New to Pump - Basal Testing Omnipod Dash

Status
Not open for further replies.
Lizzy78

Lizzy78

Well-Known Member
Relationship to Diabetes
Type 1
Hi all.

Just looking for some info/advice.

Started the Omnipod Dash this week so very early days for me. Since Tuesday my sugars have been high during the day and were dipping at night. I did a fast last night and DSN has advised to lower ratios in the evening to counter hypos. Its the daytime I'm having issues with - really high sugars that refuse to come down. It's like a day of 2 halves at the moment and I'm finding it a struggle. I was on levemir and novorapid before. Anyone had any similar experiences? I am receiving guidance from DSN but as I say, not used to dealing with these high levels again.

Thank you.
 
I have never used the OmniPod Dash but I assume it is like all other pumps (unless you are Closed Loop).
If your levels are rising during the day, that suggests to me that you need more basal during the day - this is not unusual. Are you able to adjust your basal pattern/profile?

In my experience, when starting a pump, the DSN starts with a simple conservative profile that is adapted over time to suit your needs. It can take a month to get the right pattern for you (and it may change in the future).
 
When I switched to the pump from injections it took some time to adjust the basal patterns to suit me. They started us with a profile based on any info we had about doses of Levemir prior to the switch and then with basal testing we gradually adjusted the rates. As @helli says this takes a bit of time at the start and then changes are needed to suit other factors like seasons of the year. Well worth the effort.
If you are using a sensor along with a pump, even if they are no linked to loop, the patterns on the sensor output can show you the areas to work on, and help you check the adjustments made.
let us know how you get on.
 
helli said:
I have never used the OmniPod Dash but I assume it is like all other pumps (unless you are Closed Loop).
If your levels are rising during the day, that suggests to me that you need more basal during the day - this is not unusual. Are you able to adjust your basal pattern/profile?

In my experience, when starting a pump, the DSN starts with a simple conservative profile that is adapted over time to suit your needs. It can take a month to get the right pattern for you (and it may change in the future).
Click to expand...
Yeah they started me on a lower ratio during the day than at night, even although I took 22 AM levemir and 10 PM levemir. I guess I'm probably just being terribly impatient, my control was ok on MDI so the high sugars during the day are telling on me.
 
SB2015 said:
When I switched to the pump from injections it took some time to adjust the basal patterns to suit me. They started us with a profile based on any info we had about doses of Levemir prior to the switch and then with basal testing we gradually adjusted the rates. As @helli says this takes a bit of time at the start and then changes are needed to suit other factors like seasons of the year. Well worth the effort.
If you are using a sensor along with a pump, even if they are no linked to loop, the patterns on the sensor output can show you the areas to work on, and help you check the adjustments made.
let us know how you get on.
Click to expand...
Hi. Yeah it's definitely the daytime that's causing the issue just now. To make another adjustment to basal ratio today and see how it goes. Guess it's just trial and error until I get what suits me. Just not used to numbers being this high. I'm shattered and back to work next week.
 
Lizzy78 said:
Yeah they started me on a lower ratio during the day than at night, even although I took 22 AM levemir and 10 PM levemir. I guess I'm probably just being terribly impatient, my control was ok on MDI so the high sugars during the day are telling on me.
Click to expand...

That makes no sense! It sounds like you’ve been started on a not particularly good estimate of your needs. If that’s so, don’t be afraid to adjust until it suits you. I was fortunate enough to get a fab pump trainer who got my basal rates almost spot on. I was fine within a couple of days. So, it can be done and your basal rates for the daytime are likely way out. One thing to say is to do small changes. Small changes on a pump can have a surprisingly big effect.
 
Lizzy78 said:
Yeah they started me on a lower ratio during the day than at night, even although I took 22 AM levemir and 10 PM levemir. I guess I'm probably just being terribly impatient, my control was ok on MDI so the high sugars during the day are telling on me.
Click to expand...

