Pump backup?

I’ve been using an omnipod for a year with no problems. Last night prepping a new pod, the PDM wouldn’t recognize a new pod. I cycled the PDM and it finally worked. But it got me thinking. What kind of backup do you have in case of pump failure? My Endo gave me syringes for the fast acting but what about basil insulin? Also, are there syringes that come in less than 1 unit increments. I rarely bolus more than 5 units & although I haven’t used a syringe yet, the ones I have look like they would be difficult to measure less than 5 units. Thanks.

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For basal, it depends on if your basal rates are constant throughout the day or if they are higher/lower at night.

If your basal rates are constant, get Lantus. I know some people might recommend Tresiba, but Tresiba sucks as an emergency backup because it takes too long to fully ramp up and ramp down. For an emergency backup, you want a basal that kicks in right away.

If your basal rates are variable, get Levemir. Levemir has a shorter duration, so you can take it twice per day and have different rates. Like your morning dose can be less than your nighttime dose, and that allows you to have different basal rates.

Get 1/2 unit syringes. Yes, they make them! BD makes the best syringes. Here is the NDC (national drug code) for the one that is 30 units (0.3 ml) with 1/2 unit markings and an 8 mm needle length. NDC: 08290328440. The NDC will make sure you get the correct one, because sometimes they will just give you a syringe that does not have the 1/2 unit markings. So you have to be clear on it with the doctor/pharmacy. Depending on where you live, you can just get them from Amazon without a prescription!

Also, BD makes 1/2 unit syringes with a variety of needle lengths if you think 8mm is too long. Just check them out on Amazon and specify the 1/2 unit markings.

When you buy them, make sure it has this 1/2 unit marking on the box.
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Finally, and probably the easiest thing to do - call Insulet and buy a backup PDM. I think they are only about $190 now without insurance, just as a cash pay. Tell them you want a backup PDM and that you want to buy it, and it’s very easy because they will just verify your prescription with your doctor and send it and then bill you.

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Thanks so much @Eric2 for all info. It is very helpful and I appreciate your help!

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Before covid began in force, I made sure I had basal and bolus insulin for use incase of ‘critical failure.’ You doc needs to call you in a basal insulin Rx to your pharmacy for emergencies. If he hasn’t done that, that’s a failure on his part and you need that taken care of ASAP.

You were sold the wrong type of syringes. You need a prescription for syringes and to have a box of them at home all the time because pumps fail and you will have days with no access to meds. Call your doc and have an Rx sent to the pharmacy. Syringes will only allow for 1 unit dosages, nothing smaller.

When your pump fails, you will have a disaster. So, its good you are starting to ready for this. It will save you a lot of grief to be prepared. It will fail eventually.

My pump has not failed recently, but I have seen supply chain failures where I couldn’t get pump supplies and went back on syringe insulin.

@Eric2, Do we have diabetics now who have never been on basal insulin? Is that a thing?

Oh boy. That’s a serious potential critical failure. I never thought about that.

That’s kinda bad. We might encourage our younger diabetics who have only ever pumped, to use some basal when covid is over, for maybe a couple weeks or a month, just to increase their comfort level with it. That would be a scary transition now.

Geeze. You are asking a VERY important question, @Gracie9.

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Certainly not a younger diabetic, but I never used “modern” basal. Started on Lente only, no mealtime. Then NPH+Regular in 1980s, and pump with Regular in 1990s. But I do have Lantus and Levemir as backup. If I took an extended pump break, I think I would get Tresiba.

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Point taken. hmmm…Maybe I haven’t either. I fell back on NPH during covid. That’s funny, eh? I thought it was funny when I did it. I laughed.

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You can buy syringes at Walmart without a prescription at least where I live They sell syringes that have 1/2 unit markings

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Thanks. I have an appt this month. Will discuss. Thank you!

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Learn from my many, many failures to do this Gracie9. I created really bad situations for myself many times by not having supplies. Terrible things happened. Terrible.

Hi. I use humalog in the pump. Are you recommending Tresiba as the basil vs Lantus? Thank you.

Yes, I realized that last night when I couldn’t get my pump going. Kind of scary.

It would depend on circumstances, and which one is covered by insurance.
I might try tresiba if insurance cover, or endo has sample. But currently have levemir and lantus on hand, likely expired, but would use if pump failed.

Tresiba is supposed to last longer than 24 hours, allowing some leeway as to time taken, which I think I would like.

Thanks again @MM1 I appreciate the info.

When my daughter’s Tandem broke last year (the face got smashed) they said I wouldn’t get a replacement for 3 days!! Tandem support is in the US, and of course this happening the Friday of the US Thanksgiving weekend. Anyway, our endo team said that since my daughter isn’t on basal insulin we would have to give her fast acting insulin every three hours via injection around the clock, could you imagine? But it is nice to know that there is an alternative to basal insulin, at least for a short while.

Thankfully our Canadian rep went to work for us and found us a pump and got it to us by that evening, so we were spared the every three hour thing.

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I agree with mm1 on whichever basal your insurance company covers, I personally use tresiba, but it does take 24 to 40 hours for any adjustments, which might be too long for a short pump break…I also recommend disposable humalog, novolog, etc pens many will come in half units, pens are easier on the go and when I was on the pump, sometimes those short breaks would turn into a week quickly, and syringes seem too 1918

It’s great to know your local rep !!

I have my old Animas pump as a back up but I also have a a box of Lantus Solostar prefilled pens and a box of Humalog Junior Kwik pens - which measures in half units - in the fridge if I have to do MDI as a back up. I also have a box of syringes which measure in half units that I got from Walmart. I just showed them the pump and said I would like to purchase one box to have as a back up injection method for insulin if my pump failed. It was no problem.

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Regular insulin used to be considered fast acting because it was the fastest before analog insulin’s were invented.
So now it’s a medium acting.
In a pinch I would use regular insulin. You can get it without prescription in most places.
I lived for years on regular and nph. Nph had a 4 hour peak and regular had about an hour peak.
I switched to ultra Lente and regular in 1992. It was a real game changer to have basal insulin.
I went to a pump a few years later, another game changer for me.
Then with a looped pump again a game changer.
I’m now ready for a cure.

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I’m hoping to be able to loop. Understand it can’t be done yet with omnipod Dash. Hopefully it will change. Thanks. Ps. Can’t buy insulin in NY state without a prescription. I tried ordering syringes & they can’t be ordered without a prescription here either :pensive:

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