Type two wanting insulin pump

[shezza48]

Hi I’m a type two, diagnosed in 2012, I’m getting quite low blood sugars early in the morning. DSN has lowered my humulin I but with no improvement. When I was in ICU and had an insulin pump my blood sugar never changed much so I’m thinking I’m going to have to self fund a pump. If anyone has information on price etc that would be great

 

[catapillar]

@shezza48 Insulin pumps cost about £3,000 plus around £100 a month for consumables - https://www.diabetes.co.uk/insulin-pumps/buying-an-insulin-pump.html

Insulin pumps are for people using a basal bolus insulin regime, as this is what they deliver.

You aren't on a basal bolus insulin regime. You are just taking intermediate acting insulin. If that's not working for you, before considering buying a pump (which no sensible supplier would sell to someone who has no idea how to use it safely - and if you don't have experience of a basal bolus insulin regiem then you don't wont know how to use a pump safely - without confirmation they will be supported by a clinician) you'd be better off considering switching from intermediate acting insulin (which starts working 1-2hrs after injecting and carries on working for 16 hrs, so needs you to keep regular food times with regular amount of carbs) to basal bolus insulin.

 

[ringi]

@shezza48 Have you've tied any diets to control BG, also what drugs have you tried other than insulin?

Have you had a recent C-peptide test and do you know the result?

 

[shezza48]

I follow a low carb diet, I don’t think I’ve ever had a c peptide test. Catapillar, I do take insulin Bolus, I have novorapid breakfast, lunch and dinner, dose depending on what I’m eating. My insulin doses have been changed several times but I’m still not improving, I had a hypo yesterday morning and then another at lunch time. I’ve had another one today. Currently blood sugar is reading 4.7 I’m self funding a Dexcom, I’ve eaten about 30g carbs. Taken my insulin but I can’t get it to go up and stay up.

 

[tobyduke]

Have a look at the Cellnovo pump

 

[Jaylee]

Hi @shezza48 ,

Welcome to the forum.

I don't pump. But what I am seeing is an issue with the current prescribed insulin dosage coupled with a low carb diet...

Unfortunately, this is also a little difficult to work out exactly what's going on regarding other aspects of your lifestyle.?
Also we can't prescribe medications for you on this forum. This is down to your HCPs.

The good news is, you appear to have a CGM to monitor your blood sugars.
You need to keep a log of exsactly what you eat, along with the timing of insulin dosage & BS. This will help your health care professionals, help you.

How low are you going with the hypos?

 

[shezza48]

Sometimes the hypos go as low as two or three, usually they are about four. When I had my pulmonary embolism and was in ICU I was on pumped insulin, four units of I think it was humulog every hour and my blood sugars stayed between seven and eight, didn’t change much even after food, as soon as they took me off pumped insulin is when levels started to go off. I’ve not had a hypo yet today, had three yesterday. I’m seeing DSN on February 15th, she did say in last phone call (I have one a week) she was going to change my insulin I think to lantus. I’ve lowered my evening humulin I dose but still have hypos, really awkward when I’m at my mums because I have to contend with stairs to go get my Mum to get my hypo kit, mums bedroom is at top of stairs and I get really shaky when I have a hypo so I’ve on many an occasion nearly fell down them.

 

[Diakat]

Why are you not keeping a hypo kit with you if this is happening regularly? How old are you, getting your mum to look after it?

 

[shezza48]

Diakat, Mum looks after my hypo kit at the moment because I have a frozen shoulder and can only use one arm, I can’t open gluco juice on my own. She’s helping me with all my medication till I have my physio

 

[donnellysdogs]

It is important if you are experiencing 3 hypo's a day to have a hypo kit close to hand... even if it means wearing a bumbag all day...

A bottle of glucojuice is not medications as such and you should have someting in a kitchen cupboard... bottom cupboard if necessary..

You will not get a pump given to you unless you have gone through triallung different insulins first.

Being on a drip in hospital is different to a pump at home. On the sliding scale system in hospital they can adjust both insulin and add glucose as necessary through the system too. You do not get that on a pump at home. You also have to set the pump up and manage it on a daily basis after training and be able to manage hourly basal rate changes and adjustments such as a temporary basal rate or perecentage changes for exercise, illness, stress etc.
It is very, very different to being in a hospital....
The hospital would not be checking your bloods as offen as basal testing is needed on a pump for setting up. There is a huge difference.

