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Changing Isf and changing basals etc

K

kkkk

Well-Known Member
Messages
185
Type of diabetes
Type 1
Treatment type
Insulin
I have hoy been pumping a short while and it may just be me, but just before I went on the pump my doses had all quite dramatically dropped -probably the warm weather...however over the last week or so I've been climbing and I've had to up my basal by about 40% at some points in the day! and also my carb ratios have come down by a similar amount. I am back to being quite peaky after meals too (do all the wait and eat and low GI etc).....anyway with that the corrections that I have been taking have not been bringing me down by the 5.2 for 1 unit that I was initially set up at (in my opinion) so I googled the rules on ISF and on that basis my ISF should be around the 3.8 mark, so I've changed it to 4 for tomorrow but may chicken out of such a drastic change and start with 4.5 just to be safer. Is ISF something that you find you have to play with much? Should you adjust it as your doses change for either hormones or weather or just cos your diabetes decides to do those changes?
 
Somdtimes yes esp when westher gets hotter or colder and at those odd times when you just need more insulin for who knows reason. I just use the 100 rule as that works ok for me

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I have had about a 40% rise so I was thinking surely that effects my ISF, glad I do kind of understand the pump thing logic a bit. I am also figuring with the ISF rise my carb ratios might need to go up a little as I wonder whether these were masking some of it. I'll see how it goes, it's just getting your head around a new way of doing things - even on injections my doses were not massively static, but the pump gets sold a little like you put in these numbers and then it all works perfectly forever after, so I often fell a bit like an oddity cos stuff changes quite often for me, and so it is just working out which numbers to change etc. I want to do some basal testing and check the changes I've done there and hopefully it will all settle down .
 
Just check that you haven't started a new box of tubes or cannulas that may be a causation of the higher levels.

My recent higher basals are down to pump, not my body, but I'm just figuring out which boxes are the problems...


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Many people get a tiny bit mislead about using a pump as everthing does greatly depend on the settings being correct and for myself even with bg and basal rate testing, I usually have to adjust the settings about every 8 to 10 days. I did this on the Combo and am now having to do it on the Vibe as well. The good thing about the Vibe is that there isn't so many basal rate time slots to adjust (12) whereas on the Combo there are 24.

Its hard going in the beginning so dont be disappointed that you wont always achieve perfection. You have to be careful that you dont end up saying yr prayers every day to diabetes and the pump

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Thank you I do feel a little more normal now I am sorting stuff out and working it all out with the help of the CGM...I think I am probably a little hard on myself but then people post these flat line CGM graphs and it makes me wonder whether I am an oddity as I work hard at it but then my graphs still go up and down and I have peaks and troughs - though I have found that if I adjust the basal at the time - when I think about it then that really helps for the next day. I am on a much more curvier basal pattern than I was when I started, and I have found I need to do a temporary basal when I get up 'cos just getting up raises my blood sugar most mornings (must be the stress of it - it isn't really stressful ) - so the temporary thing lets me lie in and get up when I want rather than go hypo if I was still asleep!
 
Im sorry I am late to the thread but I am so glad I have found this thread. I have been on the pump 2 years, type 1 for 26 years and I am still learning new things. I have found the last two weeks I have had to up my ratios and basal rates by quite a bit just to stay below 10.

iHs - has it always been the case you have had to change your rates every 8 - 10 days as mine seem to be like that, and I thought I was the only one, I am on the combo. Do you think there is anything that causes it, or it is just a case of it will always be like that. Previously I had put it down to being new to the pump & then being pregnant but now I am neither! Its so frustrating - just as you think you've cracked it, it changes!!!

I struggle as whenever my sugars don't behave how I think they should I am convinced it is because the pump isn't working and get really anxious! Do any of you struggle / experience that?
 
