Switching from MDI to Omnipod

This isn’t really a question. More of asking for any feedback if anyone has had experience with this. I have been a T1D for 10 years and have been on MDI the entire time. I am switching to an Omnipod this week. While I am very excited I am also nervous because I am on Tresiba, and I am aware that once switching over to the pump I will only be on short acting insulin in the form of a basal rate. However I am nervous about how the basal rate will be calculated if I still have lingering Tresiba in my body. Does any one have any feedback on switching from MDI to a pump and how it went for you the first few days/weeks? Thanks all!

I would ask your doctor, when I transitioned I did not take my Basaglar the night before my appointment. But my pancreas isn’t quite dead yet (LADA) so you’ll want to check before you do that.

Good luck! I hope you love it!

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The Tresiba would be totally gone in about 2 days. Generally they start you a bit lower anyway, just to play it safe.

If you tell them you are on Tresiba, they might even reduce your basal a bit more on the first day.

Yeah the trainer that I have been in contact with told me to only take half my dose the day before I start on the pump and she said she’ll probably put on a temp basal to start. Guess it just makes me anxious!

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I’m just gonna throw this out there - I try to do only 1 major change at a time.
So, either changing insulin or changing to a pump would be a good first step.
Too many changes at once can be tricky.

However, you have been a diabetic for a long time. Your going to be OK switching to a pump. Check back with us because it may be a long time until your next Drs appointment. Stay in communication with us about how things are going. There are lots of Omnipod users on here. There are also some tresbia users. I’m not sure how many of us are both. You might be in a small subset. You might become our ‘go-to’ expert on this.

I use Omnipod. I do not use tresbia.

Main lesson I learned from my transition after 30 years on MDI in its various forms, is not to expect that you’re going to be back to your previous level of control by the end of the first week, or even the second. Or third. The medicos have always been much more strongly hypo-averse than hyper-averse when it comes to treatment transitions and not without reason, so at least while you’re under their direction expect slow and very incremental changes as they help you get dialed in. I finally got to the point where my confidence in understanding the system met my impatience at the pace of adjustment and started tweaking my own basal and other settings without my team’s “Adult Supervision.” Might have been six weeks at that point. Probably should have been sooner.

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My body hated the pods. I had my highest a1c in 15 years with it. I was lean and even still the short cannula with 45 degree angel cause absorption to be very poor. I ended up going back to tubing pumps and now MDI on Tresbia and a happy camper. I hope it works for you but it was the longest 1 1/2 trying to deal with the site failures.
I think 3 days your Tresiba will be out of your system. I needed about 25 % more insulin on a pod cause I wasn’t really getting the insulin.

Maybe I wrote the post confusingly, but I will not be on Tresiba as well as the pump. I am getting my basal from short acting insulin. I was more concerned about switching from the Tresiba to relying on a calculated basal rate. Today’s the first day on the pump, so far so good!

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Well, thats good.

Heed DrBBs warning that stuff might not be totally smooth upfront. If it is, expect it to fall out of wack eventually. But, thats ok. There’s a learning curve anytime we change tech. It gets worked out. Stay in touch.

Thanks for the support! Basal rates definitely need some tweaking, I am not used to being as low as the first basal rate keeps me so that’s something I need to get used to, but it’ll definitely be trial and error.

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Unfortunately, it does kinda come down to trial and error. Its basically human experimentation. Do your best.

@gsmergss Due to the constant change in each of our metabolism’s, basal rates always are being tweaked.

I’d been injecting for more than 50 years when I switched to a pump, and I recall wondering how anyone could have a half-dozen (or more) different basal rates over a 24 hour period.

Probably took me 8-12 weeks to develop a basal rate plan, and even now 5 years later I’ll change it as needs be.

Here’s a sample of my current basal (using FiASP insulin)

Oct%202019%20Medtronic%20Basals

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FWIW, I tried Omnipod after years of tubed pumps and had a horrible time. I had bad skin reactions and poorer control. I found the pump itself to be extremely annoying with its beeps/alerts and strict time frame for replacing it.

I’m telling you this so you realize you have 45 days to try the Omnipod system out, and if you don’t like it, you can return it to the manufacturer. It’s been a year now that I’ve been on the Tandem pump and I love it!

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I love my Omnipod but I was on Lantus and just skipped the Lantus shot the day I started the pump. They actually took my basal dose and divided it by 24 to get my daily hour dose, and a slightly less dose at night.

But I had already programmed my pod because I would have drops at night and then in the dawn hours I had DP start and I liked my settings better.

Very quickly my need of basal and bolus dosing lowered and I started making constant adjustments. They had told me I would use about 25% less, it turns out I used about half as much after a few months. Supplying it when I actually needed it really helped me.

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Thanks for the feedback everyone. Having some what of a hard time. Been high the past few days, trying to work with my CDE omnipod trainer to tweak my rates and ratios. Tonight has been tougher, ketones are present. Blood sugar has slowly been coming down. T

@gsmergss …you do not want ketones to be showing up.

Try not eating for 6 hours at least, if your numbers keep creeping up, your basal is not set high enough. If you are unsure how to do adjustments/corrections ask your trainer for parameter guidelines if you still stay too high.

@Marie20 I got my numbers down and stable overnight however I woke up and still had ketones. I am assuming this may be because I did not eat anything for almost 16-17 hours as I was petrified of bringing by blood sugar higher. I have since had breakfast. Hoping they go away.

@gsmergss I would like to say when I fast for basal testing that I don’t have ketones, but actually I don’t know as usually that means I am running a nice low steady figure so I never test for ketones!

But I think by the time you have ketones, it takes some time to completely get rid of them. But keep a close eye on them if your settings are too low and you are running high. There are people that have had significant issues that have ketones at 180 plus. Not common but it happens. Watch out for the signs of DKA.

I think running ketones is kinda serious. Have you put in a call to the doc? I’m worried

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I just decided to call the doctor now I am waiting for a call back. Still normal number all last night and this morning.

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