Pump

[Auckland Canary]

A lot of questions here. I think I may have fallen into a trap of trying too much too soon when things immediately went wrong however due to the severity of the hypos I had to take action.
My basal rate is 0.675 and I am using novorapid. My levels are set between 6 and 8.
I tried basal testing yesterday afternoon which is when I got a 2.2 so that would suggest the levels are too high. However I normally swing quite a lot so don't have fixed basal rate for the whole day. I cycle 12 miles twice a day for work but in the morning my levels seem to increase whereas on the evening ride they decrease rapidly. It is this complexity I am struggling with.
I will talk to my DSN about this shortly as I am floundering with the different rates and levels. Unfortunately I am also so busy with work and an ongoing house renovation I haven't even read the manual yet! I am having a break this weekend and will try and spend some time with it.

Sorry for hijacking the thread somewhat.

 

[Auckland Canary]

Sorry my levels are set between 4 and 8 not 6 and 8. I have barely hit one yet.

 

[Fayefaye1429]

Not at all Auckland I think we all love to help so please do speak.

My bloods do that sometimes with exercise. On the evening can you eat something before the ride? and in the morning can you maybe leave earlier (pain I know) but stop every so often on the ride check your sugar and maybe adjust, just till you get the hang of reducing insulin and the reset of the pumps features.

 

[CarbsRok]

A lot of questions here. I think I may have fallen into a trap of trying too much too soon when things immediately went wrong however due to the severity of the hypos I had to take action.
My basal rate is 0.675 and I am using novorapid. My levels are set between 6 and 8.
I tried basal testing yesterday afternoon which is when I got a 2.2 so that would suggest the levels are too high. However I normally swing quite a lot so don't have fixed basal rate for the whole day. I cycle 12 miles twice a day for work but in the morning my levels seem to increase whereas on the evening ride they decrease rapidly. It is this complexity I am struggling with.
I will talk to my DSN about this shortly as I am floundering with the different rates and levels. Unfortunately I am also so busy with work and an ongoing house renovation I haven't even read the manual yet! I am having a break this weekend and will try and spend some time with it.

Sorry for hijacking the thread somewhat.

Ok what you need to do is go to your basal section and set it up so you can make the changes every hour or 2 hours. Having a set rate right across the board is a non starter. just as a guide and it's a guide only 0.05u change will drop you by about 3mmol. small steps and all that.
You really need to start sorting out your setting otherwise you will hate the pump and give up on it. Poor pump is only doing as it's been programmed

 

[donnellysdogs]

Ok, so are you on a static basal of 0.675 all day?

Have you adjusted your levels to stop the hypo at that time?

 

[donnellysdogs]

Ok what you need to do is go to your basal section and set it up so you can make the changes every hour or 2 hours. Having a set rate right across the board is a non starter. just as a guide and it's a guide only 0.05u change will drop you by about 3mmol. small steps and all that.
You really need to start sorting out your setting otherwise you will hate the pump and give up on it. Poor pump is only doing as it's been programmed

Ditto!! Just my thoughts too!!

 

[Gaz-M]

I was/are hoping to get put on a pump as working as a chef it is sometimes so hard to eat something during the day, reading this thread has made me wonder if it is the right thing to do?

There is some very valid points that have been made but from what I see "if you are unwilling to have a few highs/lows it is not for you.

I have been trying to go on a pump from the NHS for 4 year so if you are on a NHS pump I would think yourself lucky.....

Man I wish I had total or most control of my condition but I think some people are unaware of long term Diabetes, I have said enough for now and hope I don't upset anyone

 

[donnellysdogs]

I was/are hoping to get put on a pump as working as a chef it is sometimes so hard to eat something during the day, reading this thread has made me wonder if it is the right thing to do?

There is some very valid points that have been made but from what I see "if you are unwilling to have a few highs/lows it is not for you.

I have been trying to go on a pump from the NHS for 4 year so if you are on a NHS pump I would think yourself lucky.....

Man I wish I had total or most control of my condition but I think some people are unaware of long term Diabetes, I have said enough for now and hope I don't upset anyone

A few highs or lows are manageable as on mdi we've all experienced them.

However a pump involves a lot to think about. Like for example. My pens I kept in bag and changed the cartridges once every 10 days, and needles to be honest were about the same. On injections you knew the insulin had gone in.. So if you went high or liw it was down to two things insulin or food to be basic.