A nice flat line is a very rare occurrence on my CGM. I do need to change my doses fairly regularly...I've just had a massive drop over the last few days (and then tonight I am up and high and not coming down as quickly as I would like...must be why I love Alanis Morisettes's Ironic song ). I do think that it takes a while for your body to recover after having kids...at least a year in my unscientific book - maybe someone knows about pregnancy hormones and how long they linger for! Also if you've completely come off the pill or changed to a different one of been on a hormonal based one (which tricks your body in to thinking you are pregnant...so I figure must make you a little more insulin resistant) then that is also a change. Also having kids and sleeplessness and being active all plays havoc with it. I had my kids long enough ago for that not to effect me now (they still keep me active)...but I still have to play with my doses quite often - I still reckon that if I lived in a bubble and ate and did the same things for several days my sugar profile would be different each day too. I am fairly sensitive to exercise and stuff like that...I think we are all different and I would love to believe that there are people out there who find dealing with diabetes a breeze and they have lovely stable sugar levels and never need to change them....but unless you are honeymooning or still have some of your own islet cells kicking around I reckon most people have that daily grind of checking and adjusting and as most of us on here are more aware of it and what it should be and care about it I think that we see the ups and downs more. So you are definitely not alone....complete empathy with the having it cracked and then it changes!!!! Other thing that I have noticed and might help...a bit of regular exercise each week does help stabilise things a bit...again nothing is complete - but it is good for you too
 
Using a pump takes a lot of sorting and even then things frequently need tweaking.

Non diabetics have peaks and troughs in their blood sugar with a fully functioning pancreas making constant micro adjustments . That's what we are up against. A pump is giving tiny amounts of basal every few minutes and a bolus that you time to the best of your knowledge to coincide with the glucose release from your food. It is brilliant that we manage to account for all the variables and get results in a target range most of the time.I try my best to keep my CGM within my chosen upper and lower limits but it certainly isn't a flat line and it requires frequent tweaking of my basal rates and carb ratios to get control I am happy with.

I've used a pump for 12 years and I never go for too long without having to change basal and other settings usually only by tiny increments -just because. Often there is no apparent reason for things starting to go haywire, it's nice when there actually is a reason you can blame such as warm weather.
 
Thanks for your replies it's really helped me as I was really starting to get down about it all. It's just so frustrating sometimes....most of the time!! I don't have a CGM so rely on testing and the drs keep telling me I'm testing too much but I don't do it for fun I do it because I'm worried or my sugars are too high/low!!!

Glad changing basal rates this often is normal! It's strange I need more insulin now it's hotter so who knows what I will be like she I go to France next week!

Now waking up with highs of 14!16 after going to bed at 5-8 son looks like some overnight testing for me!!

Do either of you get anxious when you change your cannula? I'm finding I get really nervous it's not working and getting myself into a bit of a state for the 2-3 hours after changeover whilst I monitor my sugars. I know it sounds a bit weird but just wondered if anyone else had the same problem?

Annie,


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Can't recall ur pump... However I believe the worst prob with an accuchek one is airbubbles.. They far exceed troubles with rapid d sets...
Eg i had two days at perfect levels..5-7.... Next day perfect to start off with... Within hour of leaving house gone to 14!! Was covered in muck, so just did correction and carried on.. Couple hours later.. Still 10... Went home...scrubbed up, took off clothes.. Massive airbubble 1/2 way down the tube...and probably another one already in me replacing the insulin....
(Due to work, I cannot just detach and prime, I do need to clean up first).

Set probs really should be absolutely minimal. I used my bum.. A small size 10 jlo one for nigh on 90% of 30 years with needles n cannulas.. And believe me, it is still a beautiful bum to be proud of, not a bump or a lump!!


Loving life
 
I'm accu chek too and use rapid Ds but just in my tummy...maybe I'll give my bum a try then! And yes I have the same issue with air bubbles but only recently so I must have been lucky until now.

I just panic it's not working even when everything indicates that it is... Maybe I just need to become more confident with it!

Thanks for your help! X


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I used to worry a bit - but then I had to change insets and when I was on the inset 2 I had quite a few failures and then blood gushers so I think that knocked my trust and made me worry. Now on the inset30 and I am able to trust that it will be ok and nowhere near the failures that I was having before - and the more I've changed them the easier it has gotten. You know when your set fails - are you meant to call it in to the provider e.g animas in my case (I know you do with CGM failures but I didn't know whether the NHS would get a refund on a set failure - so if it is kinked or not delivering properly...or is that just put down to user error or something?)
 
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