Depending on you timings of these hypos it needs to be established whether it is yoyr basal or bolus or both that is incorrect. You need to learn how to manage this yourself otherwise you will never get a pump... you have to have a complete knowledge of basal/bolys regime/carbs/foods/effects before consideration is normally given for a T1... T2 and it is likely to be harder to get one.

 

[paulus1]

if your getting that many hypos a day you urgently need a review. i would stop low carbing just for now. get the issue sorted and then re start. have you adjusted your insulin to cope with your lower carb load. its amazing the reduction a low carb diet can do. i really doubt your going to get a pump. i dropped 69 units and stopped my insulin on low carb its very important to adapt to your bg figures.

 

[Shiba Park]

if your getting that many hypos a day you urgently need a review. i would stop low carbing just for now. get the issue sorted and then re start. have you adjusted your insulin to cope with your lower carb load. its amazing the reduction a low carb diet can do. i really doubt your going to get a pump. i dropped 69 units and stopped my insulin on low carb its very important to adapt to your bg figures.

Another thing to bear in mind when you're on insulin - and it's counter-intuitive for most T2's - is you MUST eat enough carbs to keep you liver fully charged to take care of you. If you're having 3 typos a day you are certainly not giving your liver a chance to build up stores to smooth out the lows.

As others have said, it sounds like you need to allow your body to recover an recharge after these typos and then work on getting your basal rate right then work on your insulin:carbs ratio(s).

Regards.

 

[shezza48]

Yeah had all my insulin changed several times, doses adjusted, had metformin raised then lowered then raised again, been put on gliclazide then taken off it, been put on byetta then taken off it, had insulin changed recently, tried a low carb diet, tried the dash diet, I check my insulin carb ratio every time I eat and adjust novorapid accordingly. When I was in hospital I had an arterial line bloods were checked every hour. It’s only this last six months since I’ve had eight flare ups of pancreatitis that the problem with hypos has occurred. I see my DSN on February 15th, she’s going to look at changing my insulin again,

 

[donnellysdogs]

One thing springs to mind ref the care you are getting...

Only ine thing with insulin/ meds should be changed at a time.. not everything. Otherwiise nithing can be established as the cause or the problem.....
Even altering a dose of a single insulin... it should be one insulin alteration... ie basal before altering the bolus's.

Altering all meds at once, well it jyst creates chaos..

 

[Olufisayo]

@shezza48 Insulin pumps cost about £3,000 plus around £100 a month for consumables - https://www.diabetes.co.uk/insulin-pumps/buying-an-insulin-pump.html

Insulin pumps are for people using a basal bolus insulin regime, as this is what they deliver.

You aren't on a basal bolus insulin regime. You are just taking intermediate acting insulin. If that's not working for you, before considering buying a pump (which no sensible supplier would sell to someone who has no idea how to use it safely - and if you don't have experience of a basal bolus insulin regiem then you don't wont know how to use a pump safely - without confirmation they will be supported by a clinician) you'd be better off considering switching from intermediate acting insulin (which starts working 1-2hrs after injecting and carries on working for 16 hrs, so needs you to keep regular food times with regular amount of carbs) to basal bolus insulin.

Basal bolus insulin regime! I must confess I don’t understand many of these terms.

 

[paulus1]

are you sure your type 2 the pancreatitis attacks could now mean your type 3 and why you diabetes is now different. if it is so your treatment will be based on insulin.has this been investigated.

 

[Juicyj]

Basal bolus insulin regime! I must confess I don’t understand many of these terms.

Hello Olufisayo - this term is relevant if you are taking insulin as these are necessary insulins required to manage blood glucose, as your on tablets then it should only be something that you are aware of unless this changes and then you will need to be educated further.

 

[shezza48]

No my diabetes has not been investigated since I had pancreatitis, I’ve had it now eight times within six months.

 

[ringi]

It possible that the pancreatitis is resulting in your body making very little insulin some days, and a lot other days.

If so, a pump linked to a CGM so that the insulin is stopped whenever your body makes some may be of great benefit. Personly I think the first step is to get a CGM recording what your BG is doing, along with high-quality records of all meals/drinks plus your insulin doeses.

But to get anywhere, you need to stop talking about Type2 and talk about pancreatitis and get a consultant to say if you have Type3. (Pumps just don't make sense for Type2.)

 

[Olufisayo]

Hello Olufisayo - this term is relevant if you are taking insulin as these are necessary insulins required to manage blood glucose, as your on tablets then it should only be something that you are aware of unless this changes and then you will need to be educated further.

Appreciation!