high BG levels on pump

[weeezer]

as of last weds i am attached to the accu-chek combo pump. i realise they like to start off with 'safe' doses of insulin, but i really feel like i'm getting nowhere near enough insulin.

although it's nice to be hypo-less (a common, daily occurence that i tolerated in the quest for a complication free future!) i can't carry on riding these double figures, i'm feeling so groggy & sick. i don't know if it's the basal rates or bolus ratio's, or both? i've edged up the hourly basal rates but nothing has changed. i'm between 12-17 mostly, with the odd 8 or 9. i talked to my DSN on fri who agreed that i should put basal up, but what do i do next if i'm still this high? i started on 0.68ph and inc to 0.71 then 0.75 today.

i used to use 1 unit per 10g carb apart from breakfast which was 2 units per 10g - but my pump ratio has started at 1 unit per 15g carb throughout the day.

i'm being super careful about measuring the amount of carbs i'm eating, weighing and being strict.

is this just pump teething troubles that everyone experiences? or should i be increasing basals and ratio's? i am correcting all day long so far. i'm testing around 12 times to try and keep on top of it, but most results are just too high.

any advice or experience greatly appreciated

 

[l0vaduck]

as of last weds i am attached to the accu-chek combo pump. i realise they like to start off with 'safe' doses of insulin, but i really feel like i'm getting nowhere near enough insulin.

although it's nice to be hypo-less (a common, daily occurence that i tolerated in the quest for a complication free future!) i can't carry on riding these double figures, i'm feeling so groggy & sick. i don't know if it's the basal rates or bolus ratio's, or both? i've edged up the hourly basal rates but nothing has changed. i'm between 12-17 mostly, with the odd 8 or 9. i talked to my DSN on fri who agreed that i should put basal up, but what do i do next if i'm still this high? i started on 0.68ph and inc to 0.71 then 0.75 today.

i used to use 1 unit per 10g carb apart from breakfast which was 2 units per 10g - but my pump ratio has started at 1 unit per 15g carb throughout the day.

i'm being super careful about measuring the amount of carbs i'm eating, weighing and being strict.

is this just pump teething troubles that everyone experiences? or should i be increasing basals and ratio's? i am correcting all day long so far. i'm testing around 12 times to try and keep on top of it, but most results are just too high.

any advice or experience greatly appreciated

How does your total basal compare with what you were using before on the pump? I think they usually recommend a small decrease because the constant drip-feed of insulin from the pump is more efficient than one or two large injections a day.

I don't think I changed my bolus ratios when I went on the pump though.

It is all a bit trial and error - are there particular times of day when you're higher? Perhaps you could do a basal test at those times to determine whether your basal is set right.

It takes a bit of calibration but I'm sure you'll soon get there. Good luck!

 

[CarbsRok]

You need to do some basal testing before you start messing around with anything else.
Here's a simple guide of how to basal test http://www.diatribe.us/issues/13/learning-curve

 

[weeezer]

Thank you both so much. On MDI i was on 30 background (split 13/17) so my current total daily amount of basal is 18, quite a lot less. My total bolus was 15-18 so I averaged my total overall insulin dose as 47, so when started on pump therapy they knocked 30% off & halved to work out new basal (16.32 which I increased on fri and again sat).

Im not higher at any particular time of day, I have tested between 2-4 every morn and have been between 9.6 - 14 so have corrected each time.

So I still think I can afford to push it up, maybe to 20 even, without being risky.

that article is fantastic carbsrok, thanks. I won't be changing ratio's yet then, even though I can't believe my ratio is right. Another lady who was starting pump therapy had v similar total daily amounts as me, but she is about 3 stone lighter than me, we went off with similar pump settings and she also is experiencing double figs (she went to 22.9 yuk) I can't believe I shld be on same amount if my body weight is significant higher??

Anyway, I will continue to adjust basal. Thank you both again.

 

[leb]

Hi
I habe been on the animas vibe pump for about 3 weeks now. Like the others say its all a bit trial n error. My total amount of insulin is roughly the same as it was on injections. My dsn said alit of people nned less on the pump but its not always the case. Also ad far as weight gies again its not always relavent. I need much more insulin than alot of people my weight. Apparently i hsve quite high insulin resistance.
It does get a bit frustrsting at times, and i kniw im still only just beginning too but hopefully it will all prive worth it in the end. I am a bit opposite to you as far as leves go. Before pumping i stayed at above 14 all of the tIme. SInce going on the pump it stays below 10 mist of the tIme but to start with i felt awful when i wad in NORMAL range. Now my bodys used to it if i go above 10 i feel achey sick etc.
Have you used diasend to upload your info? Not sure if it works with all pumps but its a great tool to help work out trends in glucose and insulin amounts
Hope you get the balance resl soon
All the best

 

[ChrisMaleType1]

Weeezer, it sounds like your basal is too low so I would personally consider increasing it. It doesn't sound like you're going to go into a hypo any time soon so I would start increasing it asap. Also, I would do some basal tests.

 

[Riri]

Hia Weezer – I had to increase my original basal settings almost every third day for the first couple of months (the advice was not to change it every day but to do it gradually to give things a bit of time to see the patterns). I would have thought though that if you're up in the teens you do some need extra basal straight away. I would take a note of your readings today and tomorrow and speak to your DSN if you're not comfortable changing things yourself at the moment. I know I was terrified to change basals etc. to begin with but now, 9 months in, I do change my own basal rates if required - as my DSN says - you're only changing very small amounts so for instance I may go from 0.65 to 0.675 over a 3 hours slot. That's the beauty of pumps - its a lot more controllable. Don't give in you'll get there... I had my doubts at the start and to be honest I'm still on a learning curve but I do find it's worth it. :thumbup: