Remembering to bolus / test

[rhiannab13]

Hi all,

I am on an insulin pump and have increasing been having trouble remembering to test / bolus / change sets at the right times.

What I'm wondering is what techniques you all use to remember to test and bolus etc.?

I would love to just be able to remember but it just isn't working for me right now. So far I've tried setting alarms directly on the pump and I carry my blood testing kit with me when I go to lunch (and still manage to forget when its on the table right in front of me)

Any suggestions appreciated.

 

[Juicyj]

Hello @rhiannab13 I have to admit it's an auto response to bolus on my pump, so literally as i think about what i'm going to eat then I tell my pump and do the bolus, you need to be thinking ok so carbs are going in I need to match the bolus and do it. In regards to changing my set I do it when the alarm goes off, not always as it could be the next day but I know I have to do it as generally the units left are in red but it's always within a day of the alarm going off, my set changes are every 2 days, and I am pretty thorough in doing it as I don't want to run high so try to stay on top of doing it within 3 days max.

If you're busy or got alot going on then can you write yourself a note or message on your hand to remind you ?

 

[catapillar]

I don't really struggle to remember to test and bolus. It's fairly automatic nowadays - it's built in, before I eat, I have to bolus and the pump asks me to test before I bolus. It's pretty difficult for me to get away from the pump, or at least too far away as the cannula's quite short.

Are you really forgetting to bolus? Or are you making a concious decision not to bother. Because you have a pretty decent sized reminder, the pump, on you, all the time. Most pumps can be set to alarm reminders. Those reminders can be a prompt to test or bolus or to change set. If you google "how to set a reminder on a [use your pump name]" hopefully you'll get lots of tips on hope to set alarms on your pump.

You could set alarms to test, bolus and change set on your phone.

To make the behaviour automatic you need to make it as easy as possible for yourself. So are you the kind of person who has the same thing for breakfast everyday? If so, make sure you know the grams of carbs in your breakfast before you go to bed, you have your test kit on your bed side table as you go to sleep, the alarm on your phone is set with the words "test blood sugar". Then you have every thing you need to test and bolus for breakfast. Set yourself a goal to test and bolus for breakfast every day in a week. Then tests and bolus for breakfast and lunch everyday next week. Once you've done it everyday for two weeks it should be becoming habit. Once it's habit, that's the thing that makes it automatic.

Have a think about what are the things that make it hard for you at the moment. Is it knowing the carb value of your meals? You can download the app myfitnesspal and use that to carb count your meals. Is it finding time to test and bolus? If you have a spare hand and time to eat, then you have time to test and bolus. You can make it a bit easier by keeping a spare test kit in your kitchen - pop it in your cutlery drawer and that will make forgetting rather difficult. Is it finding a place to test? Are you uncomfortable having people see you testing or getting you pump out? If you're in work your work should give you somewhere like the first aid room or just a quiet room to test if you ask, but remember that no one will notice you testing, it's a tiny little thing and no one will see it, you can quite happily do it anywhere, surrounded by people without anyone giving you a second glance.

I'm not very good at changing my set every 3 days, I tend to just let it run until the reservoir runs out. I'm on about 30 units a day, filling the tube and cannula is about 10 units so a 180u reservoir lasts about 5 days. It's not recommended. If I notice problems with insulin working on day 4 or 5, I'll change the set but that doesn't happen very often. I don't have problems with my cannula site healing. So I'm not particularly motivated to change site more frequently. It's not recommended, but it's not doing me any harm. I'm not forgetting to change sites, I make the concious decision not to.

 

[noblehead]

What I'm wondering is what techniques you all use to remember to test and bolus etc.?

It's just force of habit to test and bolus, just the same as it was on MDI really, so no technique as such.

As for set change, my pump (Omnipod) has a built-in alarm which alerts you when the Pod is due to expire.

 

[Snapsy]

@rhiannab13 my pump has various alarms that can be set. And I LOVE post-it notes for reminding me to do stuff in all the other aspects of my life - Chateau Snaps has a veritable rash of them all over the place, much to Mr S's (minimalist) dismay....

But I am a little sad to report that I have absolutely no problem knowing that I need to test or bolus. In fact I admit - here goes - that in my day-to-day life, my diabetes management is the most prominent thing I think about.

There. I've said it out loud. But then I've been living with my diabetes for three times longer than the decade I lived without it. It's all now rather deeply ingrained.

Set some reminders. Get into the habit. You'll get there, I'm sure.

Love Snapsy

 

[tim2000s]

Hi @rhiannab13 - what you describe is often linked to burnout and diabetes distress, and is something worth raising with your diabetes team, as these are both recognised issues that people with diabetes of all types face.

 

[slip]

I just don't get how a T1D can 'forget' to test and bolus pre-meal Having said that I'm sure there's 101 things that can lead to this if you think about it, as Tim says burnout could be the cause, but is it more the uncomfortable embarrassing feeling of doing what's necessary in front of people? or the hassle of getting your kit out and going through the rigmarole when you just want to eat?

Did you have the issue when you were on MDI?

As for set changes I've no idea as I don't pump but I like the thought of having the reservoir lasting the 2-3 days so you can do a change and fill up all at the same time.

 

[Bopps]

I am having this trouble too (for me it has been burnout). I'm trying to find a goal to work towards to help me get back on track, that's my only solution so far. Hoping it will work. Really happy to hear all and any suggestions for moving onwards from burnout and for me what has turned into chronic forgetfulness (I can literally not think about my diabetes for half a day some days)!! Thank you all for this forum thread.

 

[jasmine1616]

If you have a phone, use it to your advantage! Set your alarms for every four hours to help you remember to check your glucose. To help you remember to change your pump site, it depends on what kind of insulin pump you have, so I'm not sure how to help you with that. I have a Tandem G4, and whenever I change my pump site, it has a setting where I can choose when I would like to change my next pump site (in 1-3 days of course). To help you remember to bolus, I always bolus before I eat, so when ever you get something to, bolus before you take that first bite!

Hope this helps!

 

[Deleted Account]

I think of bolusing in the same way as cleaning my teeth. I can't imagine not doing it. Do you clean your teeth every morning and night? If so, how do you remember to do it?
Testing is a different matter. I usually do it but I am much more likely to do it when I am alone as it is a faff and not as easy to prick your finger discretely. To try and make up for that, I take more readings when am I alone and give myself correction doses. Not perfect but, I like to think, it is pragmatic.
As for changing sets, that one is easy for me: after 3 days, it itches so much I have no choice. If you are lucky to be less sensitive than me, the only thing I can suggest is to make it part of your weekly schedule. If you wash your hair every third day, remove your cannula In the shower just before your wash your hair; if you always do your ironing on a Sunday, keep some set changes near your iron; if you always do the weekly shop on Thursday, put some more set changes with your shopping bags; ... you get the idea.

 

[Chas C]

I change cannula every two days and the tubing with every cartridge, so with the Insight roughly when my cartridge looks half empty then its time to change the cannula, then when its empty and I add a new cartridge I use a new cannula and tubing. Its not perfect as if you have high insulin days then the changes might be a bit early but it works for me.

I had a much harder time with the Combo as its cartridge lasted me about 6 days so remembering make changes when it was third and two thirds empty was more complicated.

I'd tried the alarms but this did not work for me.

As already mentioned if your missing bolusing for meals then please take some time to talk to your consultant.