help please?

[lely]

How did you get on over night @Type1Lad, hope you got some sleep and no major lows.

 

[CarbsRok]

You need to reduce todays rates at least 2 hours before you hypoed yesterday. There is no point in reducing when you have the hypo as that's not the time slot causing the problem.
This is only a rough guide as obviously everyone is different but 0.050 reduction will drop you by about 3 points.

 

[Chas C]

I make my adjustments 2 hrs prior to the need, guess it varies from person to person.

 

[Type1Lad]

Hey guys all my rates were a bit over the place so today at hospital i'm 71% in range the rest are lows or a little high, they have set me up with a new profile that if it was added to the old one it be -30% >.<

anyway they told me if i go high to go to the +10% profile

I also dropped in hospital and forgot my strips and run out of lancest in my click pen

 

[donnellysdogs]

Hey guys all my rates were a bit over the place so today at hospital i'm 71% in range the rest are lows or a little high, they have set me up with a new profile that if it was added to the old one it be -30% >.<

anyway they told me if i go high to go to the +10% profile

I also dropped in hospital and forgot my strips and run out of lancest in my click pen

If you can go 5 hours inbetween meals..and you are going low2-3 hours after meals then this would actually indicate the bolus giving a bit much.
Have you been advised to try and keep 5 hours between meals and to test 2 hours after?

Also... If say you are 7.1 at 4pm (no food) and 3.7 at 5.20pm what basals would you be changing?

I personally don't think you are altering the basals yourself and relying upon the nurses etc to look at basal rates etc....switching a tbr on is not going to give a good clue as to anything... And won't give you readings to go by...

Far better to treat hypo's, analyse nd have confidence to change rates. You can easily set the insight to 1/4ly rates if needed but to me changing a whole profile over by 30%???? is odd.... I suppose in one way at least you will be out of hypo land...

 

[Type1Lad]

If you can go 5 hours inbetween meals..and you are going low2-3 hours after meals then this would actually indicate the bolus giving a bit much.
Have you been advised to try and keep 5 hours between meals and to test 2 hours after?

Also... If say you are 7.1 at 4pm (no food) and 3.7 at 5.20pm what basals would you be changing?

I personally don't think you are altering the basals yourself and relying upon the nurses etc to look at basal rates etc....switching a tbr on is not going to give a good clue as to anything... And won't give you readings to go by...

Far better to treat hypo's, analyse nd have confidence to change rates. You can easily set the insight to 1/4ly rates if needed but to me changing a whole profile over by 30%???? is odd.... I suppose in one way at least you will be out of hypo land...

im new to the pump this is my first ever pump, i've got confidence in changing rates myself but the nurses advised me not to as of yet until we get some picture :]

 

[Type1Lad]

If you can go 5 hours inbetween meals..and you are going low2-3 hours after meals then this would actually indicate the bolus giving a bit much.
Have you been advised to try and keep 5 hours between meals and to test 2 hours after?

Also... If say you are 7.1 at 4pm (no food) and 3.7 at 5.20pm what basals would you be changing?

I personally don't think you are altering the basals yourself and relying upon the nurses etc to look at basal rates etc....switching a tbr on is not going to give a good clue as to anything... And won't give you readings to go by...

Far better to treat hypo's, analyse nd have confidence to change rates. You can easily set the insight to 1/4ly rates if needed but to me changing a whole profile over by 30%???? is odd.... I suppose in one way at least you will be out of hypo land...

no food all day? or just at that time? if its that time u would lower doses 2 hours be4, so 2pm and 3pm 3.7 a hour and 20 mins after eating was your carb ratio right or maybe just over esitmed i'd check to see if i could see if its pattern then maybe change my carb ratio for that time or add a new time block for that time.

 

[donnellysdogs]

Ok.. My consultant recommended to keep meals 5 hours apart... Ie 8pm, 1pm, 6pm..... (For me this didn't suit-but that's me).. It is actually a good idea. Try to keep food 5 hours apart.... Then in that scenario it would be easier to think that bolus affect would be most active between 3-4pm....initially to just try and have 3 meals, no snacks unless hypo....

Using the above scenario it would be the basals to look at, just as you say...

How have your levels been since the new rate was started?

Hopefully you will be out of low levels?

Incidentally are your bolus totals for a day and your basal totals for a day generally working out at the same quantity?? Ie 50/50 ratio?

 

[Type1Lad]

Ok.. My consultant recommended to keep meals 5 hours apart... Ie 8pm, 1pm, 6pm..... (For me this didn't suit-but that's me).. It is actually a good idea. Try to keep food 5 hours apart.... Then in that scenario it would be easier to think that bolus affect would be most active between 3-4pm....initially to just try and have 3 meals, no snacks unless hypo....

