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8 days and still have high bg levels

Discussion in 'Insulin Pump Forum' started by Charisma_1630, Jul 27, 2016.

  1. Charisma_1630

    Charisma_1630 Type 1 · Well-Known Member

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    I switched to pumping with insulin 8 days ago now and am still consistently high, considering I wasn't often high on injections it's been a struggle to adjust. The hospital is lowering them but not as fast as I'd like, I can see patterns that I'm tempted to adjust myself but don't want to go against their advice!
     
  2. noblehead

    noblehead Type 1 · Guru
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    Maybe speak with them again if your still too high, I adjusted my own basal rates (I:C ratio's stayed the same) without the pump clinics input but felt confident in doing so, but 8 days in it might take a few days yet to settle things down.
     
  3. tim2000s

    tim2000s Type 1 · Expert
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    If you are concerned about going against their advice consider this approach.

    Review your patterns, determine what you think is the correct action and then call them and tell them what you plan to do.

    If it's rational and sensible, then there is little that they can do to say no.

    When I got a pump from the hospital I presented them with what I was going to set up as a fait accompli, with the supporting evidence (I'm totally confident in my own ability to do that though) and said that I would be responsible for the tweaking from there on in. They were happy with that.
     
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  4. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    And if the disagree do it anyway!:D
     
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  5. Charisma_1630

    Charisma_1630 Type 1 · Well-Known Member

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    Well my IC ratio must be set way too high (or low, however it works) every day I start from whatever number I wake on and each meal I eat it gets higher and higher and I have to correct and correct just to get it down to low teens. I understand they don't want me to have lows as it'll put me off but going up to 19/20 everyday is starting to get me down! I upload my pod info every day so they can see it and keep saying to just ride it out and it'll get better!
     
  6. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    Sounds like a basal issue? could you not eat any carbs and do some basal testing?
     
  7. Charisma_1630

    Charisma_1630 Type 1 · Well-Known Member

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    While I've been keen to start doing tests, my nurses said I shouldn't do any basal testing until my numbers come down a bit!
     
  8. noblehead

    noblehead Type 1 · Guru
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    I bet it is, those levels are really high.

    Obviously don't know why your clinic are being over cautious about not wanting to put you off pumping but you need to ask to see the pump DSN in person, often when you start on a pump they will start you off on one basal rate which over time does needs adjusting.

    Btw @charisma started a new thread for you.
     
  9. Charisma_1630

    Charisma_1630 Type 1 · Well-Known Member

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    Thank you for putting this in a new threat. It's hard to give a picture over the 24 hours obviously, but they have already set me on a few different basal rates at different times over night so they are doing something and tweaking things slowly! And the reason it's high throughout the day is by the time it starts coming down to a reasonable level it's time to eat again and shoots up. I'm having around 1.8 units in the morning when I used to have say 5 or 6 units. I know it works differently now but I'm convinced it's my ratios. I'm due to check in with my pump nurse tomorrow morning by phone so I will ask about changing ratios. It just seems such a slow process and spending weeks up in the teens must be doing so much damage to my body!
     
  10. Gaz-M

    Gaz-M Type 1 · Well-Known Member

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    Good luck tomorrow, don't get down hearted though just try see this period of highs out but explain to your DSN tomorrow the concerns you are having running numbers so high. If possible it may be worth a try setting a TBR to say 110% so basically a 10% increase for 2-3 hours (1.5 hours before and 1.5 hours after eating) just to see if that improves your readings at all, but make sure you test more often 2 hours after you have started the TBR
     
  11. noblehead

    noblehead Type 1 · Guru
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    A basal check would confirm if it's your I:C ratio or insufficient basal delivery.

    However your bolus dose for breakfast does seem quite low when you used to inject 5-6u, as said earlier my I:C ratio's remained much the same, on MDI I would bolus 5u for breakfast and still do now using a pump.
     