On a pump with a small cartridge etc mine lasts me 3 days, my sets last 2 days, the tubes 6 days, and handset about 7 days max and the battery pump up to two weeks. If I were to eat more the insulin will run oht quicker so change earlier. So it is difficult to tslly everything up at the same time. This is why it can seem a constant. Then when something goes wrong you have to be able to identify what it is.. Ie an airbubble, a set or basal or length of insulin acting time etc. on this pump it is not a case of getting up and going. I have to check my handset is charged or I have enough insulin, enough strips, or is it a set change day etc as soon as I wake up.

I am very appreciative of having £3k strapped to my arm and I do a lot of volunteer work for the NHS to try and repay them for my care.

However just like diabetes burnout, pump burnout on occasions can hit you...

 

[CarbsRok]

I was/are hoping to get put on a pump as working as a chef it is sometimes so hard to eat something during the day, reading this thread has made me wonder if it is the right thing to do?

There is some very valid points that have been made but from what I see "if you are unwilling to have a few highs/lows it is not for you.

I have been trying to go on a pump from the NHS for 4 year so if you are on a NHS pump I would think yourself lucky.....

Man I wish I had total or most control of my condition but I think some people are unaware of long term Diabetes, I have said enough for now and hope I don't upset anyone

Hi Gaz,
highs and lows will happen quite a bit for some people when they first start pumping as it's a new concept in management.
People that know the in's and outs of their diabetes i.e. how insulin/carbs, exercise affects blood sugars and how to get around the problem then they do just fine.
I find many of the problems encountered by people pumping are due to not thinking through the problem properly, then the frustration sets in plus the mind set of can't do wont do it, I hate the pump it's useless and so on.
Bottom line is if you take the time and effort to test your blood sugars at least 8 times a day keep on top of your basal testing then you will be fine.
Pumping is more intensive to MDI in certain aspects but having the minute by minute control of your blood sugars is a very small price to pay for it.

 

[Auckland Canary]

Hi Gaz,
highs and lows will happen quite a bit for some people when they first start pumping as it's a new concept in management.
People that know the in's and outs of their diabetes i.e. how insulin/carbs, exercise affects blood sugars and how to get around the problem then they do just fine.
I find many of the problems encountered by people pumping are due to not thinking through the problem properly, then the frustration sets in plus the mind set of can't do wont do it, I hate the pump it's useless and so on.
Bottom line is if you take the time and effort to test your blood sugars at least 8 times a day keep on top of your basal testing then you will be fine.
Pumping is more intensive to MDI in certain aspects but having the minute by minute control of your blood sugars is a very small price to pay for it.

I think your quote is too simplistic. I have had T1 for over 30 years and am well aware of how carbs, insulin and exercise affect my body. By your definition as I have been struggling then I know nothing. It is a whole different way of treating the condition so initially problems will occur.

To go back to some of the previous stuff here I have already begun trying out different basal rates and have figured out the pump with the training I have had and just by practising.

I had a better night last night and went to bed with a 7.1 and woke with 4.4. So although it did drop still not enough to make me hypo. I reduced my basal from 0.625 (I said 0.675 earlier but made a mistake as I am still getting the hang of the numbers) to 0.55 between1am and 4.30am. So I am going to extend that by another hour tonight to 5.30am to try and keep this up a bit more in the 5's or 6's.

I was 10.1 at lunch after increasing my basal to 0.675 after my cycle between 8am and 10am so may increase that to 11am tomorrow to try and get this down.

Yesterday evening I got home from my cycle and was 3.2 which was a disappointment as I was 12.1 a few hours earlier. I do eat about 35-40g of carbs an hour before I leave work to help keep my levels up and I also reduced my basal by 20% but maybe that needs to be 30% or even 40% for an hour or so. It seems that I am very prone to lows after cycling at that time.

I am feeling more positive about this at the minute but can see what a lot of hard work it is. But I will persevere because I can see the benefits but just need to get the hang of it more.

Thanks for all the advice so far.

 

[Fayefaye1429]

I think your quote is too simplistic. I have had T1 for over 30 years and am well aware of how carbs, insulin and exercise affect my body. By your definition as I have been struggling then I know nothing. It is a whole different way of treating the condition so initially problems will occur.

To go back to some of the previous stuff here I have already begun trying out different basal rates and have figured out the pump with the training I have had and just by practising.

I had a better night last night and went to bed with a 7.1 and woke with 4.4. So although it did drop still not enough to make me hypo. I reduced my basal from 0.625 (I said 0.675 earlier but made a mistake as I am still getting the hang of the numbers) to 0.55 between1am and 4.30am. So I am going to extend that by another hour tonight to 5.30am to try and keep this up a bit more in the 5's or 6's.

