# Basal Rates

Hello All!
I just received my Omnipod! I have done quite a bit of research on it and it seems somewhat simple enough. The only question I have is what is a good basal rate to start at? I have only dealt with MDI's and I don't really want to do the guess and check method. Any input is always appreciated!
Barney

Views: 256

### Replies to This Discussion

Divide the total of your long acting insulin by 24 and use the resulting number as a place to start the basal per hour rate. For example my daughter takes 30 units of Lantus (when we use MDI) so we started her basal at 1.25 per hour. We tweak it as needed.

So with this basal rate I no longer need Lantus? And if so, is it uncommon to not have a basal and just stick with injections once a night with my Lantus?

I have 2 kiddos on the pod, and neither one uses Lantus. (Unless there is a hardware problem - very rare). We do 3 different kinds of settings: Basal, Insulin to carb ratio, and correction factor. They get the basal rate and then at meals we use the other 2 factors. I don't know about continuing to use lantus without a basal. That's def a question for your Endo.

We initially went to the pump because my son's body doesn't use Lantus properly, so we have to be in dire straights to go back to it. I think in the last 4 years he's had maybe 3 weeks on lantus.

Both kids say that it hurts to inject lantus and that they don't even notice when they get their basal insulin.

OK great. Just these couple responses has helped a ton! I'm waiting for my spouse to get home from work so she can install my first pod! Any suggestions for first location? I am thinking back of arm, but not sure.

The standard rule is this (but see my disclaimer in the next paragraph first. I'll wait): If you take your total daily dosage of insulin, multiply by .4, and then divide by 24, this will give you a starting basal rate. Basically, this equation assumes that 60% of the insulin you are giving yourself goes to deal with the food you eat, and 40% of it just keeps your BG at a steady state.

HOWEVER, this is just a guideline, and not medical advice!!!! You should work this out with your Endo. Plus, if you're like me, no matter what you do, your body does weird things at different times of the day, requiring different basal rates. So, for me, my BG level falls off a cliff around noon. Don't know why, it just does. So, I have to adjust my basal rate starting around 11am to keep me from getting dangerously low. It may take some time to get yourself dialed in perfectly. Good luck!

I have the same issue with BG dropping around lunch. I thought I was more insulin resistant in the morning, but my Endo told me the body can release "get up and go" hormones(adrenalin). Being a steroid it can really jack with BG levels. My basal rate from 7-11 am is double than the rest of the day.

Welcome to the group! I had meetings with a CDE who programmed all the settings for me to start. There were rather frequent meetings & phone calls to solve problems & the settings were often changed slightly at those times. It's been over 5 years now since I first started on Omnipod & I now feel very comfortable making adjustments to my basals from time to time (usually only by .05 at a time). When I see the endo, he often will make some adjustment based on data in my logs/PDM. I hope you've got both a CDE & endo guiding you-it wasn't clear to me from your post if you were getting any help.

Sorry for asking, but what is a CDE? I have only seen my Endo twice (Or former Endo, for that matter) and at that time I told her I was not interested in a pump. I am now curently seeking a new endo. It's hard to find one where I don't have to drive four or five hours.

Certified Diabetic Educator=CDE; there's usually one or more in every endo's office. They're usually the one who starts you on carb counting & then pump training. So, you mean you're, at the moment, without any medical provider?
Also, my CDE trained me to change pods in the morning so that any highs or lows could be dealt with before going to sleep. Sometimes the pods do not function normally for the first 4-6 hours. There is lots of discussion about that issue on this site.

The only Physician I have is our local one. When Omnipod sent the medical necessity form to him he called me in to fill out the paperwork because hes never heard of a insulin pump. This is the same guy who had me on three different medications that my endo said they stopped using back in the 80's. That's why I look here for much of my questions. I have learned loads more here than any doctor.

Barney,
So, you're on your own for now, medically speaking. You have no expert medical provider (re insulin pumping) to turn to just yet. If that's so, you may be exposing yourself to some potential danger.
I also wonder if your insurance would feel that you had not followed protocol by not having an endo & a CDE trainer at the time of starting on a pump. They do love to find a reason to deny coverage. For example, my CDE told me one reason it was a good idea for me to see an endo routinely was because insurance companies will cover a patient only if they follow what is considered to be the "standard of care".
I know there are far more knowledgeable & articulate members here who could comment on these ideas. Be safe.

Like annecy stated, get your Doctor's office to help you. Each diabetic is different, and adjustments are almost always needed. But even with the fomulas you may not know what adjustments are required. A diabetic educator will know and understand what's occuring as you switch from MDI to pumping. You'll stay in touch with them for a while after starting, checking up and making adjustments as you go.

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