changing food ratios and pump therapy

[J-a-n-e]

Hi, I’ve been a diabetic for more than 10 years. I’m on Lantus and Humalog at the moment. My sugar levels was always unstable (high & low). I’ve been offered a pump because of changing food ratios: from 1:7 (no exercise) to 1:20 (no exercise) and because we're thinking to have a baby. I have no idea what makes my body more and less sensitive to insulins. I believe one of the factors is heat (when it’s hot my ratio goes towards 1:20).

I’ve been offered 2 PUMPS (MINIMED 640 & ANIMAS VIBE). I can see I can benefit from having a CGM, but I was told that I can have it only on self-funding basis (as I’ve got hypo awareness). My consultant said that the cost of the sensors is about £50 per/week. Is it the only cost I will need to consider if I decide self-fund CGM? My consultant didn't say anything about transmitters/receivers/batteries... Will I need to pay for these too?

I need to know if I’ll be able to reach some better sugar levels with the pump compare to injections and how? Is it cheaper self-fund CGM (Dexcom) with ANIMAS VIBE compare to Minimed CGM? It also would be great to talk to someone with similar conditions (changing food ratios)?

 

[iHs]

I think you would be better to opt for cgm rather than a pump. It could take anything really from 2 months to get the basal settings correct on a pump and as your need for insulin will definately start to vary if you become pregnant, you will be spending a lot of time trying to achieve better bg levels and before you know it, your baby will be born.

I would go back to see your D consultant again as the new updated NICE guidelines re cgm might just enable you to get cgm foc for the 9 month pregnancy period so worth querying.

 

[azure]

Lots of women use a pump in pregnancy. I actually had mine for some years before I became pregnant, but I found it really useful in pregnancy as it meant I could adjust my basal rates as I needed and in very small increments. It also allows more accurate bolusing.

I'm not sure when you're planning to start trying to conceive, but if you had a pump now you could at least see if you like it and how it works for you.

As for the CGMs, I don't have one, but I believe the Dexcom works out cheaper overall.

 

[CarbsRok]

If you go for a pump and want cgm then the animas vibe is the cheapest option as most users can get at least 3 weeks out of a sensor you will need a transmitter as well which is about £345 4 sensors cost £186 but you can have a starter pack of 4 sensors and a transmitter for £500 Transmitter has a warranty of 6 mths but usually last 12 - 14 months

 

[CarbsRok]

I need to know if I’ll be able to reach some better sugar levels with the pump compare to injections and how? Is it cheaper self-fund CGM (Dexcom) with ANIMAS VIBE compare to Minimed CGM? It also would be great to talk to someone with similar conditions (changing food ratios)?

Are you sure it's your food ratio that is changing and not your basal? My basal needs change by up to 5 units over a couple of days every so often and it's a complete and utter pain in the article. But having the pump makes it so much easier.

 

[J-a-n-e]

Are you sure it's your food ratio that is changing and not your basal? My basal needs change by up to 5 units over a couple of days every so often and it's a complete and utter pain in the article. But having the pump makes it so much easier.

Not sure why, but occasionally my body is more sensitive to insulin. Last time when I had a bad hypo and felt really bad (was really shaking for 2.5 hours) and had a sugar level between 2.2 and 4 during all that time. Prior to this I made 10 units of Humalog (wanted to eat about 70 grams of carbohydrates). To go through that hypo I drank/ate 480 grams of carbohydrates (my dinner about 70 grams of carbohydrates plus 2 bottles of Lucozade, 3 little cartridges with juice, half of jar with honey and more than half bread loaf).

Twice my consultant put CGM equipment on me to test my sugar level. I was told not to do any exercises during that time and I recorded everything I was eating. First time I was told that my food ratio is 1:7, second time 1:15. I was told not to change my basal.

 

[J-a-n-e]

If you go for a pump and want cgm then the animas vibe is the cheapest option as most users can get at least 3 weeks out of a sensor you will need a transmitter as well which is about £345 4 sensors cost £186 but you can have a starter pack of 4 sensors and a transmitter for £500 Transmitter has a warranty of 6 mths but usually last 12 - 14 months

Thanks a lot for that information as I didn't know the cost of transmitter and thought that it only last 6 months...

 

[J-a-n-e]

Lots of women use a pump in pregnancy. I actually had mine for some years before I became pregnant, but I found it really useful in pregnancy as it meant I could adjust my basal rates as I needed and in very small increments. It also allows more accurate bolusing.

