Thinking about Omnipods

I am thinking about using a Omnipod insulin delivery system .
I have exhausted all information that appears to be available online.
I have yet to contacted by Omnipod themselves as they don’t appear to have online support but only by phone.
I do however have several questions. I use a novalog pen for my insulin . Each pen holds 300 units . I have never used more the 5units at any dosing time . Typically 3-4 units at meals to maintain my glucose level.
In the material at hand it says the pods take up to 200 units with 82 units needed to start operation . 82 units itself would last me over 6 days.
My main question at this time can excess insulin be off load to a new pods

Yes.

Insulet won’t tell you that you can do this. They will tell you to throw it away when the pod expires.

But yes, you can take a syringe and remove most of what is left in the pod. You won’t be able to get all of it because there is a little dead space, but you can definitely get most of it.

Keep in mind, the pod is exposed to your body heat, to hot showers or baths, to sun, etc. And it is on your body for up to 3 days and jostled around, which causes fibrillation and degradation.

So you might want to do this only on alternate pods, so you are not using 9 or 12 or 15 day old insulin…

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I am just wondering if you use a basal dose too? If you use 5 units per meal 3 meals a day that would be 45 units as bolus dosing.

But if you use it for basal dosing, that might use up the difference or close to the difference?

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Not related to your offloading question, but if you are on the fence about what it’s like to wear one, contact them and ask for a demonstrator. They sent me a non-functioning pod to wear.

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Marie. I ll have to read up more on the difference between basal and bolus dosing .
In my mind set a bolus is a lot all at once . That “45 units “ all at once would drive me extremely low

Underarock. Not so much a worry about wearing a pod, I’ve been wear a Dexcom for several years. But more worried about wasting the excess insulin The pod require tat I wouldn’t use in three

Eric thanks for the response I will need to go back and read Insulet’s info on the difference between basal and bolus dosing as Marie noted what I presently take is less then 45 units in three days. And with the Pods needing 82 units to start out , that would be quite of waste.

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Do you use anything for basal? Is a NovoLog pen the only thing you use? Do you only dose for meals and nothing else?

If you are only dosing for meals - yes you could still use an omnipod, but a pen is probably easier.

Eric. Again thanks Ok I found the Omnipod user guide on line. It appears that I presently only do bolus dosing . Typically before each meal or if a snack raises my glucose level. I know approximately how long it take my Glucose level to start to rise after eating and how long it takes to drop. I’m thinking at this time that a basal Dose would slow down the raise I see in my glucose level after taking my bolus dose and eating.

Yes, taking basal would help. Basal is the foundation upon which the house is built.

But before starting with a pump, I would examine some of the other options for basal insulin. A pump is good for people who have no basal, because it allows them to totally regulate their changing basal needs every hour. Like if they need different amounts day vs. night.

But since you probably still have some basal still working in your body, you may not need to adjust this hourly. Perhaps a steady long-acting dose of basal insulin for support might be better. Something like a small amount of Tresiba once-per-day, for example.

Another thing that can help the post-meal spikes is bolusing a little sooner before you eat. To give the insulin time to start working. Maybe taking it a little sooner would help you too.

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Just to be clear, programming and managing basal insulin requirements are kind of the raisons d’etre for pumps to begin with. So that’s probably where any confusion comes from. You’re looking to use it to replicate your regimen, which if I understand it is meal-bolus only, no basal. But pumps are mainly designed to address the problem for T1, that your body needs a continuous trickle of insulin going all the time, and if your pancreas is kerfuft, you don’t have that. You can approximate it with a basal insulin like Lantus, but with a pump you can mimic something much closer to what a real pancreas does by programming different rates throughout the diurnal period depending on your individual metabolism.

So basically you’re looking to use the Omnipod strictly for bolusing without setting a basal rate at all, if I understand you correctly. Dunno if you can zero out the basal settings with that pump, but I’m pretty sure you can with a Medtronic, so probably. The 82-unit minimum is an Omnipod quirk I don’t quite understand, but it probably didn’t strike the designers as a problem since most of their target users are going to have some kind of basal running as well as using it for boluses.

