Help struggling with the Omnipod

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Agnew81

Agnew81

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Hi,

I am new to this community. My 4 year old daughter was diagnosed May 2021 and we have a Dexcom G6 which we love and now an Omnipod. The DNS are under staffed and are unable to give the support we need to make the pump work adequately. We are just over 1 week in and already have had a pod failure. We are struggling and would appreciate any advice on how to make it work for us.
 
Had same happen in first few weeks, must have user error as had no issues for years, cant remember last time reported one.

Some great training videos on youtube, viewed fair few when first started on system.
 
nonethewiser said:
Had same happen in first few weeks, must have user error as had no issues for years, cant remember last time reported one.

Some great training videos on youtube, viewed fair few when first started on system.
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Its more about how we achieve better control she's either too high or in hypo and we have managed some stability but still very chaotic.
 
Agnew81 said:
Its more about how we achieve better control she's either too high or in hypo and we have managed some stability but still very chaotic.
Click to expand...

Same will be for any pump believe me as it takes wee while to get basal rates right, had same happen as I'm sure others have young & old. Shame DSNs are unsupportive.
 
Thank you, it's reassuring to know it's normal when adjusting to the pump. I do feel quite frustrated we haven't been given enough support
 
Agnew81 said:
Its more about how we achieve better control she's either too high or in hypo and we have managed some stability but still very chaotic.
Click to expand...

Keeping records of when she’s too high or hypo will help. It will be a basal problem or a bolus ratio problem - you just have to find out which! New pump users are often started on a basal rate that’s pretty much the same hour by hour but most need a more varying profile. As an example, I need 7 times the insulin I need at midnight to stop my dawn phenomenon. If my DP comes back, then I simply increase my basal for the appropriate hours.

Does your daughter have a CGM or Libre? If so, you’ll be able to see better where problem areas might be.
 
Keeping records of when she’s too high or hypo will help. It will be a basal problem or a bolus ratio problem - you just have to find out which! New pump users are often started on a basal rate that’s pretty much the same hour by hour but most need a more varying profile. As an example, I need 7 times the insulin I need at midnight to stop my dawn phenomenon. If my DP comes back, then I simply increase my basal for the appropriate hours.
Inka said:
Does your daughter have a CGM or Libre? If so, you’ll be able to see better where problem areas might be.
Click to expand...
Yes she has a Dexcom G6. We do have a basal rate that is the same throughout the day and night. It could mean that her basal rate needs to be changed in the morning rather than the Bolus? Would you recommend adjusting the basal rate or bolus first?
 
Agnew81 said:
Keeping records of when she’s too high or hypo will help. It will be a basal problem or a bolus ratio problem - you just have to find out which! New pump users are often started on a basal rate that’s pretty much the same hour by hour but most need a more varying profile. As an example, I need 7 times the insulin I need at midnight to stop my dawn phenomenon. If my DP comes back, then I simply increase my basal for the appropriate hours.

Yes she has a Dexcom G6. We do have a basal rate that is the same throughout the day and night. It could mean that her basal rate needs to be changed in the morning rather than the Bolus? Would you recommend adjusting the basal rate or bolus first?
Click to expand...

Dont know how it works with young children, as adults we do basal test to determine if its basal issue or bolus, think you need to push hospital clinic for advice.
 
Ideally you’re supposed to do a basal test - ie not eat, but I appreciate that’s not easy with a young child, and tbh I rarely do one myself. I just adjust cautiously and see how it goes.

Very few people need a flat rate basal. When I had my pump training many years ago I was shown an average profile of someone without diabetes. It was up and down over 24hrs.

As your daughter is new to her pump, I’d keep records then phone her team for advice.
 
Agnew81 said:
Keeping records of when she’s too high or hypo will help. It will be a basal problem or a bolus ratio problem - you just have to find out which! New pump users are often started on a basal rate that’s pretty much the same hour by hour but most need a more varying profile. As an example, I need 7 times the insulin I need at midnight to stop my dawn phenomenon. If my DP comes back, then I simply increase my basal for the appropriate hours.

Yes she has a Dexcom G6. We do have a basal rate that is the same throughout the day and night. It could mean that her basal rate needs to be changed in the morning rather than the Bolus? Would you recommend adjusting the basal rate or bolus first?
Click to expand...
Basal rate first in all cases.
Adjust the basal 2 hours before the change is needed.
So after viewing results and if hypo at 2am then lower the basal at midnight 🙂
Invest in the book pumping insulin by John Walsh (amazon) it's known as the pumpers Bible 🙂
 
Pumper_Sue said:
Basal rate first in all cases.
Adjust the basal 2 hours before the change is needed.
So after viewing results and if hypo at 2am then lower the basal at midnight 🙂
Invest in the book pumping insulin by John Walsh (amazon) it's known as the pumpers Bible 🙂
Click to expand...
Thank you, really helpful advice, I ordered it about 20 minutes ago 🙂
 
@Agnew81 - this is the same for more or less all of us when starting on any pump - @Pumper_Sue can personally confirm that within a fortnight of getting my first one, had that option been easily been open with no comeback I'd have chucked it all in the bin and gone back to jabs. Instead of which my husband (knowing exactly how my brain works, sigh) just said in his well practised long suffering tone that he knew I'd find it too much of a challenge so he wasn't surprised I couldn't cope - which was a red rag to a bull even if I hadn't already been thinking Don't be beaten by this! - it's mechanical, it only does what I tell it to do - so be logical and try to sink down to this lump of plastic and a few electronics level of intelligence - it isn't whatsoever clever cos it hasn't got a brain, but I am and I have one ! Here I am approx 11/12 years later on my third pump ....

Always basal first - and never make more than one change at a time - if it ain't right, you need to know exactly what/which one was wrong! Also - try the smallest possible change - you'll know from the Dexcom whether the BG has responded in the direction you wanted it to and you can adjust again if it's not enough or too much. They do tell us 'only adjust by a max of 10%' but quite honestly, I've often found far less than that did the trick nicely.

Rome wasn't built in a day, and all these things take time. Beef up your sense of humour and your store of patience - both help. Good luck and hugs to both you and your little girl from this great grandma.
 
I just got an Omnipod on 19 January - prior to that I had had a tubed pump for 8 years. I have found that adjusting to the Omnipod hasn't been as easy as I thought it would be. Same insulin and it's a pump... well, yes and no... I am still adjusting basals. You will find the Omnipod basal rates can be adjusted by 0.05u which is a tiny amount. Be very cautious with any adjustments... look at her dexcom records, see when she's going hypo and as @Pumper_Sue says, decrease her basal by the minimum possible 2 hours before the hypos start. Ditto increasing by tiny amounts and again 2 hours before you see the highs. None of us have perfect control, it's virtually impossible with type 1. So don't beat yourself up too much.

In addition to the John Walsh book you might like to invest in Ragnar Hanas' book Diabetes Type 1 in children, adolescents and young adults.

Meantime do ring the DSN and insist they offer a bit more support. For a tiny child like your daughter they should meet your request with sympathy.
 
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