Just a plea to all you type 1s on a pump

[hodders]

Hi there
I am very lucky in that I got approval for a pump. This was fitted on Monday. Since then things have obviously become more challenging as is always the case when we begin something new.
Some history, I had good control on mdi using fiasp and treshiba but due to hypos and many lost hours sleep I got pump approval.
Back to the help me bit. Since Monday my handset for the accu chek insight has died, a new one is on its way.
I seem to have OK control during the night but my day time readings are generally in the high teens - yikes!
For breakfast I had my usual apple, cheese and nuts. Bolus for 1.5 units as normal BUT OF NOVO SLUGGISH with extra 1.5 as bs was 11.2. Bs is now 17.9 some 4 hrs later.
Please help. Have left message for dsn but not got back to me yet.
A massive thank you in advance.

 

[Bluey1]

It appears the carb ratio is out. Are you allowed to modify your dose? I would suggest a brisk walk should do the trick. I suspect the cheese maybe adding a delay. The pump will have a trick to deal with that, however it’s too early on your pump journey for your pump to do tricks, your DSN will sort that out for you in time. I suspect your carb ratio in the pump may need some tweaking. My pump adjusts the carb ratio for each meal. I just put in the carbs and it does the fancy math. I need much more at dinner than breakfast that I skip, I have the dawn phenomen to deal with in the morning. The pump can even deal with that so long as I go to bed and get up at the same time, which I can never manage.

 

[hodders]

Many thanks for your responses. My dsn has just called and with yours and her help things should help to improve soon.
Thank you again. It's always helpful to know that we are not alone.

 

[NicoleC1971]

Many thanks for your responses. My dsn has just called and with yours and her help things should help to improve soon.
Thank you again. It's always helpful to know that we are not alone.

Glad you are getting on track again. I've got a Roche Insight too and it takes a while to set things up e.g. I now have 2 different basal rates and once you've got the handset you can experiment with different carb/bolus ratios across the day too.
What has helped me a lot is the fsl so that I can really see what is happening to my blood glucose which is invaluable for basal rates. Are you eligible for that too? Obviously you'd still need to blood test for bolus calculation purposes (i tend not to because I am eating low carb and find the insight meter runs out of charge quickly so it's never ready to go when I am).
The other thing to do when you have unexpected highs is to change the flex and cannula to be on the safe side.

 

[hodders]

Nicole
Many thanks for response too. I have only had the Insight since Monday and have rung Roche twice with error codes that I couldn't fix. To be fair the people I spoke too were so helpful but being so new to all this, it is fair too say it has all scrambled my already baffled brain. New handset on its way.
I do use the fsl and find it invaluable. I just need to get back on track and look forward to my new pumping life.
Thank you so much for your help and support.

 

[Becca6510]

Sounds like your brekkie is a high fat meal with the cheese and the nuts. I would maybe take half upfront and extend the other half over an hour and a half and see if that stops it in it’s track.

 

[hodders]

Becca
Great advice, all part of the learning curve. Splitting a small dose over say an hour is nigh on impossible with mdi, but is easily doable with a pump.
Many thanks

 

[SweetSophia]

I'm kinda surprised no one mentioned the possibility that your basal rate is not well adjusted to your needs. Carb ratio usually decreases on a pump (in comparison to pens). Basal rate should be adjusted so that your bg stays flat, even if you don't eat when you're "supposed to". Of course, it's possible that both basal rate and carb ratio aren't well adjusted, but I don't think this is just a ratio problem.

 

[SweetSophia]

I'm kinda surprised no one mentioned the possibility that your basal rate is not well adjusted to your needs. Carb ratio usually decreases on a pump (in comparison to pens). Basal rate should be adjusted so that your bg stays flat, even if you don't eat when you're "supposed to". Of course, it's possible that both basal rate and carb ratio aren't well adjusted, but I don't think this is just a ratio problem.

I forgot to mention this: when I said "carb ratio decreases", I don't mean it as an actual decrease - it probably stays the same. It's the fact that, when we're on MDI, we (basically always) use part of the mealtime insulin to cover basal need that slow acting insulin couldn't cover, so we're used to taking more than we need for just food.

Hi there
I am very lucky in that I got approval for a pump. This was fitted on Monday. Since then things have obviously become more challenging as is always the case when we begin something new.
Some history, I had good control on mdi using fiasp and treshiba but due to hypos and many lost hours sleep I got pump approval.
Back to the help me bit. Since Monday my handset for the accu chek insight has died, a new one is on its way.
I seem to have OK control during the night but my day time readings are generally in the high teens - yikes!
For breakfast I had my usual apple, cheese and nuts. Bolus for 1.5 units as normal BUT OF NOVO SLUGGISH with extra 1.5 as bs was 11.2. Bs is now 17.9 some 4 hrs later.
Please help. Have left message for dsn but not got back to me yet.
A massive thank you in advance.

 

[hodders]

Hi all.
Many thanks to everyone for their help and advice. Things are settling down and with my new handset set up and a visit with my dsn today. I am getting used to the different regime and living my pump.