Your responses have Been a god send.
My endocrinologist has my glucose range from 100-180. However at night I’ve found I have to raise my level to around 200. To keep it from going low over night. So at this point until I have a set down with my Doc. I’ll just table this .
Again thanks for your input.

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I see the discussion has progressed while I was writing my previous, response, but some of the details may be helpful anyway.

Couple more things:

Are you using a CGM? That eliminates a huge amount of the guesswork about what’s going on between meals and fingersticks, and I would regard it as a prerequisite for starting with a pump and using one productively.

Also, responding to @Eric2’s suggestion about exploring using a basal insulin. My understanding of insulin and T2 is mostly anecdotal but my impression is that most T2s start off on a basal insulin like Lantus. And the reasons for that may be very different from how things work for T1s. You’re presumably still generating basal insulin on your own, but there may be ways that using a basal injectable eases the strain and allows you to produce more when you need a bolus, for instance. But I don’t know, and I definitely think this is something you should talk with your endocrinologist about or research more specifically on your own.

Finally, a question: since you aren’t using a basal at this time, why a pump? What problem are you trying to fix? I feel like we’ve sort of backed into asking that question, which should have come first.

Eric. Yes the basal from what I’m reading would be of great concern to me. I don’t go low often, which is of great concern to me as I do also have severe kidney impairment (not on dialysis yet). I’ll go back and look at the user manual .
You almost need a college education to figure it out.
As stated I’ve used a Dexcom for years and not only use their receiver but have the app on my iPhone which allows great trend info but will send all info to my wife’s phone as long as we both have cell service.
I’m trying to get with my Doc’s nurse educator to go over all of this.

Again thanks for you input and stay well yourself

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Sorry, I missed that in the long thread. Good to know, best thing to have, even more so than a pump!

@John70 you could also explore with your dr Ozempic or similar to help with overall mealtime control in conjunction with bolus insulin.

If you’re not on a long-acting insulin at all, there’s little reason for a pump, unless you’re just looking to minimize injections.

The V-Go patch pump might be an option for you, they come in a few different pre-set delivery options, and you can press a button (multiple times if necessary) to deliver a 2-unit bolus. It’s essentially a very dumb Omnipod. It does deliver basal insulin (continuous background insulin needed to balance the sugar your liver releases throughout the day and completely regardless of what you eat), though. You’d have to talk to your endo to see if you could tolerate and/or benefit from the lowest basal dosage available.

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DrBB. Thanks for the come back. It appears form the Omnipod user guide that I came control the basal doesages by the amount a a dose.
Again. My major concern at this time is the amount of waste due to what the pod needs to start out with

@John70 I never meant for you to take 45 units at once, just that you would be using 45 units of the 80 unit minimum needed to fill the pod and basal might use the rest. That doesn’t sound like the case since you aren’t doing any basal dosing.

But I have caught something you have said about dropping too low at night and having to raise your Bg level to 200 before bed???

If that is the case you are probably taking too much of a night/dinner bolus since you are not taking a basal dose.

Our liver makes glucose all day and a basal dose helps compensate for that with a little bit of insulin delivered either by a pump all day or a shot of a long lasting/acting insulin like lantus. People that need insulin usually benefit from some kind of long lasting insulin, although not all.

“Normal” people make insulin as they need it and don’t make too much. So if you are dropping too low, you are getting too much insulin at some point. I know you are taking your dose probably based that you are going too high after your meal. But I would look into a little less insulin being used but changing the timing of taking your insulin. Spiking can be dealt with by taking some insulin a little earlier maybe than you do now. Do not forget to eat if you take some insulin early!

The other possibility is like @Eric2 has said go on a very low dose of basal so you can decrease your bolus amounts.

You shouldn’t have to raise your BG level to 200 because you are dropping too much. at night. That is not the optional way of handling dropping too low.

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To all on this thread. I do realize a basal dose is the way to have better control.
And if I used more insulin during the day from what normally, use this would be a great deal. I’ve noted that from the use guide that the basal dose has a lot of leeway.
But from what I have read I don’t use the amount of insulin in my present dosing to offset what would be wasted from what the pod requires.
My next step is to contact Omnipod’s Tech Support to see if the Min. of 82 units is hard set or Just a suggestion.

Again thanks all for your comments