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do insulin requirements drop by much?

weeezer

weeezer

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hi pumpers

just wondering...does ones insulin units needed drop by much when using a pump? from what i've read on these forums i gather this to be true but just asking to clarify. i inject 24 background in morning & 18 at night and my DSN said this was too much, that i needed to decrease these doses and increase bolus (currently between 4-8 mostly depending on what i eat).

i am 2 stone overweight (haha can't blame it on baby anymore, she's 2!) so acknowledge this plays a part. but i am really wanting to try a pump, and wondering if it would help on the quest to lower insulin requirments?

how did it affect your insulin needs?
 
When you go on a pump you will need to use less insulin than you would on MDI. Most dsns will use Prof P's guidance in starting people on pumps whereas others will use Walsh's guidance.

On MDI I used 22u of levemir split between 14u am and 8u at bedtime and 10u novorapid split up on the bolus's for my meals. You could say that I was using too much basal and not enough bolus but I liked it that way as it seemed to improve my awareness. It might pay you to fast and test the effect that your dose of basal is having on your bg levels without eating anything. This is something that very few consultants or dsns will ever advise though ...............

When I started on a pump it was estimated that I would need 12u basal and 12u bolus which proved to be too much and I then altered it to 11.3u basal and 10u approx bolus.

You will find if you use a pump that you will lose a few pounds in weight even if you keep your carb more or less the same :wink:
 
very interesting ihs. i have tried to lower basal but always ends up pushing bg's higher, and that dreaded effect of increasing bolus always results in hypos. fasting...may just give that a go to see where i am!

i'm really trying to convince my mum (t1 37 yrs) to push for a pump - her insulin requirements have risen & risen lately and despite increasing her doses (by alot) she is still high most of the day. i am convinced a pump will maybe help her to get more of a handle on it- i think she is severely resistant, but no-one seems to want to address this at her clinic, the dsn's just say keep increasing, which is resulting in a massive weight gain for her (even though her carb intake is quite low). any thoughts anyone? may post this separately for advice, am v worried for her :(
 
so...i'm gonna give this fasting a go, anyone tried it to get a handle on what basal doses they should be on?

ihs - thanks for the info, did you try fasting?

do i test it by having usual dose of basal (insulatard) in morn then just not eat anything & test all day long? then just have usual evening dose too? so i just adjust it up or down depending on what happens???

(obviously i am aware this is skightly risky and will always have lucozade on me! i may try this on sunday when i can just stay home & test every hour!)
 
Yes, generally. Mine dropped by huge amount - think I was on something like 120u/day before pumping and am now on about 60. From my DNS, I believe most peoples reuirements go down quite a lot compared with multiple daily regimes. Also helped me lose weight too. Once you get basal right, you can eat when and what you want rather than having to eat at specific times.

I would be a bit wary at trying to check basal rate on twice daily injections. It's not really going to be very helpful as your basal rate on long acting insulin is fixed. You can't alter it throughout the day to meet your body's requirements which can change from hour to hour anyway. Be guided more by your pre-breakfast and pre-evening meal blood sugars.
 
Hi
Its true that MOST peoples insulin requirement does drop but not always. I have found im on pretty much the same give or take a unit or two. Once again everyones different so it may well b the case 4 u .
Regards
Leb
 
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