I'm not sure when you're planning to start trying to conceive, but if you had a pump now you could at least see if you like it and how it works for you.

As for the CGMs, I don't have one, but I believe the Dexcom works out cheaper overall.

We were trying, but unsuccessfully, to conceive for 3 years now. We went through some tests that were positive and were transferred to a special clinic for IVF treatment (will go to our first appointment in several weeks).

I just was offered a pump by my diabetic nurse and need to decide if I want one and which one (MINIMED 640 & ANIMAS VIBE).

 

[J-a-n-e]

Are you sure it's your food ratio that is changing and not your basal? My basal needs change by up to 5 units over a couple of days every so often and it's a complete and utter pain in the article. But having the pump makes it so much easier.

Why do you need to change your basal and how do you know when to change it?

 

[CarbsRok]

Why do you need to change your basal and how do you know when to change it?

It needs changing when blood sugars start to climb or drop. Which is obvious by the way I feel and blood testing.
It's very rare my bolus needs changing.
Basal needs can be changed by the hour so it's very handy
If you are needing so many carbs to correct a hypo has your consultant looked at your cortisol levels?

 

[azure]

We were trying, but unsuccessfully, to conceive for 3 years now. We went through some tests that were positive and were transferred to a special clinic for IVF treatment (will go to our first appointment in several weeks).

I just was offered a pump by my diabetic nurse and need to decide if I want one and which one (MINIMED 640 & ANIMAS VIBE).

Good luck with the IVF

My pump is an Animas Vibe. If you search on here you'll find various threads comparing pumps, but in the end it's what suits you personally.

 

[donnellysdogs]

Snap.. As carbsrok suggested and says. Basals are basically the ones that are in the background working and will be more affected by cold, heat, stress, periods etc.
Bokys's are more affected by the type of foods that are ate.. Ie a mackeral salad will give better readings than a pizza takeaway....

The other thing is... What are your overnight readings like?
Donyou ever basal test?

Also.. To me..only from my experience it is useless testing and altering anything on a cgm if you are not doing your usial daily routines.... You would be changing everything to a lifestyle that you don't live!! useless. The point of a cgm is to be able to do your normal daily living whether its exercise or not..

 

[J-a-n-e]

It needs changing when blood sugars start to climb or drop. Which is obvious by the way I feel and blood testing.
It's very rare my bolus needs changing.
Basal needs can be changed by the hour so it's very handy
If you are needing so many carbs to correct a hypo has your consultant looked at your cortisol levels?

Yes, it was checked and it's normal

Normally I don't need so many carbs to correct a hypo. Normally I correct it with a small juice cartridge and a slice of bread. I have problems with hypos only after incorrect injections (when my body becomes more sensitive to insulin - in hot weather or after hot bath...).

 

[J-a-n-e]

Snap.. As carbsrok suggested and says. Basals are basically the ones that are in the background working and will be more affected by cold, heat, stress, periods etc.
Bokys's are more affected by the type of foods that are ate.. Ie a mackeral salad will give better readings than a pizza takeaway....

The other thing is... What are your overnight readings like?
Donyou ever basal test?

Also.. To me..only from my experience it is useless testing and altering anything on a cgm if you are not doing your usial daily routines.... You would be changing everything to a lifestyle that you don't live!! useless. The point of a cgm is to be able to do your normal daily living whether its exercise or not..

I was offered a pump because during a CGM measuring there was a pattern of evening and morning sugar rises.
They asked me to stop all exercises and eat same food every day to find out a correct basal level. I also thought it's not right as normally I go to gym and run every day, go for 10-30 miles walks twice a week and cave, do some rock climbing or bouldering once a week.

 

[donnellysdogs]

I was offered a pump because during a CGM measuring there was a pattern of evening and morning sugar rises.
They asked me to stop all exercises and eat same food every day to find out a correct basal level. I also thought it's not right as normally I go to gym and run every day, go for 10-30 miles walks twice a week and cave, do some rock climbing or bouldering once a week.

Crikey if you do all that - thats the time when you need to see your levels and fine tune the basals to your activities.

If I used bad language I would be swearing at how stupid the advice was.

Sorry.. I know many DSNs with me 5 years ago and others here have been told to relax on basal testing days.. Why?? You'll just increase your basal rates and crash when you do activitys.

Honestly, I despair....