Things You Wish You Knew

[StewM]

So I’m going on the Pump next month. An Omnipod Dash (for a variety convenience reasons). I don’t have the funds for an attached CGM (got a disconnected Libre 2 though).

What are things you wish you knew before you started using the Pump? Had my first induction session today, so think I have the basics down. I’m also already quite meticulous with my ratios etc.

 

[searley]

Your ratios with pump will probably change.. and need to be modified as time goes by

I'm on the tandem with dexcom... I didn't have funding for dexcom when I got the pump and it can be used stand alone and though when I can afford the dexcom I'd benefit from having it... but then was given the funding for dexcom too

I don't think there is anything I wish I'd know.. as I did a lot of research first and knew what I wanted from day 1

Only thing you may want to be prepared for is carrying spares if you go out for more than a few hours

 

[In Response]

Things I wish I knew …
- a pump can fail but you don’t need to carry a full set change with you every time you leave the house. You can get by with a syringe and extract insulin from most pumps. My DSN and the pump rep didn’t know about extracting the insulin.
- how to manage airport security with a pump. A pump should not go through the X-ray because it has not been tested for it but airport security are not always considerate when you point this out.
- basal profiles and bolus ratios change. When I got my first pump, it was configured to only allow one basal pattern. It was only through personal research that I found out how to enable more.
- how to interpret Libre patterns to adjust/match basal patterns/profiles.

 

[StewM]

Things I wish I knew …
- a pump can fail but you don’t need to carry a full set change with you every time you leave the house. You can get by with a syringe and extract insulin from most pumps. My DSN and the pump rep didn’t know about extracting the insulin.
- how to manage airport security with a pump. A pump should not go through the X-ray because it has not been tested for it but airport security are not always considerate when you point this out.
- basal profiles and bolus ratios change. When I got my first pump, it was configured to only allow one basal pattern. It was only through personal research that I found out how to enable more.
- how to interpret Libre patterns to adjust/match basal patterns/profiles.

Can you say more about your last point?

 

[h884]

Hi StewM

I started on the Omnipod Dash in February. Here are a few things which maybe useful.

I would totally agree it takes some time to get basal rates correct. I would say that I am just getting things sorted now. That maybe me and the fact that I currently seem to be needing more insulin.

Basal rate testing is essential to get basal rates correct. Locally they guide us before making any changes to do the test for a particular time period twice.

Keep a record of your pump settings. These can be essential if your PDM fails or away from home

Pod placement - I have found that placing the Pod in some areas can be sore and cause redness where the cannula goes in. In addition absorption is better in some areas than others.

Hope this helpful. Good luck once you get past the initial startup period you will see the difference.

 

[StewM]

Hi StewM

I started on the Omnipod Dash in February. Here are a few things which maybe useful.

I would totally agree it takes some time to get basal rates correct. I would say that I am just getting things sorted now. That maybe me and the fact that I currently seem to be needing more insulin.

Basal rate testing is essential to get basal rates correct. Locally they guide us before making any changes to do the test for a particular time period twice.

Keep a record of your pump settings. These can be essential if your PDM fails or away from home

Pod placement - I have found that placing the Pod in some areas can be sore and cause redness where the cannula goes in. In addition absorption is better in some areas than others.

Hope this helpful. Good luck once you get past the initial startup period you will see the difference.

Would you say the differences in absorption from site to site is similar to what you experienced with injections?

 

[In Response]

Can you say more about your last point?

With a pump, you can set your basal rate for every 30 minutes throughout the day. This is the basal pattern/profile.
With Libre, you can see the pattern of your blood sugars throughout Gothenburg day.
How do you set your basal profile to keep the Libre pattern as flat as possible in the absence of food, exercise, stress, etc.?
For example, if my blood sugar levels start to rise at 4am most days, when do I need to increase my basal and by how much in order to reduce the blood sugar rise?

 

[h884]

Would you say the differences in absorption from site to site is similar to what you experienced with injections?

Hi StewM

I would say they were more significant possibly because I have been trying more sites. I tended to use my tummy and legs more for injections.

 

[Soplewis12]

Hi, I had never used a pump b4 starting omnipod dash in March this year.
You may not encounter this but these are some of the niggles I experienced:

• It took me a few months before getting the correct basal rates set up for different activities but fantastic to use now, much less hypos.
• The pod can come off in hot weather I always use smith&nephew skin-prep wipes to make my skin a bit tacky before putting fresh pod on (Amazon)
• As only using fast acting insulin BG can rise/fall quite quickly, I found suspending insulin for 30 mins useful when falling quickly.
• When on insulin pens/using fast & slow acting insulin my body did not react to heat/sun it now does. If out in the hot sun I have a basal programme set up with reduced insulin.
• I use extended bolus for all my teatime meals as was hypoing quite often before carbs from meals kicked in.
• Ensure you prebolus to try & keep post meal spikes to a minimum.

These are some of the things I wished I knew as was pretty unsettled after changing to pod. Try & keep open minded about the initial months, think of it as a trial period for getting used to the pump. Don't expect to nail it straight away but if you do then it's a Brucey Bonus.
All the best.

 

[himtoo]

about the only thing i can think of to add is i wish i knew that when first starting on my pump ( omnipod )

that i would encounter a psychological barrier to the pump ...in other words i was trusting my entire life to a little gadget ...

so combining this mistrust along with poorly controlled sugars in the first few days ( my basal rates took about 6 weeks to get right for me ) had me ready to throw the whole pump in the rubbish.

I spoke to my DSN about this and she claimed it was a fairly common reaction at first .