Using the above scenario it would be the basals to look at, just as you say...

How have your levels been since the new rate was started?

Hopefully you will be out of low levels?

Incidentally are your bolus totals for a day and your basal totals for a day generally working out at the same quantity?? Ie 50/50 ratio?

its not 50/50 now it was be4 but it's not now. may have to change my time block 1:8 to 1:9 as i had a hypo an hour and a half after eating, i didn't have a hypo throughout the night and woke up on 5.3, i'm feeling much better now

 

[lely]

If you can go 5 hours inbetween meals..and you are going low2-3 hours after meals then this would actually indicate the bolus giving a bit much.
Have you been advised to try and keep 5 hours between meals and to test 2 hours after?

Also... If say you are 7.1 at 4pm (no food) and 3.7 at 5.20pm what basals would you be changing?

I personally don't think you are altering the basals yourself and relying upon the nurses etc to look at basal rates etc....switching a tbr on is not going to give a good clue as to anything... And won't give you readings to go by...

Far better to treat hypo's, analyse nd have confidence to change rates. You can easily set the insight to 1/4ly rates if needed but to me changing a whole profile over by 30%???? is odd.... I suppose in one way at least you will be out of hypo land...

I was happy to read this @donnellysdogs. I've just had 2 days of hypos and I have now come to the conclusion that it's my bolus that is wrong. I wonder if you could be a little more help and tell me, in theory if my ISF is set wrong too will this affect the pumps bolus calculation against carb ratio or does the pump only take this into account for bolus taken with BG entry. I hope I explained that correct!

 

[donnellysdogs]

I was happy to read this @donnellysdogs. I've just had 2 days of hypos and I have now come to the conclusion that it's my bolus that is wrong. I wonder if you could be a little more help and tell me, in theory if my ISF is set wrong too will this affect the pumps bolus calculation against carb ratio or does the pump only take this into account for bolus taken with BG entry. I hope I explained that correct!

For ISF it depends exactly what you are talking about to be honest.

Ie with Insight and Combo pumps from Accuchek they have an offset time and acting time which can also impact on how and when you get your bolus's as a whole... Ie... If your machine is set up say with an acting time of 4hrs and your insulin actually affects you for 5hours then it would be offering corrections too quickly....

You have ISF set up really for correction bolus's... But again the machines have the algorythims to work out against even how long your insulin lasts for and how quickly it starts to work so that is also another factor that needs to be considered.

I used to work out my acting time by allowing myself to get up to 10.0. Intentionally.... Then I would do a correction only bolus and keep testing every hour...(or more) for 5 hours without any more insulin given at all besides the basal. I could then determine how long insulin lasted and if my correction factor was correct. If it was correct my machine would get me to normal readings at 5 hours..

I was always told (and proved) that if normal 2hrs after a correction then I would be low between 3 and 5 hours.. The aim being to be at target level at 5 hours after a correction.

Also, my body if above 12.0 always needed extra correction bolus to be given..

Hope you can fathom my meaning out!!-lol..

 

[misswhiplash]

To be clear you have gone -80% not just 80% coz that would be more.

Not necessarily - some pumps (mine included - Omnipod) tell you what you're getting, not the reduction, so when yours would say -20%, mine would say 80%...

 

[noblehead]

Not necessarily - some pumps (mine included - Omnipod) tell you what you're getting, not the reduction, so when yours would say -20%, mine would say 80%...

No the Omnipod does show +/- @misswhiplash, it shows on the home-screen if you were using a -80% or +80% TBR.

 

[lely]

@donnellysdogs thanks for that explanation, it did take me about 5 read thoughs to understand all of it. Still getting my head round all the ways to test, basal, bolus, carb ratio and ISF. The 'think like a pancreas' book does explain it all too. And the ' pumping insulin' one but I find that a little harder to follow the explanations. I'm still concentrateing on getting basals right so I'm only adjusting carb ratio,and ISF if I'm having major difference between meals so all that is gonna need fine tuning. As long as I'm not having hypos and my bg are below 10, which they have been I'm happy. thanks for all the help. Gotta love these threads. Would be completely overwhelmed without all the info.

 

[donnellysdogs]

There is a lot to take on board, but it is best to change one thing at a time. Then you know whether that one change has worked or not... Rather than trying to think what may not have worked from many changes!!!

You'll get there.

 

[misswhiplash]

No the Omnipod does show +/- @misswhiplash, it shows on the home-screen if you were using a -80% or +80% TBR.

Oh yes - you're right - I meant to say this the other way round