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A diabetic decision

Omnipod

Well-Known Member
Messages
533
Location
West Sussex
Type of diabetes
Type 1
Treatment type
Insulin
I have been on the Omnipod for just over a year.
I enjoy the freedom of the Omnipod and that fact that I dont have to inject 4/5 times a day. In saying that I dont mind the injections.

I started on the Libre and have been carefully watching my blood glucose levels over a 2 week period.
My glucose pattern seems like a 'yo yo'. It rises sharply and drops sharply - Its not a nice stable line. Its almost like an ECG pattern. My pump does seem to be fine tuned in that if I dont eat and just take my basal / background that my levels are pretty stable.

This weekend, I decided to take a break from my pump so I went back to using Tressiba as my background insulin and injecting Humalog as and when I eat.
My blood glucose pattern over 24 hours is completely different. Its completely stable with tiny rounded peaks and has remained within target.

Im thinking this just boils down to using fast acting insulin only with the pump. Perhaps peakless insulin like Tressiba is better for me.

This Libre has definately given me more insight into treating myself and seeing just how any food affects my blood sugar levels.
 
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Hi Omnipod. That really is a dilemma. I'm seeing the same thing on the Libre on MDI as you're seeing on the pump though. I'm now more certain than ever that Levemir doesn't work for me. It has peaks and troughs and I am basically trying to compensate with the Apidra. So after nearly two weeks I've decided that I have to get my basal sorted out.

As for the pump, could you change your insulin to start with and see if a different fast acting works better for you? Maybe it's the one you're using that doesn't suit you rather than using fast acting as a basal per se?

Smidge
 
Perhaps Tresiba might be a better option for you @smidge, by all accounts it is a very good basal insulin and Robert72 has excellent bg control on this insulin.

@Omnipod, I don't know a great deal about basal rates using an insulin pump, but wonder if the other pumpers on forum can help you to get the settings right, I don't think I'd be too keen going back to MDI if I was to change over to a pump.
 
It just sounds to me as if you haven't set your pump up properly :( But saying that if you are happier using MDI then go for it, it's your choice. :)
 
Perhaps Tresiba might be a better option for you @smidge, by all accounts it is a very good basal insulin and Robert72 has excellent bg control on this insulin

Thanks @noblehead. I was thinking the same thing myself. My control has been much poorer overall since moving from Insuman basal to Levemir two years ago, but the consultant won't listen as he is just dazzled by my HbA1c. With the new evidence from my Libre, I think I'll ask for a switch to Tressiba when I see him next month.

Smidge
 
i think i have my basal rates fine on the pump. Using fast acting insulin alone seems to be the issue for me.
Tressiba is the newest longest acting insulin which is peakless. It just seems to give me more stability. My graph just seems to be a long stable line with very small peaks and troughs. On the humalog alone...my graph is not stable at all.
Surley if both give me the same HBA1c number, then having the stable graph would be better?

is the graph pattern important if your HBA1c is the same?
 
i think i have my basal rates fine on the pump. Using fast acting insulin alone seems to be the issue for me.
Tressiba is the newest longest acting insulin which is peakless. It just seems to give me more stability. My graph just seems to be a long stable line with very small peaks and troughs. On the humalog alone...my graph is not stable at all.
Surley if both give me the same HBA1c number, then having the stable graph would be better?

is the graph pattern important if your HBA1c is the same?
I looked at the graph you posted in the pump forum and on that bases would say your basal is out, also you stated you had no idea about having to change your basal rates an hour or two before the effect was needed.
This to me seems as if your pump team has let you down big time by not educating you in the use of the pump. :( Which I find very sad.
 
I looked at the graph you posted in the pump forum and on that bases would say your basal is out, also you stated you had no idea about having to change your basal rates an hour or two before the effect was needed.
This to me seems as if your pump team has let you down big time by not educating you in the use of the pump. :( Which I find very sad.

Thanks. You are probably right.
Im going to download my libre reports and make an appointment with my specialist.
 
Does your pump allow individual hourly changes? Or just blocks of hours? We effectively have 24 1 hour time slots for basals, what does your pump do?

Got to agree with @CarbsRok that your basals seem out to me as well. I don't alter mine the hour before, as on the combo pump you can altsr each hour and it takes a who hour for the deluvery to be fulfilled, and of course, levels don't rise on the hour.. But you can see that on your libre.
 
the omnipod is pretty much the same as all pumps. You can set a basal for each individual hour which I have done. I wouldnt know where to begin if I had to reset them all.
 
Hi Omnipod. That really is a dilemma. I'm seeing the same thing on the Libre on MDI as you're seeing on the pump though. I'm now more certain than ever that Levemir doesn't work for me. It has peaks and troughs and I am basically trying to compensate with the Apidra. So after nearly two weeks I've decided that I have to get my basal sorted out.

As for the pump, could you change your insulin to start with and see if a different fast acting works better for you? Maybe it's the one you're using that doesn't suit you rather than using fast acting as a basal per se?

Smidge

I am in exactly the same position smidge- my consultant advised that I switch to twice daily inj of levemere, I'm waiting for my pump start so not going to switch to a different type of basal but it would be interesting to hear your experiences on a different insulin.
Omnipod if I were you I would buy the book "pumping insulin" I have been reading it prior to my pump start and it is superb. It will give you an in depth guide to changing basal/bolus etc. they always recommend basal testing first prior to any bolus changing so as said above that is where to start.
Also with your peaks after meals is it after eating certain foods or consistent? I am on MDI and have found that since having the info from the libre I can inject 20-30 mins before a meal and see a much shallower and gradual peak that if I inject just as I am starting to eat the meal.

Hope you get everything sorted.
 
So Omnipod you could adjust your 1pm and 2pm levels up?

I have 24 differenr basal eates through my pump works **** good for me.

I don't think you have really had enough education about changing rates etc.....
 
Hi Omnipod, it does sound as though your basal rates need fine tuning. Frustrating, I know - I thought I would never get there. Try and focus on sorting out one set of timeslots before moving on to the others. I started with the overnight period first, then the morning, then afternoon etc. It's too overwhelming trying to tackle the whole 24 hour period in one go.

Hope they can offer you more support at your consultant appointment. Good luck.
 
Ref timeslots for basals...don't forget raising a timeslot for 1hour will actually effect time slots for up to 5 hours later.. So if you were to up the 1pm rate by say 0.05 you may well have to lower the 3-5 hour after ones down by 0.01 each hour.....

It really takes quite a lot of work to balance... But 1hrly change can effect up to 5 hrs later....
 
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