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Bummed- need to wait to go on Omnipod

Discussion in 'Parents of Children with Type 1' started by Anyelday, May 9, 2013.

  1. Anyelday

    Anyelday Approved members

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    We were hoping to get get started on the Omnipod but at our clinic appointment today we found out that her Lantus dose is too small for the pod. Bummed! I guess I shouldn't complain about her insulin doses being too small for the pump...but we were hoping to get pumping soon.

    A1c was good...but she is honeymooning so that was expected
     
  2. sooz

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    The Omnipod does not use Lantus. Do you mean her basal dose is too small? Surprising because it can be custom set. I didn't know there was a minimum. That is too bad. :(
     
  3. Anyelday

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    yes...sorry...i meant basal would be too small. They said it is the only pump with this issue. She gets 1 unit. They even called Omnipod to see if there was a way to work it out...but there is not. Since they are not sure what basal needs would be once we switched they don't want to try it and then not be able to get dosages correct.
     
  4. swellman

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    I'm confused but maybe I'm overlooking something but I thought that the pod administered insulin in 0.05U increments. At that rate it would be 1.2U per day and, I guess I never considered it but, maybe you could even do a 0U per hour rate for a couple of hours adding up to 1.0U?

    I need to refer to the manual.

    EDIT: TIL the minimum basal rate is 0.05U/hr

    Still I think it's close enough that you could work with it IMO - with a snack somewhere during the day. There's the temp basal off as well. You could dilute the insulin as well but that's tricky IMO for the non-science people but I think people do it successfully.
     
    Last edited: May 9, 2013
  5. Anyelday

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    One of the questions they asked was about 0U and the pod people said it isn't an option. Edit: just saw your edit- sorry. but the 0u is something she has done with other pumps in the past. I guess they are assuming her basal rates might be different on the pod and don't want us to get all set up and then not be able to get it right. She said she would prefer we were up to 2-3 units.
     
    Last edited: May 9, 2013
  6. swellman

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    The question is what do you prefer?
     
  7. Darryl

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    I disagree with your doctor. The basal issue is the easy part - you could just set 0.05/hour and that would be 1.2 per day. If that's too much, a few carbs here and there would make up for it and you can always set a temp basal of 0.00 for an hour or more at a time.

    The main reason I disagree with your doctor, though, is because if basal is that low, you probably need very small and precise boluses for meals and corrections, and the omnipod is much more capable of that than a syringe.

    I would try the pod now, no reason to put it off. Of course, check BG often (or get a CGM) whenever changing insulin delivery methods.
     
  8. mmgirls

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    I beleive this is a reason to move to the pump rather than one to keep you from it.

    You might not to get creative in basal patterns and or the use of a temp basal of suspending insulin from the pump but, you would be able to consistantly and acurately give insulin in the small doses that you need.
     
  9. Anyelday

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    Thanks everyone! I definitely agree that it would give more precise doses and that is definitely what we need. We hadn't discussed turning the basal off. Do people use this feature often? She was concerned that there was a reason for not being able to do 0U and that it might have to do with the cannula clogging. I hadn't considered the idea of just giving uncovered carbs to deal with slightly higher basal and certain time of day...and it makes total sense.

    She did mention that kids in Charleston often went on MDI over the summer because of the time spent in the water and at the beach. I am not sure about kids on Omnipod or how the tape holds up and I am sure it is different for everyone.

    I was also thinking there is the possibility that with all of the increased activity that comes along with summer and the Charleston heat her basal needs might drop to 1/2 unit. This is our first summer so we aren't really sure how it will go.

    I don't think she was trying to deter us at all...just give us food for thought. I think if I called today and told her we wanted to go for it she would say ok. However, I think I'd be ok if we tried on the pod and it didn't work but I think my daughter would be crestfallen if she had to go back to shots.
     
  10. MomofSweetOne

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    Could you order one of the tubed pumps and then Cut-the-Cord for a pod? That would give you the option of using the tubed pumps with the smaller doses or going tubing-free as her needs increase?
     
  11. JQ33

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    My son wasn't on Lantus at all when we started the pod - his dose had been reduced to zero at least a month before. The CDE was a little nervous about having him go low at the minimum .05 basal and suggested that we could manually do a -100% temp basal as needed throughout the day if we had issues. And as it turned out, we never had an issue with it being too much basal. We didn't add extra un-covered carbs or change ratios - but since he felt like he could eat more spontaneously and with more variety on the pump, I'm sure he was eating more carbs overall. It probably would have been a minor nuisance to have to do the temp basals here and there if we had experienced issues, but it's definitely doable.
     
  12. virgo39

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    It is true that the minimum amount delivered by the Omnipod system is 0.05 while other pumps use 0.025. However, I agree with the pp's--I think you could definitely work around this issue, either by setting a rate of 0.0 for an hour or two (if possible), using 0.05 all day and perhaps knocking a few carbs off of a meal or providing an uncovered snack, or using a temp basal.

    Our DD swims a lot and we seldom have problems with the pod adhering -- we were recently in Florida and she swam a couple hours every day in a pool and the ocean. We had one pod get a bit loose and taped it down.

    YDMV--it seems that some people get better/worse adhesion, but there are plenty of things you can use to secure a pod for swimming--Tegaderm or some of the flexible stretch tapes, etc.
     
  13. 3kidlets

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    Hana swims competitively 4-5 days a week. We've never had an issue with pods coming off. We don't use any additional adhesives.

    I agree with everyone. You can be very creative with the basals on the pump. Plus, what her Lantus dosage is, won't necessarily directly translate to pump basal.
     
  14. mmgirls

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    We have always needed allot more fast acting insulin for basal compared to Lantus as basal.
     
  15. maciasfamily

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    Ask for diluted insulin. We've used it for the past 9 months and it works great. Our son was only on .5 and then went to nothing for Lantus. He needed some, but not a lot.
    Even now he's only on a little more than .5 of real insulin in basal a day.

    We love pumping with the pod!
     
  16. RomeoEcho

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    Interesting. I have seen the opposite, I need more Lantus than fast acting basal.
     

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