Pumps reducing daily insulin dose?

PepperTed

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Type of diabetes
Type 1
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I'd love to hear people's experiences of how their dosage changed when they moved to a pump.

I've been on multiple daily injections since I was diagnosed in 1999. I've always needed more insulin than most type 1s seem to, although my team have decided I don't have type 2 as well and metformin had no effect. But I am now on really huge amounts of insulin... 200 units a day is not unusual. Because I have so much insulin I am constantly hungry and I'm now seriously overweight. When I reduce my insulin intake the hunger disappears and I can eat normal portions and feel satisfied, but of course my blood glucose skyrockets, I feel miserable and ill, and it's not a long-term solution.

The main reason for getting the pump is that I have a horrible dawn phenomenon, wake up with BG 13+ every morning and feel like **** until at least 20 units of corrective doses later. But, although they haven't said it, I think my team are also hoping it will help me lose weight. I hope this too, of course!

So am I building my hopes up for nothing, or is it really likely that I will be able to reduce my intake on a pump?
 

himtoo

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why can't everyone get on........
Hi pepper Ted
first a welcome !!

that is a lot of insulin.
i am waiting to go on a pump myself right now and have been keeping food and medication diaries for the past 6 weeks.
everything i have read and reading other peoples experience suggests TDD ( Total daily Dose) does decrease on a pump.
 

ElyDave

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2,087
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Mine has gone down by about 50%. it was always quite low anyway as I am quite insulin sensitive, possibly also still having some honeymoon effects.

Not sure if you'd get quite the same degree of reduction from such a high starting point.
 
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Nyadach

Member
Messages
15
Type of diabetes
Type 1
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Pump
Mine came down from about 34u a day to 16u now. Although on very active all day exercise days can tweak that down further (lowest so far was 4.2u TDD). So yeah, well under half what I used to be on which is great...but even better not having a hypo I haven't corrected myself since I got it :)
 

Alzibiff

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76
Type of diabetes
Type 1
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Pump
My TDD went down by around 33%. Lost a stone and a half too within 18 months of switching to a pump without trying and that was after 40+ years on MDI. Happy days!

Alan
 

Spiker

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My TDD stayed about the same but my average BG got much better. So in other words I wasn't using enough insulin before the pump. In effect that means my insulin requirements came down.
 

niknak15

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Messages
75
I'm just coming to the end of a 6 month trial, have dropped by about 50% also, but also have better control, also had DP which hasn't occurred in a long time since going on a pump and I feel fantastic, canulating still scares me but have a dramatic improved in daily bg's, got my first hba1c since starting on the pump next week :)
 

PepperTed

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Messages
104
Type of diabetes
Type 1
Treatment type
Pump
@niknak15 (or anybody else who knows) : What's 'DP' ?

Alan[/USER]

Dawn phenomenon, where the liver causes blood glucose levels rise early in the morning. I hope I can get mine under control, it's horrible waking up every morning feeling rubbish from high BG :(
 

niknak15

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75
Once my basal rates and eve bolous were correct it stopped, you will get there, the pump requires a lot of hard work but the blood and sore fingers are so worth it!! Good luck x
 
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Jemzor

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Type of diabetes
Type 1
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Insulin
Hi @PepperTed. I used to be on about 40% more insulin back in August 2013 (the point where I said enough was enough) when I pretty much underwent a complete change in lifestyle - nutrition and exercise. But even with the higher insulin doses, my BG levels were still reading high and I found myself correcting a lot more and chasing the right levels from the outset. When I reduced the insulin levels, my BG levels also reduced. But I was clearly on a slippery slope when I thought I needed to increase insulin to reduce BG levels when actually it needed basal and CP ratio adjustment. I now weigh 20% less than I did.

All this was with MDI and I am still on this. I will be moving onto a pump very soon as HbA1C and hypos are still problematic and I suspect at this stage that the insulin levels will go down even further.
 
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noblehead

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Hi @PepperTedAll this was with MDI and I am still on this. I will be moving onto a pump very soon as HbA1C and hypos are still problematic and I suspect at this stage that the insulin levels will go down even further.


Reading the books Think like a Pancreas and Pumping Insulin both authors say that on average a persons basal needs drop by around 20% when changing from MDI to a insulin pump.
 

Jemzor

Well-Known Member
Messages
71
Type of diabetes
Type 1
Treatment type
Insulin
Just on MDI's, my lantus went from 24u to 16u (so 33% reduction). Looking forward to the prospect of an evern lower basal.

No doubt the difference in insulin profiles for different types of insulin will also impact on the extent of drops.
 

kitty55

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158
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I have started on a pump last summer and am now on slightly less than 50% of total daily insulin than I was before on MDI. Whereas now I sometimes have only 24.50u total daily (basal+bolus) I was on 40u basal daily before and all my bolus came on top on it. So I do need loads less:)
 
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PepperTed

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Messages
104
Type of diabetes
Type 1
Treatment type
Pump
I've just had a look at my TDDs. I'm currently on 100u a day average, which for me is a massive reduction! This will increase in the coming weeks because I am still running high, but then I'm hoping it will come down again if I can lose some weight. So it's looking really positive for me.
 

dtennant9

Well-Known Member
Messages
714
Type of diabetes
Type 1
Treatment type
Insulin
My TDD has stayed much the same so far but it still needs refined yet. I'm surrently on correction doses quite alot, but would take a correction dose on the pump at times I wouldn't have done with MDI.
My DSN also thinks that my balance of Basal/Bolus is out, she reckons I need more Basal.