Omnipod basal variations

[Sadjers]

Hello I started the Omni pod about 2 or 3 months ago and I'm trying to settle in. Things are getting much better now but I am having trouble keeping my basal settled. It seems tgat just as I get it right, it changes.
I feel that the variations are either:
1) because the injection site affects my response to the insulin over the three days that it is installed or,
2) my response to the insulin changes depending on where the pump is fitted.

It is likely to be a combination of both these but the variations are really significant. While I think my basal requirements reduce with each day of wearing a pump. The variations are not consistent and I think this is to do with where the pump is fitted.
I fit the pump in the stomach, the thigh, the arm and just below my belt line on my backside.
Dies anyone else have these issues?

Chris

 

[himtoo]

are you finding that your basal requirements are really varied … as in double or half the amount -- so example -- going from 0.5u per hour to 1.0u per hour in the same time frame ?

have you experimented with temporary basal rates to overcome this ?

It took me about 8 weeks to get my basal rates set to levels that worked for me when I started on omnipod.

 

[Sadjers]

are you finding that your basal requirements are really varied … as in double or half the amount -- so example -- going from 0.5u per hour to 1.0u per hour in the same time frame ?

have you experimented with temporary basal rates to overcome this ?

It took me about 8 weeks to get my basal rates set to levels that worked for me when I started on omnipod.

Hi, thanks for the reply.
I haven't been able to validate my thinking. And every time I think crack the basal levels they change. They change both upward and downward. I use meal fasting to check my basal.

Yesterday I set up three basal programmes (Day1, 2 & 3) with Day2 slightly lower than the Day1 and Day3 slightly lower than the Day2. Im on Day2 today.
Im gonna stick to the same site (both hips) and compare fasting for the same days. It's going to take a few pumps to compare for repeating patterns. And a week or two without alcohol.
I'll let you know how it goes.
Chris

 

[Postleneo]

Have similar issues myself... Been on the Omnipod now for about 5 months.... As soon as I think if cracked my basal requirements ii suddenly either start requiring more basal... Then after a few days start needing less!! Seems like I'm adjusting every 5 or 6 days no mater where I place the pod.. Sites used are stomach, lower back, hips, chest and back of the arm. If you get to the bottom of it please let me know

 

[himtoo]

Hi, thanks for the reply.
I haven't been able to validate my thinking. And every time I think crack the basal levels they change. They change both upward and downward. I use meal fasting to check my basal.

Yesterday I set up three basal programmes (Day1, 2 & 3) with Day2 slightly lower than the Day1 and Day3 slightly lower than the Day2. Im on Day2 today.
Im gonna stick to the same site (both hips) and compare fasting for the same days. It's going to take a few pumps to compare for repeating patterns. And a week or two without alcohol.
I'll let you know how it goes.
Chris

I hate to tell you that this sounds very intriguing when actually its your life we are talking about...…..it does raise a lot of thoughts and questions though

how long are you diagnosed Type 1 ?
are you a really active person ?
is your job really stressful ?


sorry for all the Q's but just wondering what other factors may be influencing what is happening ?

 

[Medusa41]

Following these posts as I have sent off for a trial omnipod. My DSN isn’t keen & was surprised I wanted to opt for this! Will follow to see what you guys say. Thx.

 

[CranberryIce]

It took me about 8 weeks to get my basal rates set to levels that worked for me when I started on omnipod.

Ah this gives me some hope! I am on day 10 and feeling frustrated at the constant swing in my sugars!

 

[Chas C]

Pretty sure when I started on a pump 8 yrs ago I was told 3 months, think it took about 10 weeks or so. Also basal checking was painful, you need to do it on a quiet day and I had to miss at least two meals (to start the checking after the first), also you need to be stable with good BG before you even start each check.

It was after this that I decided to get a Dexcom so I could see the changes every 5 mins.

Remember to make the basal changes around an hour before your testing shows you need them to take effect and not to change by large amounts, just 0.1 or 0.2 each time you change.

 

[Sadjers]

I hate to tell you that this sounds very intriguing when actually its your life we are talking about...…..it does raise a lot of thoughts and questions though

how long are you diagnosed Type 1 ?
are you a really active person ?
is your job really stressful ?


sorry for all the Q's but just wondering what other factors may be influencing what is happening ?

