New Pump and Ratios

[ReaL]

Hi

I am getting a pump at the end of August and wonder how critical it is that your Insulin to Carb ratios are accurate. I have a rough idea but get varying results depending on how active I am etc (like everyone) and tend to keep an eye with libre and just correct if necessary. Should I spend some time in the coming weeks trying to tie down my ratios more accurately or will this be superseded by the fact that I won’t be doing basal injections and ratios may change because of this anyway. Hope this makes sense and thanks in advance.
Rhona

 

[Finnlee]

Hi

I am getting a pump at the end of August and wonder how critical it is that your Insulin to Carb ratios are accurate. I have a rough idea but get varying results depending on how active I am etc (like everyone) and tend to keep an eye with libre and just correct if necessary. Should I spend some time in the coming weeks trying to tie down my ratios more accurately or will this be superseded by the fact that I won’t be doing basal injections and ratios may change because of this anyway. Hope this makes sense and thanks in advance.
Rhona

The very first thing my team had me do when I got a pump was basal testing. After my basal rates were set, I worked out my mealtime ratios. Both my basal TDD and bolus ratios were different on a pump than on MDI (I need less insulin overall on a pump).

Both basal and bolus are important, but basal rates really need to be nailed down first.

I think some pumps try and work out your basal needs. I have the Tandem t:slim so I can program my profiles (both basal and bolus) for different situations (activity levels, monthly cycle, etc).

 

[ElenaP]

Hi

I am getting a pump at the end of August and wonder how critical it is that your Insulin to Carb ratios are accurate. I have a rough idea but get varying results depending on how active I am etc (like everyone) and tend to keep an eye with libre and just correct if necessary. Should I spend some time in the coming weeks trying to tie down my ratios more accurately or will this be superseded by the fact that I won’t be doing basal injections and ratios may change because of this anyway. Hope this makes sense and thanks in advance.
Rhona

When you have the appointment to collect your pump, the DSN will input your hourly basal rates into the pump, but for food bolus you use your normal ratios. Of course the pump uses one type of insulin only, i.e. the fast acting one, hence the hourly rates (that replace the basal insulin) need to be as accurate as possible (but they can be adjusted later on). If I remember correctly, they calculated the amount of Tresiba I had used per 24hrs. I had supplied them with my fasting blood glucose numbers over three different 24-hr periods, but separate 6/12-hr tastings will also work. The DSNs already knew the bolus ratios that I used for different meals. Be prepared for a long appointment because it takes the DSN some time to insert figures manually. But you will have follow-up appointments with DSNs, so don't worry too much.