Why is this taking so long?

I like your analogy :slight_smile:

What is your TDD (total daily dose) of Lantus that youā€™re taking right now? That will more or less be your starting point for basal TDD. So if you were pushing 24 u of lantus each day, thatā€™d be 24 u of basal to take, divided by 24 hours would be roughly 1 u per hour. Itā€™s not usually that simple unfortunately (which is where basal profile testing comes in to playā€¦one of thing things discussed in that pumping insulin book). For example Iā€™m pretty insulin resistant overnight and when I first wake up so my basal rates are higher during that time. During the afternoon and evening Iā€™m most insulin sensitive, so my rates are almost 1/2 of what they are during the night. And then I will back those rates off substantially for periods of exercise. I think once the trainer and you have the opportunity to pick a time to meet, it will be really helpful for you (and youā€™ll be a pro in no time :slight_smile:

I think for rate adjustment stuff one of the most important things to keep in mind is that the insulin thatā€™s pumping into you now is actually not going to be active for about an hour. So if you need a reduction for a sport, for example, you need to adjust your basal about 60-90 minutes prior to that activity. Itā€™s not an immediate change.

Anyway, good luck w/ those first few pedal strokes :wink:

Good post Bradford. The only thing I would add if you do decide to figure your own basal Jared is that you will likely get better absorption from the pump so figuring from your Lantuis dose you would probably want to reduce it a bit.



Lantus dose * .7 (this will make the basal dose 30% less than your Lantus dose which is a common starting point) = new basal dose



new basal dose/ 24 = hourly basal dose to use in Pump.



Whether doing this by yourself or other people figuring out the doses this is a guessing game so testing CBGā€™s frequently is a must. Also, Bradford alluded to it, but basal testing is probably one of the single most important parts when going on to a pump. It is in my opinion the best way to determine what your rates need to be throughout the day. You would be suprised to see how much a .1 unit per hour basal rate change can make!

Thank you everyone for your input. It has helped a lot. Your formulas, Bradford, make sense to me but are giving me numbers much higher than any of the others that Iā€™ve come across. MossDogā€™s formulas are giving me better numbers but they are still a lot higher than I would expect. A lot of what Iā€™ve seen base my units per hour on how much total Humalog I take during the day but that is never the same. If I donā€™t eat much at all then that number is very much lower than a day where I might have 3 full meals and a few snacks. Iā€™m still trying to figure this all out but thank you so much everyone for your thoughts.

Your humalog doses should pretty much all be boluses when you convert to your pump. Right now your lantus should be providing all of you basal insulin. Thatā€™s why they said to work off the lantus dose to figure out basals. My insulin intake is closer to Bradfordā€™s formula (I was on 32 units of lantus / night, I now take 30.35 units of basal throughout the day) but itā€™s better to start lower and then correct for highs than to be giving yourself to much insulin! And you will find that it does vary by time of day. Iā€™m strange in that during the night I use 1/2 as much basal as during the day. For most people it works the other way. Just remember to test A LOT when you first start and youā€™ll figure things out pretty quickly.

Hi Jared,

You can learn it 95-99% all by yourself, in three easy steps:

Step #1: Order Pumping Insulin (at the Diabetes Mall, or over at Amazon.com, by Walsh & Roberts. Get it shipped as fast as your wallet can stand.

Step #2: Read the OmniPod manual, cover to cover.

Step #3: Once received, read Pumping Insulin cover to cover.

This should give you enough information to get going, IMHO.

Cheers and good luck!
Mike

Basing the basal rates on TDD (Lantus + Humalog) assumes that the Humalog is in part covering some of your basal needs. For me this was not true and using my Lantus dose was much closer. The person who started me used what you are talking about Jared. Within 1 day I changed it to what I had previously calculated based on my Lantus dose and it worked much better for me. As always YMMV.

Despite who calculates the dose, as I said before, any one of the estimates is going to be just that- an estimate. I am sure we could fill this thread with how each person did it different and what worked best for them.

So sorry to hear thatā€¦ the person we have here is sooo goodā€¦ she will get back to me w/in 10 mins! She has made several visitsā€¦ maybe you need to complain to Omnipod about the person who is supposed to be there for you . I heard they are supposed to give you I think up to 10 hrs of training as part of going on a pumpā€¦ not just Omnipodsā€¦

Yesā€¦ for my son the reduced the long acting compared to the lantus dose. I heard the same thing about it absorbing betterā€¦

I just got a call from a trainer. Looks like everythingā€™s going to work out. :smiley:

My trainer came right to my house and trainedā€¦ after speaking to my endo to get all the correct info, but I set it up directly with Omnipod.

Thatā€™d crazy. I had my rep contact me immediately & I met with him 3 times in 3 weeks, at his home. He was awesome.

The trainer told me that it should be some time next week but that it may not be him. He has contacted my endoā€™s office but is supposed to contact them again. Iā€™m not sure what will happen now but I canā€™t wait.

We did our training with our endoā€™s Certified Diabetes Educator. All five meetings were scheduled before the first meeting so they knew you would complete the full training program and they would have you in their schedule. This may give you an idea of things to ask about as you progress.

Before the order, we had done the saline test to make sure we like the pod and we did not have severe allergies to the cannula or latex. Before the first day, we also did a test of the Apidra using a sample pen instead of Humalog to check for allergy reaction.

First day, the PDM was programmed using their and our records of Lantus and Humalog use daily (Basals, Carb Factors, etc ). Prior night, we had to transition off of Lantus (not do nightly Lantus to let it run out but test every two hours and adjust with Apidra if too high). Learned to do single Bolus for meals with Corrections to replace Humalog injections. Cautioned to not do correction within 3 hours of meal due to Insulin On Board function. Started fasting/basal testing for over night by testing every two hours overnight for three nights. Samples and RXs for Apidra, new test strips, supplies, etc.

Second day (3 days on pod), the pod was changed with assistance and data downloaded to adjust factors/basal rates. Learned more about IOB and how to do snack bolus without corrections especially if within 3 hours of prior meal correction. Continued with some fasting/basal testing of different parts of the day. We did this starting late June until late July and then had to do some of it again when school started due to different activity schedule. Talked about importance of rotating sites for insulin adsorption and how to pick a good site by looking at flexed muscles, etc.

Third day(1 week later), data downloaded and factors/basal rates adjusted. Talked more about Extended Bolus functions and their use and adjustments to suggested Bolus. Talked about ā€œTemporary Basalsā€ for exercise (-) or illness (+). Learned about BG History screens that give a BG average by day, week, etc like your BG meter, totals so you can cut down on insulin in the pod if you are not using all of it in three days and tagging of BG. We also looked at reports in download and learned more about the download.

Fourth day, (2 more weeks later), Data dowloaded and factors/basal rates adjusted slightly. More Q & A time available.

Fifth day, (1 month later) Data dowloaded and factors/basal rates adjusted slightly. More Q & A time available.

Getting setup on the pump was fairly time consuming but my son really likes it now. Iā€™m sure some of this could be combined into fewer meetings or we could have downloaded data files and emailed it to the CDE but it was nice to have the extra Q & A time. Reading the Pumping Insulin book and the Omnipod Manual will help. It is a lot to absorb at once when you are in the middle of it with no sleep due to Basal testing all night.

Insulet trainers in Dallas also had a flyer in the waiting room about a monthly ā€œAdvanced Omnipod Pumpingā€ meeting monthly. If you had really specific issues, you could schedule a private meeting before or after the open / support group type session. We never went but several patients did and learned extra information.