Adjusting basal rate when moving from stomach to thigh

[tigger]

So after yesterday's disaster (which for once turned out not to be set related!) I decided to try a different site. I suspect that some of my problems over the last 2 days have been due either to scar tissue forming in my stomach from all the set changes or to my insulin needs increasing as I move into the next stage of pregnancy. So to isolate which I have tried putting a set in my thigh but the rates are going wrong. Before I just adjust the basal rate does anyone know a rough formula for the amount of increase you'd expect between thigh and stomach? Also do the different absorption rates affect the carb ratio?

 

[azure]

Hi Tigger,

There's no exact formula - it's a question of careful trial and error. As always, make any adjustments really cautiously.

It's a long time ago that I used my stomach, but personally I didn't find that much difference between that and my thighs. Bear in mind some people say their thigh need less because the legs are active.

If you do have scar tissue in your tummy, that could possibly have meant you'd needed extra insulin, so, by moving to a fresh area, your insulin requirement might decrease. I would be extremely cautious and, because you're pregnant, I'd check with a DSN just as a back up even if you're pretty confident. I phoned mine a lot when I was pregnant, sometimes just for my peace of mind.

As far as ratios go, I don't find they change between sites, but it may be different for you. However, pregnancy affected my ratios a lot.

 

[tigger]

The problem is everytime I ask my DSN a question, the response I get is well I don't know anything about your type of insulin. Which isn't very helpful and is why I spend so much time here!

Hopefully I can do the basal test for this pm and then I'll adjust carb ratio for the evening and see if that helps too.

 

[noblehead]

Poor absorption will effect all doses right across the board @tigger, you'll likely use less insulin if you change to a site that doesn't have any lipo issues as you won't be using so many correction doses and such, so do monitor your bg levels closely.

As for your DSN, is she a specialist pump nurse? The reason why I ask is not all DSN specialise in insulin pumps and you should ask to be seen by one who does, if she a pump nurse then her reply is inexcusable, so probably better to ask to see someone else (if possible) or speak with the consultant.

If you've not got the book already I highly recommend you purchase the book Pumping Insulin.

 

[tigger]

Thanks I'll press that then. She is the only nurse they've referred me to in the hospital.

Yes I have the book thanks.

 

[azure]

The problem is everytime I ask my DSN a question, the response I get is well I don't know anything about your type of insulin. Which isn't very helpful and is why I spend so much time here!

Hopefully I can do the basal test for this pm and then I'll adjust carb ratio for the evening and see if that helps too.

I'd hope your DSN would still find out the answer even if they didn't know it themselves. Your insulin isn't that unusual, after all! Are you able to speak to your consultant? Or ask your DSN to?

I hope your basal test gives you some useful information. When I was pregnant, I found I had to adjust my carb ratio quite frequently once the insulin resistance kicked in.

 

[tigger]

That's useful to have confirmed.

It was a bit rubbish as I realised I'd bolused too close to it so I've no idea if my going down was due to delayed bolus or basal rate. I'm going to basal test tomorrow morning instead and see how that goes.

 

[donnellysdogs]

If your stomach has scar tissue etc you may well find that it wasn't good at absorbing the indulin anyway. So you could actually find a new area of usage could need less insulin.

Only testing and changing will be the answer..

 

[tigger]

I think it was just the basal rates suddenly increasing now. Another saga this morning to add to my infusion set thread