Does anyone use the temp basal feature of the OmniPod on a regular basis? And if you do, how do you know the percentage and the length of time is right? Is it one of those situations where everyone’s reactions are different? I’ve had the pod since Dec of 2008 and have probably used the temp basal feature twice with limited success.
Any time we are considering making a change to a basal level we run it as a temp for a few days.
If a high fat meal is eaten, where we have seen fat spikes in the past we run a temp basal to fight the fat spike
If there is an illness… temp basal (both high and low depending on the illness)
Exercising a lot ---- Temp basal
Growth spurt— temp basal
your #'s or % for a temp basal will be different than ours because everyone is different,but some days we are all temp basal and some days we never use one. BUT a good temp basal will keep #'s in range MUCH better than repeated corrections.
For mac and cheese, or a lot of pasta’s and bean dishes we run a temp because they digest over the course of several hours instead of just a straight dose or even an extended bolus.
Extended boluses work well too, but it is your call as to what works best for you… trial and error.
Presets “memorize” bolus amounts that you use often, so if you tend to eat the same foods for lunch that requires same dose every time, you can create a preset named “lunch” that already has the right dose dialed in. Temp basal presets work the same way, so if you tend to need more basal when you are sick, you can create a “sick day’” temp basal already programmed to deliver 120% of your usual basal rate.
I do not use a pump but I think I would use a reduced temp basal from time to time to avoid lows from activity. To calculate how much to reduce and how long, use your correction factor to estimate. In my case one unit of insulin drops me about 66 points. If my total basal dose over 24 hours is 12 units, then my basal schedule on pump would be delivering half a unit per hour (12/24). In my case, half a unit is worth about 33 bg points (66/2) so if I were to turn off the basal rate for one hour I would get a 33 bg rise to avoid a low due to exercise or activity. I go low pretty quickly even for light activity so I think I would use a 1 hour, 0% temp basal for housework or yardwork. The main thing is figure out how much a temp basal will raise your bg by using your correction factor. Hope this helps.
I’ll address the ‘presets’ or at least some of them. If you click on the Carb presets…you’ll have the option of keying in info regarding foods that you eat often…for instance under “snacks”…I have nutrition info about Graham crackers…baby carrots (raw)… grapes… applesauce, etc. This way you can bypass the food library. What I do know regarding the temp basals is that you’re probably/most likely going to have the input of your physician because everyone IS different; and it depends upon what you are doing…walking is different than swimming, jogging or running.
The temp basal and extended bolus sometimes really confuse me. I often do not know which one is best to choose. Even while on MDI my BG numbers were not often stable. There was a lot of variance in one day’s time from low to high, sometimes in a very short time. That variability is one reason the endo suggested a pump. I appreciate anything that I can learn from the experience of other diabetic people.
Any time Caleb eats anything high fat we see high BGs. We always administer an extended bolus, and check, check, check throughout the night. I have figured out dosing for most foods, but whenever there’s something new (like at a restaurant) ugh, I cringe waiting for the unexpected…For Caleb, these foods typically require extra insulin at the time he eats and on top on that an extended bolus for about the same amount again over 8 hours.
I use temp basal often, although I tend to use it for short periods and I use increments, not %age. These 2 areas are the most frequent uses of temp basals for me:
if he reaches an unexpected high (that’s an oxymoron - when are they really expected?), but what I mean is Caleb goes through waves of highs and lows, and I’ve come to learn that in a wave of a high, I not only need to administer a correction, but also increase is basal slightly during that period to ensure that it works. There are times where he is high and I know it’s because of a carb guess - then I just correct. But when it’s in what I assume is a period of growth, I need both a correction and a higher basal for a couple of hours.
If I check Caleb at night and he’s at a borderline number - like 80 or 90, I will lower his basal a “tick” or two for the next hour or two to help mitigate the risk of a dangerous low. I always do this in conjunction with assessing when his last bolus was, what he ate for dinner and what his trend was the night before.
I use these features almost daily.
Because things are constantly changing for Caleb, I have not found the preset function useful.
All of Caleb’s dosing is on a trial an error basis and I believe it’s just something you have to experiment with and figure out what works for you.
I use a temp basal on the days I change pods. I’ve discovered that with some placement locations, my BG tends to run high for the first 6-10 hours (usually covering 1 meal or a snack and a meal). I’ve found that using a temp basal of about +50% for that first half-day helps keep my BG under control while the new site “adjusts.”
Thank you for sharing how you handle Caleb’s dosing situations. I believe you’re right in that I probably need to experiment and find out what works for me. Caleb is one lucky young fellow to have you for his Mom.
Eric - I have almost an identical situation as you on the days when I have a pod change. Up until now I’ve been reluctant to change anything on the day to day operation of the Pod. Thanks for letting me know what works for you.
As far as extended bolus and temp basal - I tend to use an extended bolus when it comes to food and I need more of an even distribution of insulin over a period of time. I use temp basal for other issues when I think the change in insulin should be proportionate to Caleb’s basal schedule which varies significantly, sometimes by hour, throughout the day. If you have a steady basal schedule throughout the day, there may be no noticeable difference if you were to use a temp basal or an extended bolus. I have found that an extended bolus cannot go beyond 8 hours. I think you may be able to set a temp basal for longer than that. And certainly if you want to reduce insulin delivery - for periods of exercise, or when Caleb gets sick his needs actually go down, you would have to use a temp basal reduction - bolus’ only add insulin.
I have heard of others who need the increased basal for a period of hours after a pod change before - that does not seem uncommon.
Our son, Will is now 3 years old and has been on the OmniPod for a year. I use the temp basal when I do a pod change because he sometimes goes high right after. Start off by using 15% for 2 hours and then work your way up. When he was ill with stomach flu in the hospital - the dr.s told me that anything under 20% when you are ill won’t do anything. Illness means more insulin so if Will is ill, I then up his basal to around 20% every two hours. I check him normally ever two hours regardless of what’s going on (I’m his CGM!! :+) so if he’s is anywhere in the 150 or lower, I’ll often stop the temp basal but if he’s hoovering above 175 or so, I’ll up the basal for a couple of hours. He is now going through this crazy growth spurt and so I find myself using this feature more and more.
That said, I don’t use the extended bolus at all. I’m sure I should but haven’t gotten that far. We’re supposed to be in a study regarding CGMs this spring and I’m excited because then I’ll be able to see how foods affect him and then will feel more like learning the extended bolus feature.
Susan, I didn’t know that illness means more insulin. I got a cold last Friday and have been struggling with high blood sugars ever since. I will try adding a little bit of temp basal today and see if it helps at all.
Best Wishes to you and Will when you are in the study for CGMs. Yesterday I got rejected by my insurance company for one of these monitors. Haven’t decided whether we will appeal or not. If you have time after you’ve been in the study, please post how things went for you both.
Yes, when you are sick, be sure to up your basal as well as keep checking for ketones. You can go south really quickly if your ketones are out of whack. Unfortunately for us, Will has been hospitalized twice since diagnosis (will be two years this April). Vomiting with both high or low blood sugars will bring on the ketones and we had an incident of each with Will.
I’ll keep you posted on the study. Our babysitter, who is Type 1 and 17 did a trial with the CGM. She felt like it was great information but would be a drag to have it on all the time. My plan is to try to understand how different foods effect Will so I can use the data to better utilize his pump.
I don’t know where you are but I know that Stanford is trying to work out a way that folks can use a CGM for two weeks at a time for this purpose. The hold up seems to be how to bill insurance. If you go to that clinic, you could ask about that.