Pump approved

[lely]

Never took any Tresiba in the end, blood sugar was okish at 8.5 this morning

Back home now with the pump fitted

How did you find it all Gaz-M

 

[Gaz-M]

it was a very intense 2 hours lely but very interesting kind of went by in a blur but once home and had a play about with it I remembered it all

My DSN has gave me an ACCU-CHEK smart pix for the pc, I login to diasend and connect the meter via USB cable and I can send the data from the pump to her at the hospital (which I think is a great idea).

Not had anything to eat yet so will see what my BS is like after my tea later today, I did give a correction bolus at the hospital and from there my BS has been around 6.2/6.4.

How did yours go?

 

[lely]

It Was good. I've practiced with another inset to see if I remembered that, no problems.
But it'll be interesting to see how I go with the cartridge when that needs changing. I was done and home by lunch time so had my lunch and bolused for it was 5.6 and then 10.4 after 2 hours. I'm eager to see my morning BG to see if there basal is anywhere near right.
The supplies take up a fair bit of room don't they.

 

[yingtong]

Good luck to you both,don't expect miracles,it takes a while to get sorted.

 

[Gaz-M]

sounds like second nature to you lely and yeah the supplies are mad hahaha (going to have to put a shelf in the bedroom cupboard I think)

I dropped down to 3.9 at 4.15 so not a good start and the basal settings for me are higher during the night so doubt I'll be having much sleep for the next couple of nights

Thanyou @yingtong

 

[irrationalJohn]

I dropped down to 3.9 at 4.15 so not a good start and the basal settings for me are higher during the night so doubt I'll be having much sleep for the next couple of nights

If you aren't comfortable with adjusting (lowering) your actual pump basal settings but instead want your DSN or equivalent to do all the actually mucking about with settings, then I suggest you use the temp basal feature to lower your basals during the night. If you temp basal at 75% or 50% or whatever sounds right from your previous life, then you limit your risk of a hypo during the night, no?

I only mention it because while people sometimes are squeamish about changing their actual pump settings, they seem to view the "temp basal" feature more in the "user controlled" category. I guess it feels more like the food or correction bolus operation. And since the temp bolus "vanishes" after you either cancel it or it times out, you can say with a straight face to whomever might ask that you didn't change anything.

 

[Gaz-M]

I think I have probably still got some Tresiba in my system right now, I have taken a week off work to get this sorted out so will test every 2 hours tonight and again either tomorrow or Wednesday and then send the results to my DSN on Thursday morning but I understand what you are saying @irrationalJohn, I knew I was not going to be in for an easy change over and thats why I chose to take a week off from work, but thankyou for the reply

 

[tim2000s]

Hi Gaz, when I went on to the pump I did it myself and used the pumping insulin ratios to work out what my basal rate should be.

It proved to be too high and I adjusted it down from there based on how hard it was pushing me down.

I don't know how confident you are about making change, but I wouldn't settle for a basal rate that I knew was making me low.

The ball is, however, in your court.

 

[Gaz-M]

cheers @tim2000s, I am confident enough and the Accu-Chek Rep was impressed with all the reading that I had done on the pump, Iam not sure how many have came off Tresiba and onto a pump but I bet its only a few on here and that is why I want to test throughout the night to help if possible others in the future, today we only set up basic settings no temp basals etc but I know how to do that. I am on the same basal settings as I was on Tresiba and a little lower settings during the day/evening with carb ratio's.

This afternoon i never ate so it was either the left overs of the old insulin or the settings in the time block that was wrong but tomorrow I will get a clearer picture (I hope).

All the replies are really helping and I thankyou all for them

Top people

 

[iHs]

@Gaz-M and @lely ......take it easy a bit with the desire to get basal rates sorted esp because of the background insulin from pens phasing out and you don't want to look like death warmed up because of hardly getting any sleep due to bg testing every night so basal test one night and then make some adjustments and if necessary, eat some carb so that you can sleep ok the following night and then do a bit of bg testing the night after. Slowly, you will get there over a week so walk, don't run unless you are confident. The basal need for insulin will change a bit anyway over time so unfortunately, it won't stay static for weeks so dont be too tight with the bg target you want too soon.

