Featuring: Presets

I have been using a pump since 2006-ish and I have only used 1 pump – the Omnipod. It has been through a few upgrades, both to the PDM (personal diabetes manager — the meter & pump control) and to the pods. Still, I mostly use the pump in the same ways I always have. When my hypoglycemic unawareness got really bad I did start using temp basals much more, but other than that not much has changed.

From the start I have loved the flexibility of having multiple basal profiles. I have a pre-menstrual and menstrual profile since I tend to run high with PMS and then crash as soon as my period starts. I have whatever main basal profile I am using. Then if I am trying out some changes because of basal rate testing or some pattern I notice, I’ll usually create a profile based on my main profile where I can make changes without losing track of where I started from.

I have always used basal settings, i:c ratios, and correction factors that are pretty specific. I usually have from 4-6 different time breakdowns for each setting based on meter & CGM downloads.

But, the Omnipod does have other features that I have never used. One of these is the food diary. I have looked at it maybe 4 times but it never has what I am trying to look up (sorry Insulet!). These days it really doesn’t matter since I use MyFitnessPal or Calorie King on my phone but I have always wondered why Insulet bothered to build in a feature that is all but useless.

The other thing that I haven’t delved into as much is part of the “Presets.” This part of the menus offers choices of “Temp basal presets,” “Carb presets,” and “Bolus presets.” Basically you can use these as shortcuts for food, boluses, or temp basals that you use often/over and over. I started using the temp basal presets almost a year ago when I was experimenting with temp basals as a tool for managing hypoglycemia. I knew that having a temp basal along with treating a low could be helpful in decreasing the length of time I stayed low — but also that I tended to forget to set a temp basal at those times. Also, I tended to need a particular temp basal for particular workouts. And, I often need a +95% basal for 3 hours after a pod change (lots about this phenomenon on the web). The temp basal presets really are a great shortcut since it saves both the amount of increase/decrease and the duration and you can name them (“Pod Change,” “Exercise,” etc.). More recently I have added “Post meal high” (+30%, 2 hours) and “Lowish” (-25%, 2 hours).

I’m just starting to explore Carb & Bolus presets. With MyFitnessPal, I like how easy it is to “reuse” the foods that I eat on a regular basis. During the week, I usually eat the same breakfast every day and the app offers up my frequently used foods for easy adding to my log. I think that the Carb presets should work pretty much the same way for me. That menu offers “Favorites,” “Snacks,” and “Meals.” So far I have only added 1 snack (PB crackers — 16 g) and 4 meals (3 of which are breakfast things I usually get at our weekend coffee shop). I’ve been slow to add things in part because I usually think of it when I am bolusing and it needs to be done separately from that. I hope that it will keep me “honest” with my carb counting for common things that I probably SWAG too often.

I don’t know if I’ll ever get around to setting any Bolus presets. That is for specific unit amounts of insulin but I rarely dose insulin that way. I’m always bolusing based on bg + carbs (meals/snacks) or bg alone (when a correction is needed). I can’t think of any times when I just think, “I need 1.6 units of insulin.”

I feel very lucky to have the diabetes management tools that I do and I want to be sure that I’m using them to the fullest capacity. Often, all the features of a device only get explained at the beginning – usually when a person is overwhelmed with the basics and the change that comes with dealing with a new device. My various endos (since my first one whom I will probably always miss) haven’t been very familiar with the Omnipod (or the Dexcom for that matter) so haven’t ever talked with me about using it any differently.

So, how can we learn more about how to use all of the tools we have access to? How do we learn about things like dual-wave or square boluses (boli?)? My answer is the Diabetes Online Community. For any HCP who wonders whether the DOC is useful – this alone is worth its weight in gold (ummmm – that doesn’t even make sense when talking about a digital community, but you probably get my point) — real-life examples of how people use their tools. I know that some people are lucky enough to get that kind of help from some part of their medical team, but I think most of us are figuring this part out on our own*. Please keep sharing all of your stories, tips, tricks… they make a huge difference.

*And some of us are using one pump for ourselves, but have a child (or other family member) who uses a different pump. We/I really need those tips & tricks for the pump we aren’t as familiar with. I have gotten so much help with our daughter’s Medtronic pump by reading blogs.

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