Maybe coming off pump

How long have you been on pump? The choice is yours really... Not your consultants to stop pump. Personally, I would say that you may need more help to investigate and combat the 20's... And a better understanding how to get the down fro that level at 5hrs... But more importantly there has to be a reason for them.

I can personally account for every reason of a blood level altering outside of the 4-7 range...and so should you.....

I know nothing of this new insulin, other than it is meant to be better.... But my opinion is that you need more help with pump....

Jessd said:

Hi
I had clinic yesterday. My diabetes hasn't really been great last month or so,quite erratic blood sugars (high) had my HBAC1 done yesterday at clinic so should get results back next week.
Seem to be having odd highs that I can't account for (in the 20s sometimes)I
I don't cheat with it, if I do have something bad I always make sure I try & give enough for it
Anyway at clinic yesterday they said they'd like me to come off the pump & try Degludec, so back to injecting,consultant thinks this would be a good option for me,he made it clear that the
Pump was by no means getting taken away & asked what I wanted to do,kin if felt a bit railroaded into it,came as a bit of a shock. I do openly say that things hadn't been great.but was a bit cheesed off as there were no suggestions to helping me get things better if I stayed on pump,my pump nurse basically said nothing
Has anyone come off from the pump & tried this Degludec & how was it ?
I do want to have my control as best I can & if this works am all for it
I have been on pump for 5 years,kind of felt that it was a case of well been on pump long enough should have it right by now


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I too have been on the pump for 5 years and in December had high blood sugars almost daily and couldn't seem to account for the reason. Very frustrating. I finally increased my basal rate and everything is good again. I had a similar issue last winter and I also increased my basal with good results. Had to reduce the basals in May. I have read about some people having different insulin needs seasonally and from what has happened to me these past 2 winters I may be one such person. If my basal needs decrease again this coming spring I will be convinced that I am one of those people. Just something to consider if you cannot find any other reason for your problem.

I'm not a pumper, so I don't know the ins and outs of that. But looks to me like something else is wrong. Could it be stress pushing it up? Are you sure you're carb counting correctly?

I would try your basal tests and check that's not the issue (easier said than done when you've got such high numbers to start with!) and if those are clear I'd take a look at your carb counting and then finally check your ratios. Because any of those things are wrong then change back to pens won't help


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Jessd said:

Have just done a bm & 17.8 what??!!!!
So am probably going to change me set-feel as though I'm chasing it all the time


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Frustrating. When I was having highs in the 17-18 range I inched up the basals without testing (was too high test) and saw an improvement very quickly, did not have to adjust ratios but you may need to. Ty small changes to settings and see what happens. Worked o me.

Change to a different batch of sets.... Explain prob to your pump supplier. Tell them you want to try a different batch number of sets and tubes. Make sure you know the batch numbers you are using currently.
If levels don't come down then you really are going to have to go back to basics and basal test etc..


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If you remain at these high levels with new batches then you will need to do some larger adjustments to your rates than you have previously been used to. Use a different profile...so you can revert back if the cause is winter...


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Hi. I am a newbie & this is my first post.

I have been having a few problems with poor insulin absorption and looking through the forum it seems I am not alone with this problem! I would really appreciate some pointers about what to try next……

I have been on MDI since 1974. Over the last few years I have been running at 30 or so hypos/week and highs in the mid 20’s. I switched to an Accu-Chek Combo in June 2013 and things really improved over the MDI. BUT there are still problems.

Every ten days or so the insulin I pump in does not seem to work at all or not very well. Changing the set and site sometimes makes a difference & sometimes not. This can last for a few hours up to four days. I think/hope that I have ruled out everything apart from absorption. I tried 6, 8 & 10mm steel cannula in all sorts of areas and can find no reason for the poor absorption. My diabetes nurse is also out of ideas. I think the insulin must be pooling which is causing the absorption problems but don’t know how to go about fixing this.

I bought a Dexcom CGM and deal with it using this. It does mean that during the bad times I am correcting six or eight times a day for high bloods and stuffing down carbs for lows, but I manage to (mostly) keep things on track. If it seems the problem is going to last more than a few hours and is not fixed by an insulin/set/cannula change then I switch to a second basal rate which is 50% higher than my usual. Once the absorption problem goes away, everything is fine for another ten days or so.

HELP!

You've just described what happens to me. I'm on an Omnipod but think this is relevant to anyone on a pump. I've just had a great three days with pod on my stomach and moved it last night to my calf and it's not working so well and just using a higher temp basal. It gets boring going through the a) is it a faulty pod, b) is it a faulty me! c ) is it an absorption issue d) have I misjudged my carbs. Currently I'm thinking the pod might be too near muscle which I understand to not be so good at absorbtion but then again most times it's ok on the calf. Where there is more fat, say on buttocks, then I have the same problem, sometimes they work and sometimes not. I'd be very interested to hear what anyone else comes up with.

Jessd..... I was one of the first patients to try Degludec / Tressiba. Its a peakless insulin and worked wonders on me. I have recently changed from MDI to the Omnipod. Im enjoying the pod and my control has improved. My HB was 11/12% when they changed me to Degludec. In 3 months my HB dropped to 8%. By this stage I had already applied for funding for a pump and I only got the funding 4/5 months after changing to Degludec. I still use degludec as a back up if anything were to go wron with the pump. I also sometimes take weekends off the pump and use degludec. My diabetes team have said that if ever I stopped using the pump, that Degludec would be perfect for me to go back on.
Its really expensive which is why they dont offer it to many diabetics. You will find your hypos become less severe and easier and quicker to treat..
Hope that helps.

JaneC said:

You've just described what happens to me. I'm on an Omnipod but think this is relevant to anyone on a pump. I've just had a great three days with pod on my stomach and moved it last night to my calf and it's not working so well and just using a higher temp basal. It gets boring going through the a) is it a faulty pod, b) is it a faulty me! c ) is it an absorption issue d) have I misjudged my carbs. Currently I'm thinking the pod might be too near muscle which I understand to not be so good at absorbtion but then again most times it's ok on the calf. Where there is more fat, say on buttocks, then I have the same problem, sometimes they work and sometimes not. I'd be very interested to hear what anyone else comes up with.

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I wanted an Omnipod but here in Cornwall the choice was between the Accu-Chek Combo and the Animas – I chose the Combo because of the remote control.

Does your DSN acknowledge the ‘insulin not working some of the time’ problem? Have they made any suggestions?

I wonder how many pumpers have this type of problem? Looking through the forum, I would guesstimate at least 20%.

Yep had one of them days today. levels shout up after lunch. Even if your dsn recognizing its pump,cannula,tube issue not alot can be done about these one offs. For, me, probably happened 2\3 times at the most since pumping. If it was to happen a bit more than that I would reconsider the cannulas first, trying diff ones, if that didn't help would seriously consider mdi again.

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brett said:

Yep had one of them days today. levels shout up after lunch. Even if your dsn recognizing its pump,cannula,tube issue not alot can be done about these one offs. For, me, probably happened 2\3 times at the most since pumping. If it was to happen a bit more than that I would reconsider the cannulas first, trying diff ones, if that didn't help would seriously consider mdi again.

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I can’t go back to MDI – my main sites are just about destroyed due to jabbing in both thighs for nearly 40 years – I was running at several hypos/day plus ridiculous highs. The pump has been a great improvement, but this insulin not working thing is a pain – It happens every week to ten days. The DSN is out of ideas.

Have you tried all available sites, and all different types of cannula

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