 

[lely]

So first night sleeping with my pump, I think I need to give it a name if we are gonna be this intimate, I woke a few times to check it was were I put it. It was. Anyway. Bedtime BG was 13.4 had 16g carbs and bolus for that including the correction dose woke on 9.8. So my question is. can I adjust basal straight away, I'm on a flat rate for now, 21u over 24h 0.875per hour. can I adjust to say 22u over 24 or is it like MDI when you should wait for 2/3 days to see if there's a pattern. Or shall I take this as an opportunity to see this as a separate increment that needs just a bit more for overnight.
Thanks in advance for any help.

 

[tim2000s]

So first night sleeping with my pump, I think I need to give it a name if we are gonna be this intimate, I woke a few times to check it was were I put it. It was. Anyway. Bedtime BG was 13.4 had 16g carbs and bolus for that including the correction dose woke on 9.8. So my question is. can I adjust basal straight away, I'm on a flat rate for now, 21u over 24h 0.875per hour. can I adjust to say 22u over 24 or is it like MDI when you should wait for 2/3 days to see if there's a pattern. Or shall I take this as an opportunity to see this as a separate increment that needs just a bit more for overnight.
Thanks in advance for any help.

With all of these things, it's always worth making sure you have a pattern before adopting a change. I've found that 24 hour Novorapid results in a slightly different insulin use profile from Levemir, so I'd recommend taking a few days to identify patterns during the same period.

The changes with a fast acting insulin take effect within a couple of hours, but it's not a pattern unless it is repeated more than twice in the same way!

 

[iHs]

@lely

Unfortunately, probably none of the pump settings will be correct at the moment and until you are able to get the TDD okish, then the correction dose will be a bit hit and miss and the carb ratio might not be correct either, but no one can be expected to get perfect results just like that.....it takes time. Like MDI, it's a mistake to eat food when bg is high even with a correction dose and normal bolus dose. Instead, deliver the correction dose and then wait 1 or 2hrs for the dose to start lowering bg back to single figures again and then do bolus for food. Has the carb ratio on pump changed from what you used on MDI?

 

[lely]

@lely

Unfortunately, probably none of the pump settings will be correct at the moment and until you are able to get the TDD okish, then the correction dose will be a bit hit and miss and the carb ratio might not be correct either, but no one can be expected to get perfect results just like that.....it takes time. Like MDI, it's a mistake to eat food when bg is high even with a correction dose and normal bolus dose. Instead, deliver the correction dose and then wait 1 or 2hrs for the dose to start lowering bg back to single figures again and then do bolus for food. Has the carb ratio on pump changed from what you used on MDI?

My carb ratio hasn't changed from MDI. it's 1:10. However when i did the calculation for it from the ' think like a pancreas ' book it worked out 1:11 so I figured I use that later as a fine tuner once I'm confident with the pump. So it's a good idea to get that fasting BG in the morning right first then?

 

[noblehead]

@lely, absolutely you should work on getting your night-time/fasting bg levels sorted first, for most people this represents a good third of our day and can make a huge difference to your overall diabetes control, plus there's nothing worse than starting the day high and having to do correction doses.

Have a look at the following, it's for pump users and explains how to do a basal test in different time-frames:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

 

[lely]

You always have the best info and advice. Thank you.

 

[iHs]

If you want to test yr nightime basals, try to get yr bg ok before going to bed so if necessary give a bit more bolus with eve meal and make sure that you wait about 5hrs before you start the test otherwise the basal adjustment won't be quite correct and you'll end up needing to change the basals again from when you started the test because the basal might not be correct for the eve meal time period so you will get an overlap as you go around the clock.

 

[Gaz-M]

I've had to change alot of my time block dosage amounts and 1 ratio today after spending most of yesterday/last night hypo and woke up with a 1.9 BG took what was needed and it stabled itself out until 1 pm (I must have nodded off around 12 midday with being awake most the night) woke up at 1.6 , this low has again carried on most the day, been on the phone with my DSN alot throughout today and we made the changes so will see what tonight brings

 

[tim2000s]

I did that in my first 24 hours @Gaz-M. Could have happened to anyone!

 

[Gaz-M]

I did that in my first 24 hours @Gaz-M. Could have happened to anyone!

I find it odd as some of my ratio's had already been reduced, maybe my body getting used to not have any "long acting insulin" in it perhaps?