So, first the really good news...over the past 7 days, we've been able to stay at, or under 250 nearly 100% of the time. We have had 2 spikes over 250, but nothing nearing 300. 95% of the time, over the past week, we've been able to stay within 80 - 180 range (which we're both really excited about.) We've made several adjustments, which I'll list first, before I get to my question.
First, we wanted to get as close to 50/50 basal/bolus, so we increased his basal rates as follows: Between 12AM - 9AM, he gets .05 basal (which we have been suspending via a temp basal preset that decreases basal by 100%, because he was level around 150 during the nights.) Between 9AM - 10PM, we have him on .20 units of basal and from 10PM - 12AM, he's on .10 units of basal.
Since we increased basal, we needed to decrease bolus, so we increased his I:C to 1:32. This seems to be working out wonderfully. Now our ratios are around 55% Bolus to 45% Basal...a huge improvement over previous weeks and we're getting the basal/bolus ranges honed in. I've moved down my threshold on my CGM from 100 - 200, to 80 - 180, which is the ideal range I want to see him in as much as possible.
We also made another change in creating a temp basal preset that adds an additional 50% more for 3.5 hours after each meal onto whatever his current basal regimen is. This has helped us practically eliminate the spikes. What this "can" cause; however, if we're not paying attention, is hypoglycemia. So we carefully watch him post-prandial and, after he "levels off" and starts going down, we turn off that temp basal preset. Also, if we see him going below a certain level that we're comfortable with (under 150), we suspend insulin until the "down arrow, or 45 degree arrow down" stops, then we resume the basal.
So, that's the changes we've made lately and, like I said, I couldn't be more happy with the results we're seeing. We are staying between the comfort zone (80 - 180) over 90% of the time.
My question pertains to the IOB with the Omnipod and how the PDM displays things...
Specifically, sometimes, I see an IOB of 0.00 u, but I don't understand how this could be so, if the basal program indicates .10 u/hr, .05u/hr or .20u/hr? Sometimes I see 0.00 insulin on board, but I don't understand why because it seems to me that, with any of the above listed basal programs, some insulin should be onboard at all times? I'm thinking perhaps I may just be not understanding perhaps what (if any) basal insulin numbers are displayed on the PDM...I would think they should be though!