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Nearly ditched pump tonight!

V

victry77

Well-Known Member
Messages
260
Earlier this evening I was literally going to disconnect from this pump and use my injections again.

Second time within the six weeks of having it I've had to cancel plans in the evening because of unexpected high levels. First time was down to a bent cannula, this time, no idea. Changed my set, there didn't appear to be a problem, no other reason to pinpoint why I had hit 20.

I've had persistently high BG's for three weeks at least. Thing is (for the most part) they have been stable. I scheduled myself to do my first round of basal testing last week, but each time my BG was too high to start. I've altered my correction dose from 1:4 to 1:3 still doesn't appear to be helping. I have increased basal in small doses to the point where just that little bit extra is sending me dropping too low.

Yesterday, I finally managed to do an afternoon basal test (would have preferred to start with overnight, but BG wasn't having it). My BG did hold stable from breakfast to evening meal while skipping lunch. But just this bloody 20 this evening has got me into a tiz and I'm just questioning now whether I have the mental energy for this.

My levels have never been this high since I was first diagnosed and I hate it. Thursday is my next set change and I'm really considering not bothering and using my pens again and back to chasing the hypos.

Sorry to moan, honestly. I'm sure this kind of frustration is normal in the early days but
 
Have you sought advice from your pump DSN, if not you should make contact with them and ask for their input.
 
Unfortunately I don't find her especially helpful. I am due to see her on 18th June (had to cancel this months appt due to work thinking they'd give me one the following week as opposed to over a month later).

I might call her tomorrow, though.
 
Yes do that Victry, you could also ring your pump helpline and ask if they can suggest anything, the sooner you can do some basal testing the better as this is so important whether your on pump or MDI, if you've not got the book Pumping Insulin be sure to purchase it, everyone will tell you what a great book it is for those who are new to pumping insulin and even for those who have used one for some time.
 
Ive just started on my pump today and had a great training from roche representative ( diabetic himself). He gave me a choice of rapid or flex cannula but strongly recommended rapid one which doeant bend. Maybe you shoud try this one ?
 
Your sets sound like they may be giving you the problems.
If you are on the flex do consider changing to the rapids. (You will need training though-officially).

What length sets are you using?

I had horribly awful readings with the flex.. Just because of being lean but had no choice initially.

If you can't get hold of your DSN speak to Accuchek Pump careline. This is a chap there that is superb as will the ither staff.

I still get random highs on the rapids and Accuchek are aware of my probs. Because I don't eat all day and my levels are perfect I had to ask them why the eandom high readings at any time on the 2nd day.
It maybe because of my being lean, but its hard for Accuchek to determine causes as people like me that literally basal test all day and have one meal in evenings are not normal.... Most people will be putting down to not carb counting correctly or wrong basals...
With me, my consultant thinks that as I am lean that the sets are just coming to the end of their lives earlier (not known why though)..... At the moment I am having to change sets daily to avoid the random highs on day two.

Please make sure that you are priming the tube with the correct amount of insulin and the sets... Don't forget if you change length of tube or cannula then you must tell the pump to prime more. I actually prime my tube by an extra 2 units and more for the cannula as well as their settings for the cannula length for me gave me highs as well.

I think you need to speak to your DSN.

If you are hitting 20's your standard correction bolus is unlikely to be enough.

Your hourly rates and readings should be determining how much you change your basals by.

It really sounds as if you need to speak to your DSN.
 
@ victry77

Although some of yr bg problems might be down to the type of set you are using and where you are inserting it, the cause of high or low bg is usually due to a change in basal need. So try to do a basal test for the evening and then you will see when yr bg starts to change. Also, try to keep yr sets inserted in the same area for a while until you are able to stabilise yr bg with the settings you use.

Pumps are hard work initially and I too felt like going back to injections and at times when bg goes high for whatever reason, I resort to using my pen to deliver the bolus and then tackle the pump, wait to see if a pattern occurs the next day and if it does, adjust the basal settings so that day 3 will be better. Just write all the old settings down on paper so that you know what you are doing if you need to alter things a touch.
Slowly, you will get there and dont let diabetes get on top of you.
 

Yes, I have the book, thanks. It's just getting my head in the right place to start properly getting into it. I am genuinely worried now that I shouldn't have taken the pump on.

