Insulin Pump

Try going back to basics, instead of guessing do basal testing then repeat them so you know exactly where you stand.
Have you got your duration of insulin set correctly are you changing your basal at least an hour if not 2 hours before the change is needed.
Sort your basal before you thinking of changing ratios though.
Most importantly do you have the book pumping insulin by John Walsh (amazon) if not then that needs to be a priority.

Susan67 said:

Excellent thanks. I do set my basal rate an hour, sometimes 2 before the change is needed. I will go ahead and order the book now. It sounds as if all my answers will be in the book.

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The book is known as the pumpers bible and worth it's weight in gold

Hi @Susan67 and welcome to the forum.

It would be wrong to assume that basal rates and I:C ratio's don't change as they do, as CarbsRok says the first step is to start with some basal testing, have a look at the following which gives a good explanation on how to do the test in different time frames:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

Btw, the book Pumping Insulin is a must, its a book you can go back to time and time again

Until my sets caused me havoc and I stopped pumping then I consisteny achieved levels between 5-7 24/7.

First off though basal testing is ok... But you must trst 2-3 hours after each meal... If your levels fluctuate between 2-3 hours after any bolus whether its a correction or for food then your bolus may need tweaking. However, this will then depend upon the types of food that you are eating.

No way if my basals needed adjusting would I alter basal 1 hour before... If I went say higher at 2.24 I would adjust the 12 noon basal rate.

If doing basal testing I would also test hourly.

Also you may well find that if it is your bolus that nerds changing to give more it may well have an impact later on your basal rates.. For example

If I ate at 5pm and was higher by 7.30pm then I would raise the bolus insulin ratio to give more. However as that extra bolus would still be working 4-5 hours later then I would also have to consider lowering the basal at 7pm.

Also.try to leave 5 clear hours between meals to avoid stacking of insulin. It will allow you to see patterns clearer.

I'm not new to the insulin pump - have had one for 4 years. I have to say my numbers are all over the place during a 'certain time of the month' - I just have to adjust accordingly. I have set a +5% and +10% temp basal rate to try and get some normality to my blood sugars over these 7-10 days. I am also approaching 50 so probably peri menopausal which the GP thinks may be contributing to fluctuating sugars - nothing like this happening with you is there if you don't mind me asking?

Riri said:

I'm not new to the insulin pump - have had one for 4 years. I have to say my numbers are all over the place during a 'certain time of the month' - I just have to adjust accordingly. I have set a +5% and +10% temp basal rate to try and get some normality to my blood sugars over these 7-10 days. I am also approaching 50 so probably peri menopausal which the GP thinks may be contributing to fluctuating sugars - nothing like this happening with you is there if you don't mind me asking?

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Riri this was my first thought to Sues question too... The 7-10 days before my period I have to start increasing basal -- +20% up to +50% the last 2/3 days before!

I also have to increase my insulin to carb ratio - they go from 1:12 to 1:8.

Then 2 days in they all fall right back again... S'all fun ;-)

I am relatively new to my pump. I was on MDI for donkey's years, then got my pump last December. My blood sugars were swinging massively for the first few months. After about two months I bought both Think Like A Pancreas and Pumping Insulin, and sat down and read them both. In fact there is so much info in PI, it will take a couple of months to absorb it all and put it into practice.

I did my night time basal tests properly (I think you have done that) but was still getting swings during the day, and when that's happening, ironically you cannot test carb ratios and correction ratios properly.

At that point, I learned two important things: first (you know this), don't make more than one change in your settings at once.

Second, and this was the lifesaver for me, do NOT have a RANGE as your blood sugar target. I previously had (70mg/dl - 100 mg/dl) set as my target. But after reading PI, I changed it to just 100mg/dl on my pump (but kept that target range on my BS meter which is not connected.) Dramatic reduction in swings, more on-target bloods, fewer hypos and reactive hypers.

Could that be it?

After I got that sorted I started on managing bolus and basal rates to correspond with levels of physical activity. Obviously, that is always going to be less predictable but it is now 80% manageable for me. I no longer have to sit in Buddha-like contemplation all day to avoid hypos. Those two books are useful for adjustments to activity level too. But I also bought Diabetic Athlete's Handbook.

I bought all the books because I read that something like 70% of people who start on a pump give up again within a year, and that the reason they give up is because they don't get enough training to use them and they don't learn to use all the features which give them an advantage over MDI. And I realized that basically no doctor or DN is ever going to have enough time to impart as much information to you as you can get by reading. And the Internet is a bit too random and disorganized as a source of info.

I am pretty happy with mine now. My HbA1c has gone from 9 to about 6.2 since I got my pump.

At the moment I am working on the effects and after-effects of anaerobic exercise on my dosing and blood sugars. I'm pretty happy! You can do it.