Hi, thanks for replying. Ive been type 1 forever (40yrs). My only exercise is dog walking and my wife tells me that I don't know what a stressful job is (she's a Probation Officer). I do office work. I do recognise the effects of exercise, stress and illness (which are all nothing compared to drinking wine and beer).
My feeling at the moment is that it is the pod location. Im going to spend a month fitting it to my hip and try and get it sorted. I might then do the same with stomach and use a different profile.

I also get a strong correlation between my basal level and my bolus settings. If my Basal increases I need to increase my bolus ratios (resulting in less bolus). I had a similar problem using Tresiba/fiasp and needed more tresiba in the summer but less fiasp.

I think the basic fact is pumps are hard work. Isn't the healthy body just amazing.

 

[Sadjers]

Pretty sure when I started on a pump 8 yrs ago I was told 3 months, think it took about 10 weeks or so. Also basal checking was painful, you need to do it on a quiet day and I had to miss at least two meals (to start the checking after the first), also you need to be stable with good BG before you even start each check.

It was after this that I decided to get a Dexcom so I could see the changes every 5 mins.

Remember to make the basal changes around an hour before your testing shows you need them to take effect and not to change by large amounts, just 0.1 or 0.2 each time you change.

Thanks for this advice. Ill look at that dexcom. Ive also heard of a miao miao for the libre.

 

[himtoo]

Ah this gives me some hope! I am on day 10 and feeling frustrated at the constant swing in my sugars!

I would get hold of the book -- Pumping Insulin -- this was a great help to me when I started pumping

 

[Sadjers]

Hi guys.
For the last three weeks I have been placing my Omnipod on my hips and I believe this has stabalised my control. I am now starting to feel confident in methods to check and adjust control factors. These only work when my body control response is consistent.
I've confirm my basal profiles and managed to modify my bolus. I have moved my time in target to 62% in the green.
I recognise that I have been trying very hard over January, which may be a factor in this improvement. I am now going to move the pod to my arm and settle the basal profile for a few weeks. I'll update then.

 

[Sadjers]

I would get hold of the book -- Pumping Insulin -- this was a great help to me when I started pumping

Hi himtoo, I googled this book and found two. One was by Ruth Roberts and the other by John Walsh. Can you please add some more about which book are you recommending? Thanks.

 

[himtoo]

Hi himtoo, I googled this book and found two. One was by Ruth Roberts and the other by John Walsh. Can you please add some more about which book are you recommending? Thanks.

mine is Pumping Insulin -- fifth edition
by John walsh and ruth roberts

 

[Sadjers]

Hi all,
I feel that my diabetes and pump management has now stabilised. The one factor that affected repeatability/stability and thus my ability to manage my pump control was the location of my pump. I now always locate my pump on my stomach. This stabalised the pump performance and my readings became a lot more repeatable.
My nurse told me that other patients in her clinic had similar experiences.
Thanks to you all for your advice.
Chris

 

[Sadjers]

Following these posts as I have sent off for a trial omnipod. My DSN isn’t keen & was surprised I wanted to opt for this! Will follow to see what you guys say. Thx.

How did you get on?

 

[richyb]

I too have experienced this variation. But now I am just using my stomach for a while, this has helped a lot. The last 3 pods have been good control. Near to 100% in range using libre.
But I have had quite an occurance of pod failures. 2 were bleeding, 1failed to stabilise and one today when fitting made a high pitched noise and would not continue. Only been using for about 3 weeks. Quite painful cannula insertion. So think this is the cause.

 

[richyb]

Just to add. I do like them though and hope I improve

 

[cait 57]

I had very similar experience when started using Omnipod. Am over a year in now and my annual review showed 90% time in range so am delighted with this. I self fund Dexcom which has been a game changer in terms of being able to respond quickly to highs/lows. I fix the pod usually to my thighs which suits me best although have used arms and abdomen too. It’s annoying when you have a pod that is effective and when time to change it results in a faulty pod ! If rubbish results after day one I change it immediately as I know how my body responds to the good I eat. I love the flexibility Omnipod offers.

 

[Soplewis12]

Have similar issues myself... Been on the Omnipod now for about 5 months.... As soon as I think if cracked my basal requirements ii suddenly either start requiring more basal... Then after a few days start needing less!! Seems like I'm adjusting every 5 or 6 days no mater where I place the pod.. Sites used are stomach, lower back, hips, chest and back of the arm. If you get to the bottom of it please let me know

I am exactly the same, 21 months in!