Omnipod New Pump User - Lower Doses?

[day007]

Hi,

I am starting my first pump next Monday and have gone for the Omnipod.

The hospital has set me up with everything from this Monday and I am wearing a real pump filled with saline solution so I can get used to wearing it and changing it etc before going live next week. We have already programmed it with the help of the hosiptal team with basal and bolus ratios etc based on an average betweed the TDD & weight-based calculations.

I have been doing injections as per usual but also using the handset and pump as if it was live, so taking BG and putting in how many carbs I am eating at each meal to get used to it. I'm comparing what I'm injecting vs what the pump would bolus, and some of the readings are very different, maybe only 60-70% the amount of bolus. For example yesterday I injected 20u in bolus but the pump would have given me 12.15u - fairly different!

My pump basal is set at 75% of my current injection basal dose, and I understand that is due to it being a more efficient delivery method via pump. However I am wondering whether any of you had much lower doses for bolusing when you started on a pump?

Thanks!

 

[Deleted Account]

The pump takes a bit of getting used to and that includes getting the doses correct.
As you say, it is usual to need less insulin with a pump and that is certainly something I found. My total basal went down from 20 until per day to 15 (which just happens to be the 75% you mention)
And my insulin to carb ration reduced significantly too.

Once you start on the insulin, you will probably do more testing than usual at the start and, if your doses are out, you can adjust them.
It is better to be conservative at first: too many hypos and you may feel like yanking your Omnipod off and throwing across the room (or is that just me?).

 

[kitedoc]

I agree with @helensaramay , that was my experience of being commenced on an insulin pump.
The most amazing thing to me was how my specialist was able from his experience to 'sculpt' out my basal rate.
He appeared to almost intuitively work through the issues of Dawn effect, likely variables in insulin sensitivity throughout the 24 hours etc and after 4 days, my basal rates had had very little alteration from his initial basal settings.

 

[kitedoc]

The pump takes a bit of getting used to and that includes getting the doses correct.
As you say, it is usual to need less insulin with a pump and that is certainly something I found. My total basal went down from 20 until per day to 15 (which just happens to be the 75% you mention)
And my insulin to carb ration reduced significantly too.

Once you start on the insulin, you will probably do more testing than usual at the start and, if your doses are out, you can adjust them.
It is better to be conservative at first: too many hypos and you may feel like yanking your Omnipod off and throwing across the room (or is that just me?).

Yes, I have had moments of trying to envisage the largest catapult imaginable flinging the blessed thing as far away as possible. But like a favourite car or sewing machine you come to live with its faults (and one's own !!)

 

[day007]

Thanks both! Though you've both talked a bit more about basal than bolus - was the insulin to carb ratio that much lower though, i.e. almost 60%? I guess if it's wrong I will just adjust it.

Yes I definitely want to start conservatively as I am pretty active - cycle 10k each way to work, ran it today and go climbing a fair bit too and I don't want to start getting hypos the whole time. Having said that, I quite like hypos because it gives me an excellent excuse to eat delicious sweets. NOM.

 

[kitedoc]

I think caution is the byword, 60% of bolus sounds about what my starting point was.
Good luck. Perhaps save the sweets for a particularly arduous cycle or climb !!