Still trying to adjust

How long did it take you to get your settings and such adjusted when starting the pod? I went from MDI to the pod and have been on the pod for a little over a month now. For the most part everything is going well. I am still have high sugars consistently in the morning, which is the main reason I went on the pod. My doctor said it is trial and error until we find the right combo so I’m trying to be patient. I was just curious how long it took for everyone else to get their settings right.

I also went from MDI to the pod. It took me about six to eight weeks to get the settings right and I continue to tweak them with help from my diabetes educator. I’m a “set it and forget it” kind of person and am not too inclined to tinker. Setting regular appointments with my educator and exchanging e-mails with her helped a lot.

How often are you checking your BG? For the first week, I did it every three hours around the clock. It was miserable but well worth it because it helped get my settings right faster.

Unfortunately, it really does seem to be trial and error because each of us is so darned unique. :wink:

The tweaking/adjusting seems to be an ongoing thing. (I’ve been on the pod for about 15 months.) I’m struggling right now with going low after breakfast about four days a week. I have Type 1.5 and it seems that my body has decided to kick out the little insulin it still makes in the morning. I’m taking my breakfast bolus 10-15 minutes before I eat and that seems to help a bit.

Janet

it took me a few days to get everything set. but… i was on the omnipod within 4 months of my being diagnosed. but, i continue to change basal rates every once in a while.

if you’re still experiencing high bg’s in the morning, have you tried increasing your basal while you sleep? my basal is actually higher while i sleep than during the day.

Im into my 6th or 8th week and still tweaking.

Hi Mary,

When I started pumping back in January '08, it took me a good month to get my basals set up. Lots of trial and error. And THEN I started working on my insulin:carb ratios, and me correction factor ratio (BG drop per unit insulin).

Don’t worry if it’s taking a while. Things will be much better and “normal” once your basals are in line.

Cheers, Mike

Mary,

I went from MDI to the Omnipod in February and by mid-March I thought I had it all figured out. My doctor put me on a Dexcom Trial last Wednesday and it’s made me realize I’ve still got a lot of adjusting to do. (some of my morning highs were apparently from untreated mid-nightime lows… I would never have guessed!). Hang in there and keep trying, remember even if your control only seems on par with MDI now at least you’re doing it without tons of shots a day and you can correct for the little things (reading of 136 that I would never have thought of correcting for when it meant a needle). You’ll get there and it will so be worth the start up time.

Thanks for all the suggestions and support! My basal rate is set higher at night but I don’t think we are quite there yet. I fax my bg’s in to my doctor for tweaking and have been talking with them quite a bit over the last month. I check my bg’s before and 2 hours after meals, before bedtime, and at 2 am. I’m going to try testing every 3 hours at night to see if I can pick up a pattern. During the day, once I get that morning bg down, everything is great and within range. I’m definitly a “set it and forget it” type person as well. I created different basal programs based on when I’m more active at work and that has really reduced the low bg’s during the day. I always forget to set a temp basal rate so the programs for work have helped out quite a bit! Hopefully, my doc and I will get the morning highs under control.

I went from MDI to the Pod. I had to fax my BGs to the endo every week. I started on 5/26/09 and my last adjustment was 6/28/09. I have been on these settings since with great results. I am expecting my next A1c to be around 6.7 or so based upon my BG average over the past 2 months.

Just an update, we tweaked my settings just ever so slightly and I am doing so much better! Haven’t had a low bg since Tuesday and any highs have been very low 200s, much better than bgs in the 400s… And I’m feeling much better :slight_smile: Thanks for all the support everyone!

Thanks for starting this post. It’s nice to know that I am not alone. I had a miserable weekend. I went live Friday afternoon, and have been going hypo all weekend. Fortunately I have CGM to give me some advanced warning but yesterday I still dropped into the 30s. Today I had to consume over 100 extra grams of carbs to get out of my lows. I wanted to reduce my boluses so I wouldn’t crash, but I wanted to have the hard data showing my hypoglycemia for my endo and CDE. My CDE has orders from my endo to make changes, but I think I may need more that she is authorized to make. Tomorrow morning I will be faxing results to her and following up with a call. For anyone new to pumping, I suggest you do not start on a Friday unless you have 7 day access to someone who has authority to change your settings.

It took about 6 weeks to get the setting I have now. My post-meal readings have been creeping upward. When I see the endo on Tuesday I expect an adjustment.

I am not advocating that everyone disregard their physician’s wishes (or anyone else on his or her medical team for that matter), but another approach you could try (so you’re not constantly fighting a hypo) is to adjust your bolus amounts, or adjust your basal, document it, and show those results to your doc. Especially in your case of starting on a Friday (which definitely left you with a void on your diabetes management team’s availability)…
I don’t think any normal doc would say, “why did you not listen to what I told you to do?” if you can document that you used less insulin and still had stable control…they want you to be successful in the conversion from MDI to pumping, but going hypo and having an extreme episode is probably not on their ‘to-do’ list…

It’s comforting to know that other people have needed some time to adjust to the pod. I’m doing so much better- I just saw the endo last Monday and we tweaked some more still trying to get that nighttime basal rates just right to help bring down my A1C a little more. It’s so much better now and I have only had 1 low in the last month and a half which is awesome to me! I also spoke with an omnipod rep who had been also been using the pod and he told me not to get discouraged if my first A1C after starting the pod was higher than I would like and that it takes some time to get into a good groove with your settings. He said for him, the second A1C after he started pumping was more realistic. Thought I would pass that bit of insight on to everyone. :slight_smile:

After some tweeking by my CDE, I am doing much better. First she changed my insulin to carb ratio which made a huge difference. She has changed my correction factor twice so I am not going so low when I need to correct. She also changed my basal rate slightly so I won’t wake up quite so low.

Basal must be fixed first. “Pumping Insulin” is a great book you should consider buying. Obviously consistent daily activities and eating patterns (just like MDI). Increase BG/insulin level stability. I agree you may need to consider small changes yourself. Dont forget the 40%-60% basal to 60%-40% Bolus ratio, the pump gives this ratio data for each day.

Good luck!

I wouldn’t worry too much about those percentages as they will be changing slightly in the upcoming version of Pumping Insulin. Find what works best for your system and use them as a guide to start with but don’t kill yourself to get there.

I was having similar problems and I noticed a HUGE difference in slighly changing my IC ratio and my correction factor. I’m glad you are doing much better. :slight_smile: