New to Omnipod Dash & seeking advice

[Bluemarine Josephine]

Hello lovely friends,
I hope you are very well.

Please, I need your advice.
Yesterday, I had my meeting with my diabetes nurse at the hospital as I was offered an Omnipod Dash. I have been a Type 1 for 13 years and my HbA1c is at 7.2. We decided that it was time for me to have the assistance of a pump to deliver better HbA1c results.

My training at the hospital lasted for about 2 hours. I will confide in you I am not at all comfortable with the training that my diabetes nurse offered as she did not seem to fully comprehend how the basal/bolus scheme affects blood sugars during the day and depending on the circadian rhythm requirements combined with glycemic loads etc etc. I am confident you all already know the hazards of being a diabetic.

So here I am, with my inactivated pod on filled with salt water for now, watching Youtube tutorials on how to operate the PDM, whilst staring at my Omnipod Kit feeling baffled.

I have a series of questions for you… my first one is, how did you switch from the pens to the Omnipod?

In my case, I inject 13 units of Levemir in the morning and 6 units in the evening. If I wish to start with the Omnipod in the morning, do I skip my 13 unit Levemir injection and start with the basal program that has been calculated in my PDM?
In such a case, wouldn’t I risk a hypoglycemic episode during the time that my 6 units of evening Levemir overlap with the Omnipod basal program for some hours?

Please forgive me if I am becoming pedantic. I feel so perplexed.

Looking forward to your advice.

Jossie

 

[h884]

Hello lovely friends,
I hope you are very well.

Please, I need your advice.
Yesterday, I had my meeting with my diabetes nurse at the hospital as I was offered an Omnipod Dash. I have been a Type 1 for 13 years and my HbA1c is at 7.2. We decided that it was time for me to have the assistance of a pump to deliver better HbA1c results.

My training at the hospital lasted for about 2 hours. I will confide in you I am not at all comfortable with the training that my diabetes nurse offered as she did not seem to fully comprehend how the basal/bolus scheme affects blood sugars during the day and depending on the circadian rhythm requirements combined with glycemic loads etc etc. I am confident you all already know the hazards of being a diabetic.

So here I am, with my inactivated pod on filled with salt water for now, watching Youtube tutorials on how to operate the PDM, whilst staring at my Omnipod Kit feeling baffled.

I have a series of questions for you… my first one is, how did you switch from the pens to the Omnipod?

In my case, I inject 13 units of Levemir in the morning and 6 units in the evening. If I wish to start with the Omnipod in the morning, do I skip my 13 unit Levemir injection and start with the basal program that has been calculated in my PDM?
In such a case, wouldn’t I risk a hypoglycemic episode during the time that my 6 units of evening Levemir overlap with the Omnipod basal program for some hours?

Please forgive me if I am becoming pedantic. I feel so perplexed.

Looking forward to your advice.

Jossie

Hi Bluemarine Josephine

I have been the Omnipod Dash for nearly 3 years. I switched to the Omnipod Dash after being on a Medtronic pump for a short spell. The reason I changed was problems with set changes due to arthritis in my hands. The settings were simply transferred from one pump to another.

When I went onto the pump initially I was on a once a day a basal which I took in the morning. The morning I started on insulin in my pump I was guided not to take my basal in the morning, just a bolus for my breakfast. I take it that the settings are already in your pump for your basal rate and boluses etc ?

I would suggest calling the Diabetic Nurse in the morning to ask her what to do. Delaying your pump start for 24 till you have your questions answered would seem sensible. It may be that you some other questions that You can ask at the same time. Do you have a follow up today’s appointment. I had daily contact for the first week, then a review at one week, then one month, then 3 months. I now have 2 appointments a year one a pump clinic, the other a diabetic clinic.

Hope this is of some help. Let me know how things go

 

[himtoo]

Hello lovely friends,
I hope you are very well.

Please, I need your advice.
Yesterday, I had my meeting with my diabetes nurse at the hospital as I was offered an Omnipod Dash. I have been a Type 1 for 13 years and my HbA1c is at 7.2. We decided that it was time for me to have the assistance of a pump to deliver better HbA1c results.

My training at the hospital lasted for about 2 hours. I will confide in you I am not at all comfortable with the training that my diabetes nurse offered as she did not seem to fully comprehend how the basal/bolus scheme affects blood sugars during the day and depending on the circadian rhythm requirements combined with glycemic loads etc etc. I am confident you all already know the hazards of being a diabetic.

So here I am, with my inactivated pod on filled with salt water for now, watching Youtube tutorials on how to operate the PDM, whilst staring at my Omnipod Kit feeling baffled.

I have a series of questions for you… my first one is, how did you switch from the pens to the Omnipod?

In my case, I inject 13 units of Levemir in the morning and 6 units in the evening. If I wish to start with the Omnipod in the morning, do I skip my 13 unit Levemir injection and start with the basal program that has been calculated in my PDM?
In such a case, wouldn’t I risk a hypoglycemic episode during the time that my 6 units of evening Levemir overlap with the Omnipod basal program for some hours?

Please forgive me if I am becoming pedantic. I feel so perplexed.

Looking forward to your advice.

Jossie

Hey @Bluemarine Josephine ..when i switched to omnipod it was a learning process that took a few weeks to sort out but my diabetic nurse was quite conservative in setting up the initial basal and bolus settings so the opposite was true for me and my sugars ran higher the first couple of weeks ....you should discuss this with your nurse as i am sure she will have initially put settings in your pump to help avoid lows ... i can also recommend reading the book " Pumping Insulin" as all aspects of running a pump are explained in great detail.

 

[Bluemarine Josephine]

Hi Bluemarine Josephine

I have been the Omnipod Dash for nearly 3 years. I switched to the Omnipod Dash after being on a Medtronic pump for a short spell. The reason I changed was problems with set changes due to arthritis in my hands. The settings were simply transferred from one pump to another.

When I went onto the pump initially I was on a once a day a basal which I took in the morning. The morning I started on insulin in my pump I was guided not to take my basal in the morning, just a bolus for my breakfast. I take it that the settings are already in your pump for your basal rate and boluses etc ?

I would suggest calling the Diabetic Nurse in the morning to ask her what to do. Delaying your pump start for 24 till you have your questions answered would seem sensible. It may be that you some other questions that You can ask at the same time. Do you have a follow up today’s appointment. I had daily contact for the first week, then a review at one week, then one month, then 3 months. I now have 2 appointments a year one a pump clinic, the other a diabetic clinic.

Hope this is of some help. Let me know how things go

Dear h884,

Thank you for your e-mail reply. This is very helpful.

My diabetes nurse calculated my basal insulin for my starting program as the total of my basal insulin intake per day – 30% and divided by 24hours. I would suspect that she did this for me to avoid any hypoglysemic episodes. The she re-arranged the hourly dosage depending on the time of the day, ranging from 0.45 to 0.55.

So, I do have my basal calculations, at least as a start. But, I am still so afraid. (I am embarrassed to admit it… I know…).

Please, may I ask one more thing?

When you add your carbs, meal bolus, and correction bolus in the PDM for your meal, and after a couple of hours you realise that you are going low, what do you do?

Can you reduce the bolus rate? And how do you do that?

I saw on the settings menu that there is an option ‘suspend insulin’, would this be it?


Also, if you want to exercise, and you want to reduce your basal about an hour before exercise, how do you do that?

I am sorry for my questions. I hope I am not tiring.

Thank you for your help. I very much appreciate it.

Jossie

 

[Bluemarine Josephine]

Hey @Bluemarine Josephine ..when i switched to omnipod it was a learning process that took a few weeks to sort out but my diabetic nurse was quite conservative in setting up the initial basal and bolus settings so the opposite was true for me and my sugars ran higher the first couple of weeks ....you should discuss this with your nurse as i am sure she will have initially put settings in your pump to help avoid lows ... i can also recommend reading the book " Pumping Insulin" as all aspects of running a pump are explained in great detail.

Dear himtoo,

How are you? I hope you are very well.


Thank you for your e-mail reply and for the guidance.

I will purchase Pumping Insulin, thank you for the advice.


Thank you for your help.

Jossie

 

[h884]

Dear h884,

Thank you for your e-mail reply. This is very helpful.

My diabetes nurse calculated my basal insulin for my starting program as the total of my basal insulin intake per day – 30% and divided by 24hours. I would suspect that she did this for me to avoid any hypoglysemic episodes. The she re-arranged the hourly dosage depending on the time of the day, ranging from 0.45 to 0.55.

So, I do have my basal calculations, at least as a start. But, I am still so afraid. (I am embarrassed to admit it… I know…).

Please, may I ask one more thing?

When you add your carbs, meal bolus, and correction bolus in the PDM for your meal, and after a couple of hours you realise that you are going low, what do you do?

Can you reduce the bolus rate? And how do you do that?

I saw on the settings menu that there is an option ‘suspend insulin’, would this be it?


Also, if you want to exercise, and you want to reduce your basal about an hour before exercise, how do you do that?

I am sorry for my questions. I hope I am not tiring.

Thank you for your help. I very much appreciate it.

Jossie

Hi Jossie

Not a problem. I had many questions when starting on the pump.

