based on the amount of lantus to establish a baseline for basal rate. Luckily we also had Dexcom–so it was MUCH easier to work out the dynamic basal rates. We would then log all numbers and call in everyday so they could give recommendations until we were able to work it out ourselves. Hope this helps. You will likely need to do more finger-sticks than usual at first if you do not have Dexcom or another CGM.
It might be worth your while to read John Walsh’s Pumping Insulin and/or go to Gary Scheiner’s Type 1 University:
http://type1university.com/
The type of assistance it sounds like you need is more within the realm of what your CDE or endo, not your pump rep, should be providing for you. And a great deal of pumping effectively has to do with watching trends and making adjustments in an ever-ongoing fashion. Unfortunately, using a pump is not as simple as “set it and forget it.”
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I’m on a Dex, plus about 20 - 30 finger sticks a day because I’m trying to give them the best data possible to make adjustments as quickly as possible. We started with a baseline from my lantus, but I usually supplement that with Humalog adjustments via MI. It might take them a long time to figure out the underlying pattern.
Yea, they don’t want me making adjustments. So, I’m gonna give them time to have a shot at it. The rep is a nurse. Its in her hands, according to my Endo. I have that book, but its in storage. Thanks for the link.
I’m on the diabetes starvation diet until we get some meal bolus rates set. I don’t think it works to pre-bolus on a pump. Does it? There’s a good three hour lag before the postpranials start to come down, on a pump and MI. Im hoping they have some tools in their pump toolkit for that because my MI tools, like pre-bolus, might not work.
20-30 finger sticks is quite a lot if you are on Dex. Is the BG on your meter close to what Dex says? Realizing everyone is different–the best way we found to find the correct basal was to eliminate the variables so you can focus one at a time (which is what it sounds like you are doing). It was a bit rocky at first, but will get better as you fine tune.
They’ve been working on the overnight for five days. That seems like a long time. My Doc wont accept Dex data, only finger sticks. I think I see a bias in the Omnipod machine, so Im checking BG on three devices. I think there’s a fair amount of variance between the BG machines, more than usual. That troubles me. I think its bias, not normal, random variance because it consistently reads lower. If it were random, it would sometimes read lower and sometimes read higher.
Do you have any STD solutions that may have come with omnipod or other meters–so you can make sure it (or others) are reading appropriately?
I know that Dex provides one, but I’ve never been sure how it is calculated. Most of the time % diff is within 30%, but I am getting some 40% differences, which seems high. I guess I should calculate STD between the machines and see if V(x) is less than 20% (good) or greater than 20% (bad)? Does that seem right?
One machine might read 200 and one might read 250, which isn’t a huge % difference, but it has impact on how I dose, according to which value I use. That kinda bothers me. I have been averaging them.
I do know that Dex is designed to be more accurate when it isn’t calibrated when you are too high or too low–and when you aren’t rising or falling sharply. The big thing to keep in mind is that you are comparing apples to apples. If you are logging with two separate meters–there definitely will be inherent variability (even with the same meter). Be sure not to mix your logs in the beginning since there seems to be a 40% difference. It will definitely be harder to fine tune the Omnipod if you aren’t getting reliable BG readings. Although Dex might not come with a standard, other meter may and wouldn’t be a bad idea to check it.
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Anybody got another BG machine brand recommendation? I think I need one additional. Currently using a Relion (from Walmart), the OmniPod, and the Dex sensor.
I pre-bolus on a pump all the time - works great!
I originally started with the Asante Snap and their CDe/Rep helped me get the settings right. Took about 2 weeks to get very good settings. I translated and transferred those settings to the Omnipod ()and now to the Animas Vibe) with a lot of success. Of course, these settings need to be checked and adjusted periodically, because life - and diabetes - changes.
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Two weeks, eh? That’s reasonable, I guess. Hungry makes me angry - hangry.
I wouldn’t use the Omnipod rep to tell you what to do - what about your Endocrinologist?
I think you mess up the algorithm with that many finger sticks. I do one in the morning and one in the evening, more if I think something is off.
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Not sure if @mohe0001 meant that they calibrate the CGM that many times - just do finger sticks to satisfy their doctor who won’t use CGM data for decision making of any kind…
It took me better than a month to completely dial in my dosages, basal rates, boluses, correction factor, duration of insulin action. The clinic had the pod set very conservatively and I was running much higher than I am accustomed to. Once my basal rate was set perfectly it was much easier to attack the other parameters. Diasend is a good program to combine both Dex and PDM data so you can get a better handle on how your basal and bolus programs are set.
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Thanks you guys. Still trying to work it out. Yes, Clare3, they have set up very conservative settings. I run 400, 40, 400, 40 all day. I feel awful. I wonder if there is some place I could go to get the settings roughly accurate. If I could go somewhere for three days or a week and find someone to set approximate dosages, maybe I could fine tune. Its been about six weeks and things are deteriorating.
I’m going to reset everything to MI doses and see if that helps stabilize in the short term.
Endo has me working with the rep - she’s a nurse. They are working together.
Dex is accurate, if a little slow. My Doc wants manual readings. I didn’t eat, at first, in an effort to eliminate variables. I am getting pretty sick when I eat, and post prandial bgs that are twice as high as they were on MI (around 250 on MI, around 400 on pump), even when I deliver identical doses. None of this makes any sense to me.
You should contact Gary Scheiner/Integrated Diabetes Services.