After 38 years of MDI and at least one year of contemplation I finally took the plunge and began CSII with an Omnipod insulin pump today. I met my CDE and pump trainer last Thursday. They set up the pdm very conservatively and watched as I filled the first pod with saline solution and applied it to my arm. I spent 3 frustrating days feeding carb counts and dexcom readings in to the pdm as it dispensed "insulin". I was supposed to continue this charade for another 3 days but emailed my CDE yesterday and asked if there was really any good reason for me to continue to "practice". She wasn't surprised and pretty much gave her tacit approval, just reminding me to stop the levemir the night before. I let the initial pod run out of saline while I was at the Red Sox game at Fenway park. Great game, a come from behind victory for the Sox. When I got home I filled the new pod with apidra and followed the directions. I had a communication error while I was waiting for the cannula to deploy. Had to put the pdm closer to the pod but it was a momentary glitch as soon as I got the pod and pdm closer the needle deployed and I felt the distinct ping of needle into flesh. Something I have experienced more than 40,000 times in my life. I am looking forward to not having that experience tomorrow or the day after.
I am also taking the plunge and starting the pump on Thursday and will start the practice charade Friday. I am so excited as you to not have to do the MDI. Good luck and Congratulations.
oh, fantastic, clare...how's it going so far? one thing i was told is to put the new POD (when filling it) to the RIGHT of the PDM, very close to it, when inserting new PODS. Hope you'll keep us posted as your podding adventure continues. good luck!
Clare, just curious..what did you start your basal rate at, was it using 20 -25% less of your long acting insulin? thanks!
Hi Sarah,
It's going very well so far. Played golf today and although the basal is way off and I have averaged 139 I did not go low at all and no double up or down arrows on the dexcom either. Had a "stuck key" error on the pdm today which freaked me out a bit and did not clear when I pushed all the buttons. Found out from tech support you have to take the batteries out and it will reset. They were right thankfully. The trainer and my CDE set the pdm up completely and super conservative. Basically they split the basal/bolus 50/50 and set the basal at 0.5 units per hour during the day and 0.45 units/hour at night. So I was taking 22 units of levemir a day and they had the pdm set for a bit less than 12 units over 24 hours. It seemed like an incredible drop to me and I will have to do some serious tweaking to get it more personalized. They just set it so I would not hurt myself. But so far so good.
fantastic...did they tell you not to do corrections, unless over 250, to help determine basal rate(s)? that's the part about starting a pump that I just couldn't tolerate. So, i keep going back and forth with POD and Revel..and still trying to adjust my levemir (can't get it right). So, i'm gonna slap another POD on tomorrow and just go with it. My nurse just took 25% of my basal - levemir and we used that...I was pretty low the first day, sometimes that levemir can hang around a long. Hope you'll continue to post..hope you love it, hope I do too. :)
No they didn't tell me that. But at the same time they didn't expect me to put insulin in the second pod, they had given me saline. I currently have a temporary basal set at 50% more than they set it at because I have been too high and the CGM will pick it up if I start to drop. I have corrected a dozen times today but the maximum correction dose is set at 2.5 units and I haven't come close to using that amount. I am going to end up doing some basal testing anyway and hope to get it more in tune with me and not in tune with the pod trainer or nurse.
How's it going, Clare? I slapped my pod on this AM. so far so good although I'm probably gonna be a bit low today. The POD (vs. Revel) calculates IOB in a funky way, IMO...I turned off the reverse correction which seems to work for me. IDK, I hope this works for both you and me...as we navigate through this. Yes, in tune with you...not a nurse..ha..I hear ya.
Hey Sarah, the pod continues to work pretty well with the settings I have done. Changed Duration of Insulin action from 4 to 3.5 hours it should be 3 hours, but we'll see in a couple of days, have basically upped the basal to 0.7/hour and am still battling some high periods. Problem is yesterday during golf I wrenched my back and so have been in some pretty bad pain which always messes my blood sugar up. I saw my chiropractor today who said my back muscles are in spasm. He did some ultrasound treatments and now I just have to relax and let it heal. Easier said than done of course. I have my second meeting with the pod trainer and CDE tomorrow. I'm sure they'll be unhappy with my settings but I just don't like spending more time than absolutely necessary in the mid 200's.
