Weight gain on pump

bridkid_74

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Hi i started on pump in September after being on mdi for 39yrs. Ive had ups and downs with it and im still not sure if its for me. The reason ive come on the forum is that I've put on 8 lbs since starting pump. Its the only thing that's altered I've not changed what I eat. Theres days when ive had huge amounts of insulin as corrections or tbr. Im still doing lots of "tweaking" Am i alone in this?! Restarted weight watchers last night as really not happy with this weight gain
 

tim2000s

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How does the amount of insulin you are using compare with when you were on MDI? What have you seen in terms of hypos? If you've had more hypos it's likely that you've inadvertently eaten more glucose, which always helps you to gain weight. If you are using more insulin, this could also be the case.
 
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bridkid_74

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They worked out that on average i had about 33iu on mdi using levimir and novorapid. At the moment i using anywhere between 26 and 37iu a day!!! I still have no pattern on pump. Ive had a few hypos but nothing out of the ordinary for me. I know its early days but i was far happier on mdi. Dsn doesnt want me to go back on mdi as she says it can take 3-4 mths to titrate the pump to me.
 

tim2000s

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When I went on to the pump a month ago, I did the following:

Baseline MDI: Levemir - 8u @9.30pm-10.30pm; 14u @8am. I used to see an steady BG increase from about 6am due to the overnight Levemir running out.

Based on pumping insulin, I reduced my basal dose to 90% of my MDI dose, which turned out to be way too high, and it transpired that I needed around 75%.

Based on my Levemir split and observations of levels in the mornings, I then set my basal rate to mimic the MDI split. That seemed to work for me, although I have a couple of basal rates to take into account things like sleeping longer at weekends and DP, and exercise and non-exercise days, based on observations. On a normal day I have a day rate that runs from 5am to 9pm, This then steps down in a couple of steps to a night rate that runs from midnight to 3am.

My I:C ratios and correction factors have transferred over essentially one for one, so those didn't need any tinkering.

I had 12 hours with BG levels dropping too low thanks to the incorrect assumption from Pumping Insulin, but the rest of the time it's all worked really well.

How has your DSN moved your Basal from MDI to the pump @bridkid_74 ?

EDIT: I'd also add that I read the approach of basing it all on TDD, then chose to ignore that, as the reality is that the way it works, you need to base a basal on something, and the TDD model seems to be slightly wrong to me, if you had an MDI basal that you knew was effective at keeping your glucose level flat.
 

bridkid_74

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Type 1
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My total basel at present is 11.9iu. I used to be on split dose levimir which ranged from 14iu-17iu in total depening what i was working. My i:crb ratio not altered
 

tim2000s

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My total basel at present is 11.9iu. I used to be on split dose levimir which ranged from 14iu-17iu in total depening what i was working. My i:crb ratio not altered
So do your pump settings mimic your MDI basal split or were you put on a flat base rate for 24 hours?
 

bridkid_74

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My basel varies hr by hr. I seem to need more overnight than during the day which is weird as on mdi i use to go low overnight which resulted in nocturnal hypos hence the reason for going on pump. My dsn works all my rates out depending on bs results when i do overnight testing
 

tim2000s

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My basel varies hr by hr. I seem to need more overnight than during the day which is weird as on mdi i use to go low overnight which resulted in nocturnal hypos hence the reason for going on pump. My dsn works all my rates out depending on bs results when i do overnight testing

Have you thought about trying to work that out for yourself based on your readings? It would make your turnaround time quicker and you would be in control of what was going on?
 
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bridkid_74

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Honestly i wouldnt know where to start!? the whole thing blows my mind. I read other threads and see what they do with their pumps and im like whaaaat!????? Mdi was so much less complicated
 

noblehead

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Honestly i wouldnt know where to start!? the whole thing blows my mind. I read other threads and see what they do with their pumps and im like whaaaat!????? Mdi was so much less complicated


Pumping need not be complicated, but you need to get the basics right such as your basal rates, if your having to do TBR's & correction doses on a daily basis then you really do need to start from the beginning.

Have a read of the following, it has some good information on basal testing in different time frames:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

Also using a insulin pump shouldn't mean weight gain, perhaps when you get your bg levels under control you can then look at your calorie intake and make some adjustments. Good luck.
 
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azure

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Honestly i wouldnt know where to start!? the whole thing blows my mind. I read other threads and see what they do with their pumps and im like whaaaat!????? Mdi was so much less complicated

It gets easier with experience :) I found getting a pump similar to developing diabetes. Early in you don't really get what's happening and are terrified to do anything 'wrong', but then you gradually get the hang of it and become more confident in dealing with it yourself.

I actually found MDI more complicated because I could never get my basal insulin right for my needs. Now I'm on a pump, I know that I can adjust my basal rate to exactly what I need.

As for the weight gain, once you get your basal rates right and are confident with the pump, I'm sure that will settle down :)
 
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bridkid_74

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Type of diabetes
Type 1
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Thankyou. Unfortunately i was only 2 when diagnosed and that was 1976 so have very little recognition of what it was like. I guess the longer ur on the pump the easier it becomes, so like been on mdi it becomes 2nd nature i suppose. Fingers crossed. As for the weight issue the pump is the only thing that has altered in my life recently. Just hope ww works as well as it has previously.
 
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