I was 10.1 at lunch after increasing my basal to 0.675 after my cycle between 8am and 10am so may increase that to 11am tomorrow to try and get this down.

Yesterday evening I got home from my cycle and was 3.2 which was a disappointment as I was 12.1 a few hours earlier. I do eat about 35-40g of carbs an hour before I leave work to help keep my levels up and I also reduced my basal by 20% but maybe that needs to be 30% or even 40% for an hour or so. It seems that I am very prone to lows after cycling at that time.

I am feeling more positive about this at the minute but can see what a lot of hard work it is. But I will persevere because I can see the benefits but just need to get the hang of it more.

Thanks for all the advice so far.

It is a lot of thinking and somedays I think man I wish I didn't have to. Sometimes my partner gets involved helping me look at where I might need to change basals/bolus, he sometimes takes over the carb thinking, especially if the days has been heavy and works out my meals for me. Don't get me wrong this is only on occasions but because he knows how it can give me a break. I find people knowing around me really helps and can take some pressure of. I wonder if that might help? Your doing awesome Auckland, you really are and in time it will be quite automatic although will still need thought, just not as much

 

[Fayefaye1429]

I was/are hoping to get put on a pump as working as a chef it is sometimes so hard to eat something during the day, reading this thread has made me wonder if it is the right thing to do?

There is some very valid points that have been made but from what I see "if you are unwilling to have a few highs/lows it is not for you.

I have been trying to go on a pump from the NHS for 4 year so if you are on a NHS pump I would think yourself lucky.....

Man I wish I had total or most control of my condition but I think some people are unaware of long term Diabetes, I have said enough for now and hope I don't upset anyone

HI Gaz,
I would say if you have an opportunity to try the pump what would you lose? it sounds like you have had to wait a long time so it might be worth a whirl. I would say at the beginning it can be intense, like a phone can be, although this one there is more harsh consquences when wrong like a hypo but it really does come second nature after a while. It might not for you and it might be pants but it might help.

 

[RuthW]

I think your quote is too simplistic. I have had T1 for over 30 years and am well aware of how carbs, insulin and exercise affect my body. By your definition as I have been struggling then I know nothing. It is a whole different way of treating the condition so initially problems will occur.

To go back to some of the previous stuff here I have already begun trying out different basal rates and have figured out the pump with the training I have had and just by practising.

I had a better night last night and went to bed with a 7.1 and woke with 4.4. So although it did drop still not enough to make me hypo. I reduced my basal from 0.625 (I said 0.675 earlier but made a mistake as I am still getting the hang of the numbers) to 0.55 between1am and 4.30am. So I am going to extend that by another hour tonight to 5.30am to try and keep this up a bit more in the 5's or 6's.

I was 10.1 at lunch after increasing my basal to 0.675 after my cycle between 8am and 10am so may increase that to 11am tomorrow to try and get this down.

Yesterday evening I got home from my cycle and was 3.2 which was a disappointment as I was 12.1 a few hours earlier. I do eat about 35-40g of carbs an hour before I leave work to help keep my levels up and I also reduced my basal by 20% but maybe that needs to be 30% or even 40% for an hour or so. It seems that I am very prone to lows after cycling at that time.

I am feeling more positive about this at the minute but can see what a lot of hard work it is. But I will persevere because I can see the benefits but just need to get the hang of it more.

Thanks for all the advice so far.

I found the first three months of my pump were a complete roller coaster. It was exactly about how my basal rate interacted with my physical activity level. In fact, my basal rate has remained more or less what it was when I was on Lantus (16 units per day on an inactive day) and my carb to insulin ratio was the standard 10:1. First I focused on the differing basal rates at different times of day, and when I got that I started looking at how I should adapt to exercise. I found that as well as halving the bolus the meal before, I need to cut my basal rate by 50-70 %, that is my temporary basal rate is running at 30-40% I don't want to have to keep supplementing with carbs. I still may supplement a bit, but I don't have to keep stopping and shoving down glucose. But I am only walking and doing some weights (a lot of hills where I live, though).

But, yes, my first few months I had loads of hypos. In the last three months I have focused on reducing the swings.

What I did was to record absolutely everything, carbs, insulin, activity, etc, on an app, and work it all out piece by piece. In fact, your control does improve week by week, so really it is worth it.