OH, so sorry to hear about your back..yuck. Take it easy, did they give you anything for pain..yeah pain and 200's not fun. I have my insulin action at 3.5 too, changed it myself. but I use humalog (or novolog). Do you think Apidra works faster/better, especially with meal spikes? I'm at basal of .40 and will probably up it a bit tomorrow, see how tonight goes. The thing about the POD, it couldn't be any easier - right, stick insulin in and slap it on. I've had problems with adhesive allergies so just did skin tac this morning and taped it down. I so hope for both of us this process doesn't take too long. I too hate high numbers. So many things to adjust. Are your I:CR and ISF about the same with POD? Sometimes those can be messed up with basal not right.
I switched to Apidra in December because I had been on Humalog and it just lasted far too long, the tail on it for me was about 5 hours and I would go low hours after a meal. Apidra for me starts quickly and is gone in 3 hours it has a very short tail which is what I need.
I have had no allergies to anything so in that respect I am very lucky. You're right about the pod being easy though.
And the CDE has the pod set up with different I:C ratios and much more conservative ISF. I'll humor them for a while. I will attempt to get the basal right first and then change the I:C and ISF to better match my D. I got the pump for the most part to have the flexibility to be able to turn it off or turn it down or turn it up. And I am getting a lot of practice with that.
But I'm going to have to be a sloth for a while and let my back heal. So I won't even get to use all the temporary basal programs I set up.
Maybe I'll try apidra (again). We just took 25% less of my total levemir divided by 24 hours. I upped my I:CR too and ISF. Have you done any corrections yet? It is VERY different..like .20, for me anyway, feels like a whole unit of insulin. I was 100 before lunch and 118 afterwards (yesterday, eating the same thing, low carb, I was 179..ha!). So far so good on my end too. Thank god for CGM's no? Yeah, pump for that reason too, can't wait to be able to really work out again and also for the dual/square/extended boluses (I'd like to eat more), although I haven't used them yet. Also, no more long acting; i could never get my split levemir doses right; too high, too low. are you setting up temp basals or just adding additional basal rates, like for PM, different times, etc..? Here's hoping for a good night for both of us. Hope you feel better soon.
Thanks Sarah, my PCP called in a script for pain killer and muscle relaxant so at least I should sleep better tonight. I was on lantus as basal for 7 or 8 years and could never get it right, always high or low, I finally asked my endo for levemir because it is not supposed to peak. I liked levemir so much better than lantus and still curse my stupid previous endo for putting me on it in the first place.
I have corrected a few times and yes you're right when the pdm says 0.4 correction I'm like really are you kidding me ? But hormones work in minute amounts in a normal body so there is no reason they shouldn't work in minute amounts in our bodies.
Recently I have made a lot of changes in my exercise and diet. I lost a lot of weight and have started working out, swimming, playing racquetball, and tennis and I need to be able to just stop the basal. I have had some serious lows after a swim and can get out of the pool with my blood sugar at 27 which is scary. So the pod is the perfect way to do this.
good, glad to hear you'll get some pain relief and sleep. anything back-neck related is very painful, it's the body's core, every movement effected..ugh! please be careful with the meds and BG's...keep CGM close, close, close!
well it is raining cats and dogs so I couldn't take the dog for a walk if I wanted to. Dexcom was flat all night long nothing lower than 95 and nothing higher than 127 so I am really happy about that. And I slept really well with the help of the drugs. My back is improved at least but I know this is not going to just disappear overnight. I already got a substitute for my tennis game tonight.
that's great. so, i started dropping low 80's before bed so lowered to .35, everything OK on CGM, but at 1AM I wake up starving, ate some cheese, 3AM i'm 168 ((???) did .75 correction on pump and increased back to .45, 6:30 154 did another 1 unit correction increased up to .50 and gave 2 units injection for coffee, yogurt. So, this is the same thing i was doing on levemir. I have no idea what is going on between say, 12am - 3am, am I taking too much, dropping and having rebound highs, not taking enough. Hope I didn't just crank up my basal rate too much but morning are always my highest, DP..I think? Hope my nurse can help me figure this out. raining here too. :) LOVE tennis. just relax and take care of yourself.
how do you know, clare, when we fist start out if it's our basal/bolus rates not right or a bad pod? do you feel nervous about sleeping on the pod. do you have it on your arm. i'm afraid to turn over on it? well, now...I'm starting to drop, drop. crap, turn back basal again. I don't know what I'm doing. ugh! I'll send you email, maybe we can help each other along through this..ha! :)
I have the pod on my back hip area and no I don't get nervous about sleeping on it. I am still getting good numbers from the Dex. I have the basal set at 0.7 seems fine. Last blood sugar was 85 so I'm ok with that as well. I know the nurse and pump trainer are going to freak out that I changed stuff but I didn't do anything truly stupid or dangerous and the numbers bear it out.