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Does anyone use an untethered approach with their insulin pump?

MeiChanski

Well-Known Member
Messages
2,990
Location
Warwickshire
Type of diabetes
Type 1
Treatment type
Insulin
Hello friends,

Out of curiosity, does an untethered approach defeat the purpose of a pump? Is it approved by diabetes team?

Untethered approach is using your basal insulin like Tresiba in conjunction with your pump. Like minimal amount of basal insulin from your pen and continue boluses doses on your pump.
 
It's rather expensive equipment to use for only insulin to cover meals. I can't see the point of that, as it's the basal use of the pump that is most helpful.
 
dancer said:
It's rather expensive equipment to use for only insulin to cover meals. I can't see the point of that, as it's the basal use of the pump that is most helpful.
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Could you elaborate please? @dancer We still need to eat. "Fuel the fire" so to speak..

Curious to know as a non pumper.

Interesting concept by the way @MeiChanski .. What insulin do you use to pump? Novo, or Fiasp?
 
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I must admit it's not something I have heard of doing, when you say untethered do you mean disconnecting your pump and then reconnecting for bolusing or would you have your basal as zero? (if you can do that with a pump?)
 
Hello, no, I’ve read some people have a fear of DKA and inject their basal insulin whilst using their pump for partial basal and mostly bolus for food, so they can disconnect or if their pump is broken etc.

Apparently it works for some people, I’m just curious because I feel it defeats the whole purpose of a pump. I use Fiasp in my pump because novorapid isn’t good enough
 
This seems a very odd way of managing and much more complicated.

Injecting your basal via a pen with long lasting insulin will cause the peaks a troughs you would normally get with a pen dose, low action at beginning and end and higher action in the mid point. It would also not cover the adjustments most of us need across the day for basal (like dawn etc).

Anyone doing this would have to work so much harder to cover the either under dosing or over dosing of basal and then the meal bolus's would be affected too.

I don't personally see that the benefits outweigh the extra effort needed, but there could be people with other impacting conditions where this might be there better option but not for me.
 
This would be a disaster for me because it is too fiddly as a regime however I do want better insulin than the humalog I am stuck with.
I do feel that if I varied my basal a lot more it would keep on top of my blood sugar creeping up in response to life.
My body often takes a while to respond to it though I am not insulin resistant as far as my doctor is concerned as I am relatively lean and the effectiveness varies in the usual ways (illness, hormones, exercise throw a curve ball).
 
MeiChanski said:
Apparently it works for some people, I’m just curious because I feel it defeats the whole purpose of a pump. I use Fiasp in my pump because novorapid isn’t good enough
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I think it defeats the purpose too, but didn't want to be too dismissive in case you were going to try it
I can't really see many NHS doctors agreeing with this approach considering how much pumps cost but that's just from my own experience
 
sleepster said:
I think it defeats the purpose too, but didn't want to be too dismissive in case you were going to try it
I can't really see many NHS doctors agreeing with this approach considering how much pumps cost but that's just from my own experience
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Gotta agree with that, you might as well stay on a basal/bolus MDI regime if taking the basal separately
 
It totally defeats the point of a pump! Your team would not me impressed at all. Would your pump team consider not funding your supplies?
Wikepedia should be shot for the explanation they give on the "benefits" of disconnecting the pump while maintaining the flexibility that the pump gives. The major advantage of a pump is the flexibility to be able to adjust your basal intake over a 24 hour period
 

I feel the same way because pump gives basal flexibility so I don’t quite understand how a manual basal injection gives flexibility.

I have no clue, I was just curious to see if anyone did anything like it. I know my team would come at me with pitch forks and torches
 
sleepster said:
I think it defeats the purpose too, but didn't want to be too dismissive in case you were going to try it
I can't really see many NHS doctors agreeing with this approach considering how much pumps cost but that's just from my own experience
Click to expand...

My hospital will probably come at me with pitch forks and torches. Indeed, pumps are expensive and give as much flexibility to one’s insulin needs without having to do a manual injection.
 
I know some people that do this for various reasons. They prefer once a day or twice a day shots of long acting insulin. The last one I am interested in is trying a basic basal insulin rate in a shot but with his pump to make the higher adjustments for things like DP still.

He got close to DKA one night recently with a pump failure and sensor failure at the same time. He had elevated ketones when he woke and discovered the situation and lives alone. So he likes the idea of a long acting insulin shot so that he always has a minimal level of insulin, but he can still do his bolusing plus some higher basal rate doses during part of the day/night with his pump.

I am actually interested in his results. I'm not sure I would want to do the work at this point, because it really sounds like some work to try to figure it out, but I really see the point of why he is doing it.
 

That is interesting, do you know if his team approved that approach? I could ask my team just to answer people’s curiosity. I don’t even want to start thinking about how he got it all working without hypos.
 
This is US lol, I don’t know anyone that has a team! We do see endo’s 2-4 times a year. We could e-mail with questions if we wanted or call. But he is like me and considered well controlled, We are most likely just going for any scripts needed and blood work done. I would no more ask a team or doctor for advice or even confer with them? I would be more likely just to ask if anyone had tried it before and try to learn from people that had experience with the situation. I would never even think of seeking approval or input for any kind of change. Not for my type1 diabetes’s. But there is a wide range of people here, some that ask and some that don't.
 
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I know a few who people who go untethered with their kids on holiday. The benefit is they can stay stable when unclipping the pump on the beach/water parks etc for long periods. My own daughter really struggles with the lack of basal when removing her pump swimming, so I can see the thought process of having long acting in that situation.
 
As most others have said.......this is mostly unheard of......

if someone has a fear of DKA, then they shouldn't be on the pump or should be making efforts to overcome what some may describe as a completely irrational fear.....

the many basal rates a pump can deliver is the main reason for it.......in all pumpers...... the bolus doses is almost identical to an injected bolus, just a tad more efficient.......so it makes no sense......to me.....
 
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