Once you have delivered your bolus as far I know that is it. You can see the bolus being delivered when you put in your carbs and your blood glucose and it will beep once the bolus has been delivered. You would have to take some carbs if you are going low. Using the suspend insulin would your basal insulin and prevent you delivering a bolus. I hope this makes sense

To reduce your basal rate for exercise go to the menu icon then set temp basal rate Which is the first option. There you input how long you want to reduce your basal for and by how much

Hope this helps. Good luck. Any other questions please ask

 

[cait 57]

Hi there. Type one for 12 years and on the Omnipod dash for last two. When I started on the pump my basal injection dose was halved on the first day then I moved on to the pump settings. These were quite conservative for the first week however, I Had telephone ( no face to face due to Covid ) input with diabetic nurse to review my results and amend my settings throughout the week. As I progressed I amended as necessary
Myself. I really like the flexibility it offers snd my results are great. Go for it and dont worry. The temp setting is helpful and it’s easy to amend the bolus ratio settings too.

 

[Finnlee]

I'm on Tandem T:Slim, not Omnipod Dash, but when I switched from pens to pump, I was told to not take basal the day before or the day of my training. My numbers ran a bit higher the night before my training, but I just corrected with bolus at breakfast and knew it was only one day of higher readings.

I also had a lot of questions when I switched, but I'm really happy to use my pump now.

 

[h884]

Dear himtoo,

How are you? I hope you are very well.


Thank you for your e-mail reply and for the guidance.

I will purchase Pumping Insulin, thank you for the advice.


Thank you for your help.

Jossie

Hi Bluemarine Josephine

Just wanted to see how things are going for you now. Hope things are going ok

 

[Bluemarine Josephine]

Hello dear friends,
I hope this email finds you really well.

Please, may I ask you regarding my further investigation relating to the Omnipod pump.

You may recall that I was recently approved for pump therapy and was offered my first consultation on how to use the Omnipod Dash, which, admittedly, I have not started yet as I continue the study of the manual and research on the pump.

I have a few more questions and I was hoping to receive advice from your experience.

1. My insulin requirements change dramatically during the month. Is there any training provided for me to be able to convert my current insulin basal regime or to create new regimes with a good level of accuracy? I am refering to the basal scheme (not the bolus carbs to units ratios). For example, at the moment, a 0.55 or a 0.45 Novorapid per hour is not clear to me in comparison to 13 units of Levemir… Therefore, if I wanted to adjust the 0.55 to lower or higher, I wouldn’t know how I should adjust the dosage calculation.

Or, for example, how do I convert 13 units of Levemir during daytime into Novorapid requirement per hour from? In case I need to raise or lower my Novorapid intake (as a basal insulin), what calculation method do I use to make the adjustments?

2. I also want to ask how the pump works with exercise and how sensitive Novorapid can be when used as an only insulin. This is because I am very active every day, considerably more active than most people. I walk everywhere (even long distances), I am up and down flights of stairs at work every day (I don’t take lifts), and I have my daily household, grocery shopping, and Pilates/Yoga class or treadmill training. I don’t have a sedentary day during the week, not even on weekends. I fear that I will have to either suspend or reduce my insulin intake every so often?

3. When I met the nurse at the hospital for my first training course, she told me that there is a security limit when it comes to the insulin that can be administered and which she set to 80 units (which puzzled me because at the time, I didn’t understand why she asked me this question). In my research, I came across several articles. I am indicatively sending these:

Independent Article

FDA Article

Medical Express

I want to ask you about the safety assurance provided by the NHS or the Omnipod manufacturer regarding the use of insulin pumps for diabetes management. As someone who will rely on an insulin pump, I want to ensure that I am receiving the best and safest care available.

Throughout my 13 years as a Type 1, the idea of having a pump was promoted to me by my doctor and nurses as a heavenly panacea to my diabetic management. I was never, even remotely, received as mush as a hint by my doctor or the nurses about the safety standards or failings (fatal or not) of pump therapy.

Safety Standards: Could you please advise me if you have received information about the safety standards and regulations that the NHS has in place concerning the use of insulin pumps? I am interested in understanding the measures taken to ensure the safety and reliability of these devices.

Regulatory Oversight: Is there a specific governing body or regulatory authority responsible for overseeing the safety and efficacy of insulin pumps within the NHS? If so, could you provide me with the name or any relevant information regarding their role and responsibilities?

Evaluation and Approval Process: How does the NHS evaluate and approve insulin pumps for use? Are there specific criteria, such as clinical trials, risk assessments, or certifications, that must be met before a device is considered safe for use within the NHS?

Monitoring and Reporting: Does the NHS have mechanisms in place to monitor the safety and performance of insulin pumps once they are in use? How does the NHS handle adverse events or reports of malfunctions associated with these devices?

Patient Education and Support: Are there educational resources or support programs available to patients using insulin pumps within the NHS? I would like to learn more about any initiatives aimed at ensuring patients are properly trained, informed, and supported in the safe use of these devices.

Thank you for your time and attention to my inquiry. I greatly appreciate your expertise and guidance in this matter.

Pleased to hear.

Josephine