Changed to Omnipod from 640g - hypo central!

[sophc]

Hi all ,

I know there’s a wealth of experience in this forum so am hoping someone can explain what’s going on.

Yesterday I switched from the 640g to omnipod and ever since I’ve been having a lot of hypos, has anyone else experienced this when moving pumps ?

I’m putting the pods in the same place as my old infusion sets so that hasn’t changed . On Medtronic I used to use the mio 30s which were 13mm and went in at a 30 degree angle. This are 6mm and go in at 45 degrees so could this be the issue ? I’m very slim and so thinking it could be absorption related as it’s sitting in a different layer of skin / fat ?

Anyone with any advice would be great thank you all

 

[porl69]

Hi @sophc I have no experience with the Omnipod BUT I will tag @Mel dCP who is pretty upto date with it
Hope you get it sorted pretty quick. Have you spoke to your DSN about what is happening?

 

[sophc]

Hi @sophc I have no experience with the Omnipod BUT I will tag @Mel dCP who is pretty upto date with it
Hope you get it sorted pretty quick. Have you spoke to your DSN about what is happening?

Hi @porl69 I spoke to her earlier , and as I’m the first in the area to go on an omnipod , they are new to this as well. Medtronic is the preferred supplier here but as I had a lot of issues they kindly agreed to switch me to one. Hopefully someone can shed some light thank you x

 

[Juicyj]

Hi @sophc I'll tag a couple of other pump users in case they can shed some light on this @tim2000s @himtoo

 

[kitedoc]

Hi @sophc, Sorry to hear that you are having these teething troubles.!!
Whilst I don''t use an Omnipod pump, what I did was use some graph paper and put in the angles and lengths of cannula you mentioned:
......................30 degrees, 13 mm --> 6.5 mm depth. and if you had managed
......................20 degrees, 13 mm --> 5 mm
......................45 degrees, 6 mm --> 4.5 mm depth and if the Omnipod was tilted a bit to say 5 degrees
......................50degrees , 6 mm --> 5 mm depth.
But when a cannula is fired in maybe it goes deeper to begin with and if that goes through the layer between subcutaneous tissue (where you wish the tip to be) and the muscle. Could the insulin then be being partly absorbed by going through a hole in the layer between into the the muscle giving quicker absorption of insulin and thus hypos?
But the 'graph paper' depth of 4.5 mm is smaller than most cannula depths. And with the 13 mm cannula would not you be at greater risk of going through into muscle?
Did your DSN suggest any changes to help ease the hypos ? lower the basal rate and other settings ??
Could it be that the Medtronic settings were unknowingly being adjusted for some ?inaccuracy in the dosing and thus on the new pump the 'Medtronic doses' are now too high?
Given there does not seem to be much one can do to change the cannula depth would your DSN agree to at least trying to prevent the hypos with appropriate dosage changes and then see how things go ??
Best Wishes and fingers crossed and hugs !!!

 

[LooperCat]

Thanks for the tag, I can honestly admit that I’m zero help here - I’ve only ever had the Omnipod, so have nothing to compare it to. Also, I’m far from lean

 

[Jollymon]

When I switched to Omnipod I found I needed to back my basal rates down a little. I switched from a Medtronic pump to a pod. After basal testing, the basal rates on the Omnipod just push more insulin. I don’t know why, but you’ll just have to learn and adjust to it.

Angle of infusion set shouldn’t mean anything to blood sugar. Amount of insulin delivered would.

 

[kitedoc]

Hi @sophc,
Are you winning?

 

[himtoo]

hi @sophc
i have read ( but have no actual firsthand experience ) from others reporting this phenomenon when changing pump ... so perhaps some further basal rate testing is required to get your rates correct on the omnipod

have you discussed with your diabetic nurse ??

 

[tim2000s]

@sophc - the mechanisms used by different pumps for delivering insulin affect what the output is. What most people don't realise is that when you change pumps, you usually have to change basal rates as the amounts they push out are all slightly different. I'm afraid it is par for the course.

You'll need to go back and do an entirely new basal test. If you have a libre this will be a lot easier.

 

[sophc]

Hi @kitedoc @tim2000s , thank you for the advice. I am now doing extensive basal testing and it seems I am needing dramatic changes of rates and times. I think you are right that the pump gives the insulin at different intervals.

I am the first patient to go on an omnipod as usually Medtronic is all that is offered but as I’ve had 5 failures they allowed me to go on the omnipod so my DSN is learning with me. Thank you all as always