Backup plan

[Seacrow]

As mentioned in another thread I just managed to break my pump.
The nice American lady (Customer Service) told me to go onto my backup plan. OK. The UK Customer Service person said use my backup plan. At this point I explained I'd rather not, since my backup plan puts me in hospital receiving my basal insulin via a drip. She was absolutely horrified - is it really that rare to be allergic to the long acting insulins?

I've now had a quick email and phone exchange with one of the consultants at the diabetes centre, discussing options etc. The result is one emergency prescription of Tresiba. This creates a bit of a new problem, I understand Tresiba has an activity tail of 24 - 42 hrs in theory. Switching between this and the basal supplied by a pump (tail of about 8 hours) is going to present an interesting challenge. Add to that the probability that the pump basal dose is up to 25% less than the injected basal, and I'm a little worried.

I should say the reason I want to figure this out now is that at the moment I have my husband with me 24/7 - highly useful for those sudden rapid incoming hypos!

So, basically HELP please
Anyone done this, or anything like this?
Is anyone allergic to Tresiba as well as the other two?
Do you find the Tresiba activity to be completely flat (scepticism on my part here)
Anything blindingly obvious that you think I'm missing?

 

[Juicyj]

Hello @Seacrow

To date I have never come across anyone allergic to tresiba and if that was the case it would take a while to manifest itself so don’t panic. Tresiba is as flat as a pancake and yes my estimates put it at around 36+ hours duration so start on a smaller dose and work your way up, however Medtronic should have a replacement to you within a day two so it s a quick turnaround. Just take care once you start pumping as you have to wait a couple of days with the tresiba basal still in your system or again work from small doses upwards - speak to your team to give them the heads up too.

Tresiba is not the best replacement temporary basal whilst switching pumps for the reason as it takes a while to deplete from your system, I have insulatard in the fridge as my back up.

 

[Marie 2]

When my pump didn't work for a day. Also a couple of times we couldn't give my diabetic dog her long term shot. We resorted to a quick acting shot every 2-3 hours. It's a pain and not as good of control, but it works. And yes this meant waking up during the middle of the night. But for a day, doable.

 

[Seacrow]

Hi @Juicyj
How do you use Humalog as a basal? Other than in a pump of course.

 

[Juicyj]

Hi @Juicyj
How do you use Humalog as a basal? Other than in a pump of course.

No I don’t use Humalog sorry that was my typo - I am supposed to use Insulatard as my back up from my DSNs advice but haven’t had the chance to use it yet thank goodness, however if I have to be honest I’d do what Marie suggested and use novorapid to correct as the idea of then managing my basal ratio on the pump and the cross over from using any basal would be a pain for the first few days.

 

[Marie 2]

You just give yourself a shot every couple of hours equivalent to what your basal rate was in your pump. I can increase pretty fast so I needed a shot every 2 hours. My dog on the other hand was able to go 2-4 hours in between shots.

During the day, it's no big deal, it's easy to keep track of. It's just very tiring through the night. You will only want to do it one night as it's not fun. I have a long acting back up basal now if it ever happens again as where I live I won't get a replacement pump so fast.

 

[NicoleC1971]

This has happened to me and tbh taking micro doses of humalog is very far from ideal. Surely there is a basal insulin that the OP isn't allergic too. Thankfully my pump team (Roche) had one sent out pdq. In between I minimised things that cause fluctuations like exercsising and eating carbs however it always amazes me just how much glucose that my liver can chuck out in these circumstances.

 

[Seacrow]

This has happened to me and tbh taking micro doses of humalog is very far from ideal. Surely there is a basal insulin that the OP isn't allergic too.

So far I've taken two injections of Tresiba with no reaction, I may be lucky with this one. Started at far too low a dose though, slowly increasing that (too low considerably better than too high!). I can't tell how long its lasting yet, but as soon as I know the right dose and how long it lasts me, I can start back on my pump. And now I'll have a backup plan that doesn't involve hospital admission.