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Omnipod basal rate change? Please help?!

Discussion in 'Parents of Children with Type 1' started by bandmkolb, Aug 11, 2012.

  1. bandmkolb

    bandmkolb Approved members

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    Need help changing basal rate! Harrison has been on the pod since July 30th. We did a very quick training in the endo office and didn't get much info on the basal rate. His numbers have been in the high 200's to low 400's since Thursday. (No ketones) We did a pod change on Friday evening and hoped that would bring the numbers down but it didn't. Right now his basal rate says .30u/hr from 12a to 12a. His Lantus before the pump was 9 units with good numbers. I think I need to up his basal but don't know how much or how the increments really work. Do I change it to .40 and see how that works? Thanks!
     
  2. Jaredsmom

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    I would personaly start with changing it to 0.35. It's always best to increase your basal rates slowly. Also you may find that you need different basal rates though out the day. Jared needs more insulin at night for example. A great resorce to have is the book Pumping insulin by John Walsh. Also we found that with pumping Jared required more insulin with his meals as well.
     
  3. 3kidlets

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    You can change by .05 increments. You could try just upping by that much and see if it helps. Sometimes a little basal goes a long way. But I suspect if he is in the 400s, you are going to need to up it by more than that. Is there a specific time of day he has been in the 400s? Do you have varying I:C rates too or are you using only one I:C for the entire day? If he is going in to the 400s after eating, it is probably the I:C.
    I suspect what you really need to do some basal testing because he will more than likely need different basals throughout the day. For example, Hana gets far more basal in the very early morning hours than any other time of day. From 4 a.m. to 7 a.m, she gets .90/hour whereas, the rest of the day her basals are between .60-.65. That is the beauty of pumping though. You can have several different basal rates throughout the day. Hana has 4 different basal rates for a 24 hour period.
    Hopefully some other folks will chime in on this too. There are others out there that are far better at analyzing numbers. It may be helpful if you post some of his numbers throughout the day.
     
  4. bandmkolb

    bandmkolb Approved members

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    Thanks for the answers so far. I decided to do a pod change because he was 405 so I gave correction via pod and an hour and a half later he was 497. I realized he must not be getting insulin. Changed pod and the cannula was completely crimped. He was running high before his pod change yesterday but not that high so I probably do still need to change his basal.
     
  5. Dan

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    I'm am a little concerned that your endo set your basals the same for the entire 24 hour period. When we went on the Omnipod we were required to read "Smart Pumping" by Howard Wolpert.

    Our Endo/CDE also had a series of classes regarding pumping. Then we had a two day class when we actually went on the pump. On the days that followed we were required to send detailed logs so they could make adjustments. The first weekend we did a series of basal test to fine tune our rates. I now make basal changes two times per year or as needed if I see some unexpected numbers.

    I would recommend doing the 4 basal test outlined in the presentation "Advanced Insulin Pump Management" by Gary Scheiner. This can be found here on CWD if you click on the main logo at top left of this page. Then scroll on the left hand side and look for presentations. The main info on setting Basals Can be found on slides 3-8.

    Doing these test will take an entire week so take your time and get them right before you move to bolus changes. Good luck.
     
  6. 3kidlets

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    We were set up the same way. We started at .30/hour for a 24 hour period and we took it from there. You will realize that you need to go up or down for a certain time period.
     
  7. Dan

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    Did you work with your Endo to make changes right away or were you on your own? The concern I had was that they are into their second week and no changes seem to be suggested by their team. We were making changes after day 3.
     
  8. bandmkolb

    bandmkolb Approved members

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    Yes I have been sending records to the pump trainer at the endo office. She has changed a few things mainly i/c ratios. It's more my fault because I was supposed to send records on Thursday last week but forgot to download the PDM before my son went with my mother to stay at my grandmothers 2 hrs away. I told the trainer this and she said just do it monday and we will talk then. He got home Friday night. His numbers were running high on Thursday and Friday but my mom had taken him out to eat a couple of times and I just chocked it up to that. She did the pod change Friday evening. I hoped that would bring the numbers down, but obviously it didn't because the cannula was crimped. After the pod change from the occlusion yesterday his numbers have been way better but not great. I will send reports in the morning and talk to pump trainer then. Thanks all for the help.
     
  9. Dan

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    Here are the basal numbers for Joshua:
    • 12am - 3am .30
    • 3am - 8am .40
    • 8am - 10am .35
    • 10am - 3pm .25
    • 3pm - 8pm .30
    • 8pm - 12am .45

    When doing the basal test I mentioned his numbers do not fluctuate more than 5-10 points. It took me two weeks to get to these numbers but I fell that it was worth the effort.

    I am sure all will change next week once school starts.
     
  10. bandmkolb

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    Yea I'm thinking I don't want to go trying to do basals right now because he is not on a regular schedule. For instance last night he went wild hog hunting with my husband and they got stuck and did not get home until 2:30 am. He did not get up for breakfast untill 11:30. It will be much easier to see trends when he is on school schedule. I will probably up the basal but not add basals yet. Thanks!
     
  11. Dan

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    Best of luck
     

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