Stacking insulin.... anyone had this problem with the pod?

Ours is set for 3 hours. I think in the morning it takes longer and in the evening it’s faster, but until there is a setting that lets me adjust that, I kept it in the middle.

I think the bottom line here is if you test your b/g before insulin delivery and your carb counting is spot on (or close) there is no issue. One of the great advantages about pumping is you can always give more insulin or better yet utilized the extended bolus features. You can always cancel out the remainder of an extended bolus, right?
Brad gives a very good answer above. Success in pumping is always dependent on good self management.
I wish you great success with this new device.
Knox’s dad

Natasha - Does his IC ratio result in a larger bolus in the morning than in the evening? Caleb’s is 1:18 for breakfast and 1:56 for dinner. So for the same amount of carbs he needs three times as much insulin in the morning and I find that the duration definitely exceeds the 2 hr mark in the morning because the tail of insulin is so much more significant. At least that’s what I’ve always attributed it to. It’s a good point you raise because whenever I give Caleb a larger than normal bolus, either because he ate more than normal or I administered a large correction, I have to keep an eye on that tail. Yes another exception to yet another rule for us. :slight_smile:

I have been on the pod since January. I have hypo unawareness. Since being on the pod, I have a LOT less lows. My husband used to come home from work and find me sprawled out somewher a few times a week.It still happens occasionally, I think since Jan. maybe 3 times. Don’t get me wrong, I do go low more often, just not as bad, or as frequent. Good luck and God bless!

He has a higher IC ratio in the morning, but he eats more carbs at dinner, so the bolus isn’t too different. I just think he is more insulin resistant in the morning - maybe that makes it take longer to get the carbs into the cells? I don’t know - but the large bolus idea might be true for us as well, I haven’t noticed it yet since we’ve only been podding for two months. I’ll have to pay attention and see if that’s true for him too!

Aha. I see. There are so many variables to consider. It’s always helpful to hear what other people are doing/experiencing. I concluded on the tail thing after reading the discussion of insulin duration in Pumping Insulin.

Always more to learn. Thanks for sharing. I enjoy your posts!

Most people are more insulin resistant in the morning due to hormones. Personally, I can barely eat more than 15g of carb at breakfast, even with a tighter i:c ratio, unless I want my post-breakfast numbers to soar.

Hi Olivia -

I’m thinking about you this week! Hope all goes well!

Sorry for my delay in responding. Regarding CGM:

Caleb started in early September, so we are still new to it. I have to say, I sure can’t blame your daughter for resisting. I was reluctant for the same reason. There came a point for us where it made sense and although Caleb was not thrilled about it, he was and continues to be a great sport and all is going well.

To answer your question, yes we were able to get good control prior to starting CGM, at least as far as the indicators available to us demonstrated. His average BGs per the PDM were always good and his A1C has been low 6s and high 5s since he started pumping. As I’m sure you have heard though, CGM provides the movie that the snapshots of the BG meter cannot portray. We now see everything that goes on in between those snapshots, as as expected, it wasn’t always pretty, but also at times, his BGs were much flatter than I expected. I have been able to make some changes to smooth out the “in betweens” so it has been very helpful. But I think tackling one thing at a time makes a lot of sense. There is still plenty of time to incorporate CGM when your daughter is ready.

Keep us posted on the OmniPod start!

We get the pump tomorrow, but don’t get to start pumping until after her class next Tuesday, so November 3rd will be a big day in our house.

I went ahead and ordered the Dexcom anyway. I know she doesn’t want one more thing to deal with right now and we need to get pumping down, but when the time comes I want to be ready. Her Bg has been so inconsistent that it drives me crazy so I am hoping the CGM will shed a lot of light on how she responds to insulin and meals. I really think Lantus just hasn’t worked well for her and can’t wait for the pump.

I will keep you posted on how it goes and I’m sure I’ll be asking you more questions as we get the hang of pumping. Thanks so much for all of your support:-)

Okay - so I’ll be thinking about you next week! lol

Good luck on both fronts!