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Hi - Two years ago, I was taken off my OmniPod after 2 1/2 great years of use. I refuse to go on a pump with tubes, but the minimum .05/hr basal rate is too much for me (i have LADA or MODY with secondary insulin function). Some of the pumps with tubes have .025/hr basal rate, but I do not want to use one of those! I have been doing MDI for the past 20 months. Ugh is all I can say. I am busy with work and raising my three young boys. Does anyone know if there is a way to reduce the basal level or is the only way to reduce it over night to temporarily turn it off? I remember one of my providers telling me that it is not advised to keep turning the basal on and off on the Pod, since the canula can become clogged when it is not flowing insulin. Any comments are much appreciated. Melissa

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Have you tried using temporary basal and reducing the basal rate by up to about -90%? I'm not sure that would work but it might be worth a try. I would be greatly unhappy to go back to anything else than my O'pod.

I tried this, but it did not seem to work since i was not able to reduce the minimum basal rate. Every hour (unless I suspend all together), a minimum of .05 units is given and it will not give less. I think the OmniPod is a truly amazing pump. I have 23 month old twin boys and I am certain they would pull the tubing off me if i used another pump. This is so frustrating.

Can you clarify something?

Your minimum basal rate is less that .05 u/hr continuously over 24 hours? In other words, if you basal test over 24 hours, you'll program in .05 u/hr for any given block of time and still go low 1 to 3 hours later?

I was hoping that by now you will have way more answers and there will be no point of me posting. First of all one would question your diagnosis. I even don’t want to go there. Let’s assume that this is well confirmed, you may have one of MODY. If MODY is in the picture you should have no predisposition to DKA, and you should have tried use of sulfonylurea, as some MODY are very sensitive to this class of medications. So, again, let’s take your LADA/MODY diagnosis as appropriate and confirmed.
So the situation is that your basal requirement is very low, meaning you are very sensitive to insulin.
I have seen a few cases like this; I found that the injection of 5-6 units of lantus was working perfect here. Are your basal settings elaborate or not much of variation? If simple, basal insulin injection could be the option. It looks that 2-3 units/day may do the trick here. Do you often use temp basal, suspend etc?
I think the use of temp basal may be the option, although it has minimum set, and you would need to do it every day not a perfect solution.
Let’s me make clear, I am not saying quit pods.

Thank you so much for your post. I was on NPH 2x/day(intermediate act) when pregnant and after pregnancy, I was switched to Lantus (long) act. I did not like it, since I thought there was a definite peak where I would go love (but I could never predict when that could be). I love the idea of micro doses of insulin dripping in over 24 hours, but the minimum basal level on OmniPod is too much. Animus and Medtronic have a minimum basal that is half that amount. I just wish OmniPod did.

My diabetes was discovered late in my first pregnancy when I was 38. I had a glucose tolerance test result of 337. It was so high, my OB knew I had something "worse" than gestational diabetes. Most pregnant women have insulin resistance of some level, so I had T2/GD and T1 at the same time. My A1c was a 7.4 on diagnosis. I was immediately started on NPH and MDI novolog. i have never been off insulin since then (five years ago today!). I switched to OmniPod and used it for awhile, including through a twin pregnancy in 2010-2011. I could not have kept my A1c in the 5.3 range during a twin pregnancy without my OmniPod. They know I make secondary insulin because I have been off my pump for 12 hours at a stretch (emergency surgery)and no DKA. Also, my endo gave me glyburide a few years back and my BS tanked on it. Maybe it was too high of a dose, but I do not want to experience that again anytime soon. I really do not know what type I have, I just know that I can eat a certain amount of carbs without needing any insulin but even a few carbs over that and my blood sugar soars. But I am very sensitive to insulin so I cannot correct a high number with a 1/2 unit junior pen. I love the pump for the small correction doses it can give. So MODY - the jury is out on that since I have not had gene test. My mom was diagnosed with T2 diabetes ten years ago (age 60) her father and his mother and his grandmother all had some sort of "sugar" issue. Nobody took insulin until they were in their 80s. No diabetic complications. My mom still takes nothing, kind of watches what she eats and her A1c has never moved from 6.5 in the decade since her diagnosis Looking back on that, I am beginning to wonder if they are truly T2. Like me they are thin and do not fit the stereotyped T2 profile. Who knows what it is really, but I know I do not have T2 - i am not at all insulin resistant (outside of pregnancy) MODY has been considered since it is passed down in an autosomal dominance. If a parent is MODY, then his/her child has a 50% chance of having MODY. I count five generations on my maternal side with thin people with "diabetes" All I know is that I still only require about 3-6 units of bolus insulin per day, meals depending, after five years. And my A1C never has gone above 5.7. Sorry to stray, this is the OmniPod forum. I just wanted to address MODY for you.

What you describe sounds like MODY type3: mild, passed through generation but usually easy to control and very responsive to sulfonylurea. I am not a fan of sulfonulurea in general but in this group of patients it hits the target as it seems that they have problem with receptor it this medication just works there.

We are aware about 5 MODY types, and I am sure there is more, we have just not identified it yet. Sometimes, in cases like yours, you just have to listen to your body responses and be flexible.
WOW, your A1C during pregnancy! very impressive. It's amazing what we are able to do if kiddos are involved!
BTW - the fact that you did not go into DKA with 12 hrs off insulin does not necessary means you have significant insulin production. most LADA are less prone to DKA. Highlight for MODY is NO DKA tendency.
For the tiny basal doses Medtronic may be the best choice. I used it for years before pods. I LOVE pods, but I know many people who prefer tubing.

Good luck, sorry I could not provied solution for your problem. Congrats on your kids, they look so cute on the photo :-)

Isn't Insulet able to offer a solution? That's very disappointing - I know I would hate to lose my barnacles.

Don't know if the coming omnipod 2 has this different, but Caleb's mum writes (link):

You cannot schedule a zero basal rate. When Caleb first started pumping and had a significant sensitivity to insulin (less than 2U TDD per day), it would have been pretty nifty to be able to program a zero basal at certain times. The smallest basal increment is .05 units and alternating a zero and .05 rate in the wee hours of the morning, for example, would have been nice. We worked around it by setting temporary basal rates of zero and his insulin needs grew rather quickly once he started pumping precluding the need for a zero basal. Nevertheless, I’ve always felt that would be a good improvement.

Thanks so much for this. I had no idea this would work. i just love the tudiabetes community.




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