Donnelly ~ I'm on Medtronic. They have the Quick Sets and the Silhouette. I'm also very slim and I've read that the Silhouette might be better. When I mentioned this to my DSN (when I had a problem with the bent cannula) and asked if it was likely me being very slim could be an issue her reply was "No." And that was that. She's also been dismissive of other things I've mentioned (things experienced by others).

It's really interesting that you say because your lean your sets might be coming to the end of their life sooner. Wonder if that could be happening ith me also. But I guess I still need to account for my higher levels throughout the day.

Honestly trying to get basal tests done but am constantly thwarted by levels that are too high to begin them. It's funny but in the 7rs I've had diabetes I've always been really positive and have never let it get me down (OK, was getting a bit too used to having hypos and that's why doctors suggested the pump), but in the 6 weeks of having it, never felt so miserable and affected by my diabetes. Weird.

Thank you for your advice everyone!
 
@victry77 77, 6 weeks isn't a long-time as pumps are a complex piece of kit and can take time to get use to, persevere and try and get as much help as you can from the good people on here, your DSN and of course your pump manufactures, when it all comes together you'll be amazed how well you can get good constant bg control without too many hypo's.
 
Thank you for the positive encouragement, noblehead. I find the people here priceless

I also noticed Medtronic to steel needle infusion sets. Are these a good alternative? Anyone use them?
 
victry77 said:
Thank you for the positive encouragement, noblehead. I find the people here priceless

I also noticed Medtronic to steel needle infusion sets. Are these a good alternative? Anyone use them?
Click to expand...


I'm using the Omnipod Pump so can't help you there Victry, hopefully others will reply and help you out.
 
Try an angled set for starters, or a shorter set. Can you not ring Medtronic and ask for samples to try or better still change to a different hospital or DSN?
If the set is working correctly and you are still to high to basal test then the simple solution is to increase your basal a couple of hours before the high showed up then try again a couple of days later.
Some of your problems are lack of patience (we all get like that) You need to develop sit on hands syndrome and stop making so many adjustments. As already advised read the relevant section on basal testing in pumping insulin.
 
Hi victry77

Medtronic do Sure T which is the steel needle, Mio, QuickSet and Silhoutte so there is a good choice of infusion sets. There is a comparison of all the sets and who they work best for on the Medtronic Diabetes website.

if you continue to have problems can you give Medtronic a ring and ask for some advice on alternative sets as they will be able to give you some advice on what's best for your body type.

It is hard work to start with but when it starts to click into place a pump is a fantastic piece of kit. Good luck
 
@ victry77

I didnt do any basal rate setting during the day for ages......I just got my night ok as I was going fairly low so started to adjust the midnight basal down, then the 2am. The 4am needed a tiny increase to cope with bg starting to rise at 6am but for a while, I just eat a small amount of carb before going to bed as I was starting to look worn out with not getting much sleep and my consultant told me to get some sleep in.
The way I started to adjust the settings on the pump was as DDs consultant advised her......if bg is high or low 2hrs after eating, adjust the bolus, if bg is high or low 3hrs after eating, adjust the basal. When I did get round to basal testing, the basal rates were not far out but another way to adjustthem is to look online for the basal rate adjustment guide by Gary Scheiner and follow the correct row and column in the table.
 
As others have said, ask Medtronic to send you some samples of other sets. They are very helpful on the phone. I had awful problems for the first few weeks with the quick sets but as soon as I changed to silouhettes (I'm slim too) they worked like a dream. I was like you about to give up so worth trying the others to see which suits best. All the best.
 
Do they teally send out samples? I know some pump companies won't do that unless you have had training. I know Accuchek are very careful about people swopping over sets especially with the Insight if you've used the old combo sets as they are very careful to ensure you change the fill size of cannulas and tubes etc.
 
Animas have no problem in sending out sets to try
 
 
On the medtronic - is there a "meal rise" setting like the Accuchek pumps?

Ie my meal rise is set to 2.8 so the pump knows to give a correction if my post meal readings are over 2.8 higher than my pre meal reading...

Does medtronic have the same facility on their pumps?
 
ewelina said:
Ive just started on my pump today and had a great training from roche representative ( diabetic himself). He gave me a choice of rapid or flex cannula but strongly recommended rapid one which doeant bend. Maybe you shoud try this one ?
Click to expand...
The rapid (stainless steel) definitley bend. I've pulled at least two out of me with considerable angles on them, resulting in lots of blood. I assume he means they don't kink on insertion which might be true. But when they bend it bl@@dy hurts.
 
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