  12. rockape37

    rockape37 Type 1 · Well-Known Member

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    I was told when I was put on the pump 4 weeks ago that it is expected of me to make alterations.

    Anyway I have had Low BG's since day one of pump therapy but have been knocking down by using the temp basal rate feature then set it up as a permanent thing. I record on paper my new settings for good reference.

    My Basal rate when on injections was 36 units and the day I went on the pump it rose to a whopping 64 units, it put a stop to the Dawn Phenomenon though. I really wished I had questioned this whopping dose! I've now reduced my basal to much lower than when I was on Injections and still Dawn Phenomenon free.
    I still haven't been able to do any basal testing because of the lows so I'm tackling the Carb Ratios. It takes time and I think everyone will agree that you should take note of any adjustments so that you can step back or step back a little bit if needed.
    I re record my carb settings on paper highlighting the actual ratio that I have changed purely for ease of seeing the change, it helps me anyway.

    Good luck.

    Regards

    Martin
     
    • Useful Useful x 1
    #12 rockape37, Jul 30, 2016 at 10:55 AM
    Last edited by a moderator: Jul 30, 2016
  13. Charisma_1630

    Charisma_1630 Type 1 · Well-Known Member

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    1 month on now...

    My morning ratio seems to be almost right. But my lunch and dinner ratios are still way off. I've spoken to my nurse and she seems so concerned with doing basal and breakfast bolus testing constantly rather than looking at why I'm in high teens after lunch/dinner. Is there a reason she would be doing this?? Am fed up of highs all the time!

    Also, I keep wondering as I did this a lot with MDI's. Say I test, bolus and eat, then decide I want a little more of the carb I was eating straight after, is there a way to bolus for the extra carb without having to retest?
     
  14. noblehead

    noblehead Type 1 · Guru
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    Did you basal test to see if your basal rates are correct? As said earlier you need to do this before looking at your I:C ratio, once you know your basal is right then you can make adjustments to your I:C ratio's.

    You don't have to retest, you can bolus without doing that.
     
  15. Charisma_1630

    Charisma_1630 Type 1 · Well-Known Member

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    I did a basal test about 2 weeks ago. It stayed flat throughout the night until lunch time with one small dip at around 3am. I asked if I should try doing a lunch time basal test and she said to do another breakfast one instead I'm not sure if there's method to her madness
     
  16. noblehead

    noblehead Type 1 · Guru
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    Not sure tbh, but if your bg levels are fine up to lunch-time but increase thereafter then a basal test would be my approach before looking at the I:C ratio for lunch, so that would mean having a low-fat breakfast and start testing 4 hours after as the following link explains:

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

    endocrinegremlin Type 1 · Well-Known Member

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    It can take several months to get things working right. Don't give up <3
     
  18. donnellysdogs

    donnellysdogs Type 1 · Master

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    Why don't you just do an afternoon / evening basal test?

    You need to start taking control yourself....doing a basal test in afternoon/ wvening may give you some confidence in your own abilities...

    Providing you stop if you go go high or low whats the harm? If you go high and have to do a correction - well its a chance to see if your correction bolus is right as you should be back to your target level within 5 hours.

    Like others here, I was never controlled by my nurse...its your health...
     
    • Agree Agree x 2
  19. Charisma_1630

    Charisma_1630 Type 1 · Well-Known Member

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    I actually did this yesterday, an afternoon basal test. Although I'm not sure how I should adjust my basal to match my results but I'll send that to my nurse and ask her advice. But you're right, I need to start to do regular basal testing without them promoting me.
     
  20. donnellysdogs

    donnellysdogs Type 1 · Master

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    More importantly though you need to find out how to adjust your own basal rates. My nurse carefully told a trainee on day one of her training how to adjust hers and to do it.

    The idea of pumping is to give you the flexibility to look after yourself better and you need to....

    The nurse should explain why she makes certain changes.

    Have you got the book pumping insulin?

    Glad you tested but you must now find out how to change things for yourself...
     
    • Agree Agree x 2
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