You need to make your own adjustments, when changing from injections to Omnipod pump took me about week to get basal rates right, persevere my friend.
 
Also, what no one has mentioned is that you need to adjust the basals two hours before you start to see the rises. So if you are going high at 9am, increase basal from 7 am. When I switched from the Roche Combi pump to the Omnipod dash the DSN was amazed at how many different hourly rates I needed, but I was right!
 
Inka said:
That makes no sense! It sounds like you’ve been started on a not particularly good estimate of your needs. If that’s so, don’t be afraid to adjust until it suits you. I was fortunate enough to get a fab pump trainer who got my basal rates almost spot on. I was fine within a couple of days. So, it can be done and your basal rates for the daytime are likely way out. One thing to say is to do small changes. Small changes on a pump can have a surprisingly big effect.
Click to expand...
I knew I would need less insulin on the pump than MDI, but felt my ratios were the wrong way round.
 
Pattidevans said:
Also, what no one has mentioned is that you need to adjust the basals two hours before you start to see the rises. So if you are going high at 9am, increase basal from 7 am. When I switched from the Roche Combi pump to the Omnipod dash the DSN was amazed at how many different hourly rates I needed, but I was right!
Click to expand...
Good advice. Thank you.
 
Pattidevans said:
Also, what no one has mentioned is that you need to adjust the basals two hours before you start to see the rises.
Click to expand...
Two hours may be a bit out of date if you are using faster insulins like Fiasp.
I find 30 minutes before I need a change is long enough for me and use this when exercising - I set a temporary basal 30 minutes before I start moving.
Two hours beforehand would be problematic - partially because I would see my levels rising or falling before I get to the gym or climbing wall or hillside or ... and partially because I don't always know what exercise I am going to do that far in advance.
This may work for morning rises but certainly not at any other time of the day for me.

Adjusting basal profiles is another one of the trial and learning activities for us.
 
I was told one hour for Humalog - that is, adjust the basal rate the hour prior to your problem area. I’ve also used regular insulin in a pump. I was told two hours for that - ie adjust the rate two hours before your problem time.
 
I didn't see what insulin @Lizzy78 is on now. I am on Apidra, which is definitely faster than Novorapid, but nowhere near as fast as Fiasp is supposed to be. Plus because I am quite elderly I don't get anywhere near as much activity as @helli - perhaps that is why I have been advised 2 hours by the pump consultant (and also @Pumper_Sue and several other folks on this forum). I am sure it is all individual, but certainly not instant.
 
Pattidevans said:
I didn't see what insulin @Lizzy78 is on now. I am on Apidra, which is definitely faster than Novorapid, but nowhere near as fast as Fiasp is supposed to be. Plus because I am quite elderly I don't get anywhere near as much activity as @helli - perhaps that is why I have been advised 2 hours by the pump consultant (and also @Pumper_Sue and several other folks on this forum). I am sure it is all individual, but certainly not instant.
Click to expand...
Hey, it's novorapid I am on so no change in insulin. Just obviously stopped my levemir now. My sugars start to rise around 9/9.30 so have upped my ratio from 7.30am tomorrow.
 
helli said:
Two hours may be a bit out of date if you are using faster insulins like Fiasp.
Click to expand...
Two hours is fine with Fiasp for a basal change.
 
Good luck! Hope it works.
I have a few different background settings, normal, period and ovulation these work well for me. I find it quicker to make changes than before on MDI, and this is what I have found best about the pump for me.
 
PhoebeC said:
Good luck! Hope it works.
I have a few different background settings, normal, period and ovulation these work well for me. I find it quicker to make changes than before on MDI, and this is what I have found best about the pump for me.
Click to expand...
I know the pump is going to be great for adjustments. I'm slowly getting there with Basal ratios, it's taking longer than I wanted but can see a bit of progress from Friday.
 
Status
Not open for further replies.
Back
Top