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Never seem to get the results I expect!

B

bonerp

Well-Known Member
Messages
401
Location
Dorset
Type of diabetes
Type 1
Treatment type
Pump
Hi guys,
not been on for a wee while due to work etc.

Still can't seem to get things right with this pump. I know the flexibility is there over injections but sometimes this injections work better for me!

Yesterday has a pump occlusion and seems to not recognise a blockage until about 3/4 hrs after its fed me its last dribble. Not happy about this as by the time its realised theres a problem my BGs are too high! Went onto injections yesterday again just due to timing/shower/changing sets etc. BGs were spot on all day! Typical.

2nd problem is the gym. I just can't get it right. Often I go high afterwards then low later on. Unless I use 2 different profiles (which is a pain to manage and remember to switch again), its a mare!

3rd problem, still getting bad bleeds in my eyes due to retinopathy. Would have expected after 2 years being on pump that improvements would have been experienced. Could this be an effect due to swings in BGs too? I also have problems due to not being able to go to the gym after bleeds for a week or 2 and this impacts on my results too. I've increased by basal from 24 per day to 28 due to this. Thats quite a change for me.

I don't have poor control - dont get me worng on this. average between 5-13. However its the lack of consistency that drives me nuts.

For example today had breakfast - same as every day. Started at bg of 5.1. Had breaky, bolused then 2 hours later 14.1. Not reason for this as do it every day.

I'm not looking for sympathy on this guys. Just some tips and tricks how to improve things.

Can do the basal testing but during times of no exercise and the impact of this, everything changes again!

All advice really gratefully appreciated.

Paul
 
I think that you really need to do some basal checks, to see if this is still correct, as they can alter a little bit ove time

As to your breakfast readings I'm assuming that this is an odd readings and not daily occurance, I would look at several areas... Any stress after you've eaten your breakfast, different breakfast eaten I would also check whether there is any link to your fusion site as some areas can adsorb better than others..

As to the exercise, I know that it's a pain remebering to change profiles, I wonder whether for certain exercise you could use the TBR instead, setting it either before you start, or after to cover what the profile would do, then the alarm would let you know that it's finished..

Most pumps won't show an occlusion until it's missed 3 units of insulin, if I remember righty it's activated by pressure against the piston that set's the alarm off so the longer the tube the longer it takes to notice that theres a blockage, but I would double check where your infusion sets are placed as when I've had this happen to me on the odd occasion I can put it down to having my waist band of my jeans on top of the infusion set..

Another thing to check, if readings are higher than expected is Air bubbles, unfortunately the spirit pumps are a nightmare for them when filling up the cartridges, so I regularly check for these, and I always wear my pump with the lunar/tubing facing downwards so that it helps to keep air bubble from entering my tubing...
 
Paul

Sorry to hear of the problems you're having, especially with those retinal bleeds. What does your opthalmologist say and how's your blood pressure? Some sources suggest that in patients who have some degree of nephropathy and/or retinopathy, blood pressure control is a more significant factor than blood sugar control in maintaining microvascular condition, although clearly they're both important. Eyes very often take much longer than other elements to settle down following a change in regime. Certainly did with me, I was still getting the occasional bleed 3 years after moving to pump therapy, but haven't had any now in over 2 years.

I had a Spirit pump for 2 years before switching to the Paradigm, and used to get occlusions all the time. Haven't had a single one since the switch.

Are you sure of your insulin/carb ratios? In the morning mine are nearly double when compared to the evening (1:8 vs 1:14). Took me ages to work out.

Other than what Jo's already suggested I can't think of anything else.
 
Kegstore,
How do you programme your Paradigm to give your carb ratios as you describe? I can only go up/down in values of 0.1? I am looking at your ratio of 1.14 - for me that would be 1.1 or 1.2 - no inbetweenies!

No doubt it will be a setting somewhere which I have missed - I am assuming that you are using the "bolus wizard" for your calculations - can't imagine working things out at those ratios in my head!

Alan
 
Alan

Make sure you're changing the right thing, not sure about your numbers there. Chapter 5 in the manual explains all about the Bolus Wizard feature, or: go to Bolus > Bolus Wizard Setup > Edit Settings, scroll down to Carb Ratios: and press ACT, enter the start time and the ratio you want. Once you're done you can review settings too.

You're right about the maths! I also use 1:10 and 1:12, again depending on time of day, so it can get a bit fiddly otherwise. I have enough to do already.
 
Kegstore,
Ahhh - 'tis me misreading your post - sorry. I have my bolus wizard set up with exchanges so my "ratios" settings are numbers like 1.8 and 1.6. Meaning that for every exchange, which in my case is 10g of carb, I take 1.8u or 1.6u depending on the time of day. So.... my ratio - using the proper format is 1:1.8 or 1:1.6 (the '1' being a carb exchange and the other number, units of insulin).

When you wrote 1:14 and 1:8, I was misreading the ':' as a decimal point. So... if I have it right, you are using 1 unit of insulin for 14g of carb at some times of the day and 1 unit of insulin for 8g of carbs at others - is that right?

Phew - not only is there a difference in BG readings - us with mmol/l and those across the pond using something else, we have variations when it comes to expressing our insulin:carb ratios!

Alan (does any of that make sense to anybody other than me I wonder!)
 
BP is not bad most of the time generally runs about 70/130-145 (higher end when I've had bleeds - prob stress related)!

Its a bit of a no win situation because I can't exercise with these bleeds going on, then that causes BGs to increase and subsequently further damage! Grrrrr.

I've read the candarsartan help with retinopathy so will be speaking to docs about increasing dose of that permanently (I double it for a couple of weeks after bleeds just to keep things under control).

I find docs at hospital don't explain much and never ever see the same GP!

This weekend I went out and had a few beers and a lot of diet coke as didnt want to drink too much alcohol whilst these bleeds carry on - got home and had another small bleed. Great. Don't drink much normally so starting to wonder whether caffiene might be causing some probs.

I also take some bilberry supplement in an attempt to improve things. Been off them for 4 weeks to see if that was a cause but didn't seem to make much difference whether on them or not!

thanks for your help.

Paul
 
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