 

[Soplewis12]

about the only thing i can think of to add is i wish i knew that when first starting on my pump ( omnipod )

that i would encounter a psychological barrier to the pump ...in other words i was trusting my entire life to a little gadget ...

so combining this mistrust along with poorly controlled sugars in the first few days ( my basal rates took about 6 weeks to get right for me ) had me ready to throw the whole pump in the rubbish.

I spoke to my DSN about this and she claimed it was a fairly common reaction at first .

I agree 100%!

 

[Fazzy]

I love the omnipod dash. It has made managing my diabetes so much easier. What I really like is the ability to easily alter the basel level to help keep me in range particularly during exercise or periods of illness. I have had 2 pods fail on me in the last year and half and these were quickly replaced by Insulet.

 

[Soplewis12]

I know it's personal to each & everyone of us but I'm curious to know what others have set as their upper range limit?

 

[himtoo]

I know it's personal to each & everyone of us but I'm curious to know what others have set as their upper range limit?

on my libre i have upper set at 10.0 ...on xdrip i get an alarm at 12.5 .......

 

[Peppergirl]

great thread - I'm starting the omnipod dash a week today!

 

[stayingalive]

So I’m going on the Pump next month. An Omnipod Dash (for a variety convenience reasons). I don’t have the funds for an attached CGM (got a disconnected Libre 2 though).

What are things you wish you knew before you started using the Pump? Had my first induction session today, so think I have the basics down. I’m also already quite meticulous with my ratios etc.

 

[stayingalive]

I too am getting an omnipod pump next month. The DSN however tells me she will be calculating the basal rate and I "dont need to worry about it". I currently use Tresiba, which has a very long (25 hours) half life, with novorapid for bolus and apidra for corrections (as I can use a half unit pen with this, and it has a shorter half life). I find Libre 2 a great help aswell. This all works well for me, although I do end up injecting many times each day.
Does anyone know why the DSN is talking about up to 4 different basal rates over 24 hours, when Tresiba delivers at a constant rate? I would have expected to use the bolus to adjust for more/less food/exercise. I would also have expected the basal dose to be my daily Tresiba dose divided by 24. The DSN said not so, and would not answer further.

While I'm asking questions.... I can imagine the convenience of having a pump that does the sums for you re insulin/carbs ratio, but what about exercise? I need to alter my bolus quite a lot depending on what exercise I have done/will do, and the omnipod doesnt do this, you just have to override its calculations - seems a bit pointless??

 

[StewM]

I too am getting an omnipod pump next month. The DSN however tells me she will be calculating the basal rate and I "dont need to worry about it". I currently use Tresiba, which has a very long (25 hours) half life, with novorapid for bolus and apidra for corrections (as I can use a half unit pen with this, and it has a shorter half life). I find Libre 2 a great help aswell. This all works well for me, although I do end up injecting many times each day.
Does anyone know why the DSN is talking about up to 4 different basal rates over 24 hours, when Tresiba delivers at a constant rate? I would have expected to use the bolus to adjust for more/less food/exercise. I would also have expected the basal dose to be my daily Tresiba dose divided by 24. The DSN said not so, and would not answer further.

While I'm asking questions.... I can imagine the convenience of having a pump that does the sums for you re insulin/carbs ratio, but what about exercise? I need to alter my bolus quite a lot depending on what exercise I have done/will do, and the omnipod doesnt do this, you just have to override its calculations - seems a bit pointless??

Basically, doing that with your Bolus is suboptimal. Even if your results were good (so were mine), your results with having your Basal do that job have the potential to be even better.

With exercise again, it would be a matter of temporarily reducing your Basal (which they'll teach you about) rather than your Bolus.

 

[himtoo]

I too am getting an omnipod pump next month. The DSN however tells me she will be calculating the basal rate and I "dont need to worry about it". I currently use Tresiba, which has a very long (25 hours) half life, with novorapid for bolus and apidra for corrections (as I can use a half unit pen with this, and it has a shorter half life). I find Libre 2 a great help aswell. This all works well for me, although I do end up injecting many times each day.
Does anyone know why the DSN is talking about up to 4 different basal rates over 24 hours, when Tresiba delivers at a constant rate? I would have expected to use the bolus to adjust for more/less food/exercise. I would also have expected the basal dose to be my daily Tresiba dose divided by 24. The DSN said not so, and would not answer further.

While I'm asking questions.... I can imagine the convenience of having a pump that does the sums for you re insulin/carbs ratio, but what about exercise? I need to alter my bolus quite a lot depending on what exercise I have done/will do, and the omnipod doesnt do this, you just have to override its calculations - seems a bit pointless??

having the ability to adjust basal rates as much or as little as your body needs is very individual to each of us on a pump...... i have 11 different basal rates set on my usual profile --- i need much more in the hours between 3am and 7am ( to help prevent dawn phenomenon ) ....and much less in the afternoon when my insulin sensitivity is much greater
.
as for tresiba dose divided by 24 there is another factor to consider ---- most of us on pumps need reduced amount of insulin compared to MDI --- my requirements went down approx 25%

 

[RTI]

So I’m going on the Pump next month. An Omnipod Dash (for a variety convenience reasons). I don’t have the funds for an attached CGM (got a disconnected Libre 2 though).

What are things you wish you knew before you started using the Pump? Had my first induction session today, so think I have the basics down. I’m also already quite meticulous with my ratios etc.

Currently I am using OMNIPOD Dash and Freestyle Libre 2 for the Glucose profile
You maybe worried at the beginning about all the changes and myself hesitated for a long time to make this step to switch to a pump. It may take you some to define a reasonalbe Basal-profile (,Carb/Insulin profile and Insulin/Glucose reduction values).
But the results will be positive in the end. The increase in Diabetic comfort, not take your injection openly anymore, etc.