My son (he is 5 years old) just started on OmniPod (we are in a “testing mode”). After the first pod change we found a bruise with a little blood on the site of the pod. Is it normal to see or it depends how you insert the pod, site of the body and etc..? Do you usually see anything after you remove the pod?
I’m trying to learn about PDA itself as well. Is it supposed to calculate IOB after the meal bolus? Let’s say I have insulin duration set for 4 hours and I have range for desired BG is 110-140. The IC ration is 1:40. At meal time BG was 120 and he got 40 grams of carbs. The pod will give 1u of insulin. After an hour my son wants to eat some snack for 5 grams. The BG at this time is 140 (he was active). Is PDA supposed to consider that there is still active insulin from last bolus and not offer any insulin or not? I didn’t see that happening (I’m still learning)
We will only occasionally see blood at the site and rarely see bruising, but it has happened. I think you are right that it has to do with how the insertion went.
IOB is not calculated for food bolus’, so you are correct, you did not see it in the above example. It is calculated for correction bolus’. In the case you described, I would have probably just given Caleb an extra bolus without an additional bg check. We often bolus him an amount (most typically 50 carbs) before he eats and then true it up when we know the exact count.
Hello Lorraine,
Thank you for the quick reply. Do you know if all pumps do the same (calculating IOB)? It was my understanding that they should take in consideration meal bolus as well, so it will not overstock over the time. That what I was hoping to see.
Thanks
I believe MM and Animas include both types of bolus’ in IOB.
There are two theories behind these two approaches.
The presumable theory behind only correction IOB - if you’ve calculated your carbs correctly, then you need the insulin that’s still working in your system because the food is still working in your system.
The presumable theory behind both meal and correction IOB - You have insulin still working in your body which will lower your blood sugar regardless of its original purpose.
I think the reality lies somewhere in between these two theories, but the programming of insulin pumps is not sophisticated enough to allow for it, so it opts for one or the other.
I know that Caleb’s meals typically will continue to affect his blood sugar for at least an hour and a half. But it depends on the food he eats (high or low gi) and the amount of food he eats.
In either case I feel that I would have to manually compensate based upon what I know about how insulin and food works in Caleb’s system. I’ve found myself able to do this easily with the way IOB is calculated with the OmniPod.
You are in a sense that it’s hard for the pump to predict why BG is in a range after only an hour of bolusing (it’s because of activities, wrong calculation or because the food just started to work). We basically have to be those smart chips to take everything in consideration and make correct decisions and calculations. I hope my son will be OK with OmniPod, so we can continue use it.
By the way, how did you calculate the basal for your son?
Thanks
I know I have messaged Lorrraine about this before, but Serge is new to me, and I believe this group. I have the greatest of respect for all of you parents of T1’s out there, that are doing so much good for your child, and making their life more tolerable! BLESS YOU, AND KEEP UP THE GOOD WORK! Now, Serge, to your questions, I think Lorraine has hit all the important points, I myself do have a small bump with a spot of blood after each pod removal, no pain, and it is usuially gone in the next 6 or 7 hours. also, Serge, I believe there has been 2 or 3 discussions on the pod and IOB calcs over the past few weeks, check into it! good luck, and PEACE
I have a three year old on the pod for a year now - we see that the site of the pod varies greatly when we remove the pod - most times it is a little dot with some blood - some times no blood and sometimes bruising (rarely). Most times for her it is healed within 3 days - however, we just had one that took a week (bled a lot when we removed it).
I wish the IOB would use the meal bolus as well - since my little one is in the care of others at times we have had people correct her when her meal bolus was still active. Thankfully, everyone tests her frequently so they have caught the lows that were caused by the correction.
Give it a few weeks to get the basal rates correct (took us 4 weeks) - the doctors tend to be conservative - rather give too little insulin than too much. We have adjusted on our own since then but our doctor/educator looks at our numbers every two months (more often if we need).
We are “live” with OmniPod. I have big concerns regarding testing BG using PDA. I know there is an issue with the new strips, but we use the old design and we cannot get numbers close to our old Accu-check. It’s a way off. Either we check the BG incorrectly using PDA or something else is going on. One time it can be 80 on Accu-Check and 130 on PDA, next time it can be vice-versa. Sometimes it can be in the acceptable range. When I did the test for myself – the result was almost the same.
I trust to our Accu-check (we have been using it for a year now), but would love to use only PDA to test BG. Do you have any ideas what it might be and whom to trust?
