Hypo, hypo and hypo again - new to pump - advice please!!!

[AlexandraMarnie89]

Hi,

I went onto a pump on Tuesday. I work weekends and was told to do a temporary basal last night for today, reduced by 30%. I woke up with bg levels at 11.8 at 8am, did the reduction and a correction along wth my normal carb ratio. I did this until lunch time, when I was at 3.7 (12:25) but got it up to 6.1 before lunch (12:45). I'd already hypo'd twice before this, so reduced basal by a further 10%. I was lower than I should have been after (5.3 at 14:36) and knew I wouldn't make it to 5pm as it was, so was a bit naughty and had a millionaire bar and a banana (50g carbs in total) but injected half of the bolus amount suggested by the pump. By the time I got home (17:41) I was at 3.2 yet again! I just can't seem to get my levels up at all - had a big dinner at half 6 and now, not even 8pm I'm at 7.3 still with my basal reduced :/ any ideas what to do? Really don't think I can cope with another hypo tonight but really looks like that's where I'm heading as I'm new to pump my consultant has said that I can call him at any time, but I've already had to speak to him yesterday and Friday so I don't like to bother him again any advice would be appreciated!

 

[EchoIsGreat]

Ask your consultant to be referred to go on a DAFNE Course for Insulin Pumps, which is an intensive 5 day course. I think you're making too many changes in a short space of time for your levels to settle down. The course will sort out your basal profiles and carb ratio. Once that is sorted you may have more confidence to set a basal profile for work days etc.

 

[AlexandraMarnie89]

Good advice, but I've been carb counting for 5 years and I've done DAFNE twice. We know that there wasn't an issue with my bolus rate before going onto a pump and my basal I've only changed as my consultant told me to and still hypo'd now 8 times today even with the reductions

 

[CarbsRok]

Hi,

I went onto a pump on Tuesday. I work weekends and was told to do a temporary basal last night for today, reduced by 30%. I woke up with bg levels at 11.8 at 8am, did the reduction and a correction along wth my normal carb ratio. I did this until lunch time, when I was at 3.7 (12:25) but got it up to 6.1 before lunch (12:45). I'd already hypo'd twice before this, so reduced basal by a further 10%. I was lower than I should have been after (5.3 at 14:36) and knew I wouldn't make it to 5pm as it was, so was a bit naughty and had a millionaire bar and a banana (50g carbs in total) but injected half of the bolus amount suggested by the pump. By the time I got home (17:41) I was at 3.2 yet again! I just can't seem to get my levels up at all - had a big dinner at half 6 and now, not even 8pm I'm at 7.3 still with my basal reduced :/ any ideas what to do? Really don't think I can cope with another hypo tonight but really looks like that's where I'm heading as I'm new to pump my consultant has said that I can call him at any time, but I've already had to speak to him yesterday and Friday so I don't like to bother him again any advice would be appreciated!

It sounds as if you have all of your long acting out of your system now, so nothing to interfere with basal going through on the pump. So you know where you are going hypo so reduce your insulin at least 2 hours before the hypos. Make sure you have plenty of quick acting carbs with you to treat any impending lows and give your dsn a ring for moral support and advice. As a general rule of thumb a basal increase of 0.05 will increase your blood sugar by 3mmol/l so use the reverse logic for the time being to bring your numbers up.

You really need to start basal testing as well so once you have stopped the hypos you can get on with that and fine tune things. It wont happen overnight so try not to get so frustrated when you find Rome wasn't built in a day.

 

[Dzialo]

Hi, im new to pump to and I had the same problem because it depends on the activity you do so they told me I can reduce basal myself and see if it stabilizes, so this week I reduced it by 0.15 from 9 - 21, but first ask your consultant

 

[Spiker]

From the information given I wonder if your basal rate is fine, or even too low, but that your carb ratio and/or correction ratios are too high.

Try dropping these ratios by one or two steps and see if the hypos stop.

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