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Discussion in 'Insulin Pump Forum' started by Toriroge, Jul 31, 2016.

  1. Toriroge

    Toriroge Type 1 · Active Member

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    Hi I'm Tori,

    I'm 26 and have been a type 1 diabetic since I was twelve. In October I will have been diabetic for 15 years and can't remember not injecting!

    I have joined the forum as I don't know any diabetics and sometimes think I could maybe do with the support and knowledge of other diabetics.
    Some times a conversation with a friend or family member is hard as they just ' don't get it'

    I am also being referred for a pump ( diabetic nurse will be writing the letter this week) I would love to know what people's opinions are on the pumps and the pros and cons ups and downs that people have had. I don't have any problems Injecting but suffer badly with the dawn phenomenon, so am considering the pump to hopefully settle this down!
    X
     
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  2. Liam1955

    Liam1955 Type 2 · Master

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    @Toriroge - Hello Tori and Welcome to the Forum :). There will be Type 1's along to greet you. In the meantime I will tag @daisy1 who will provide you with some basic information that all new members receive. If you go to the top of this page and click on Forums - you will be able to see all the different headings and threads available. Have a good read and ask any questions you may have.
     
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    #2 Liam1955, Jul 31, 2016 at 7:18 PM
    Last edited by a moderator: Jul 31, 2016
  3. daisy1

    daisy1 Type 2 · Legend
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    @Toriroge

    Hello Tori and welcome to the forum :) Here is the information we give to new members and I hope you will find it useful. If you look at the forum list you will find there is a section on pumps which you should find helpful. Ask as many questions as you like and someone will be able to help.


    BASIC INFORMATION FOR NEW MEMBERS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
    There are two approaches to controlling your carbs:

    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates

    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
    http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes

    LOW CARB PROGRAM:
    http://www.diabetes.co.uk/low carb program


    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips

    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic

    Note: This post has been edited from Sue/Ken's post to include up to date information.
     
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  4. Prem51

    Prem51 Type 2 · Expert

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    Hi @Toriroge and welcome to the forum. You will find a lot of support and useful advice on here.
     
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  5. himtoo

    himtoo Type 1 · Well-Known Member
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    Hi @Toriroge
    welcome to the forum :)
    i have moved your post to the insulin pump sub forum as I think you will get a response more in line with what you are looking for.

    I myself started on a pump 10 months ago -- been D for 44 years :D

    it is a bit of a leap of faith turning over everything you think you know to a tiny bit of "kit" -- but it has been the best and most life changing thing i have done so far

    do keep posting and just know you are not on your own
    all the best
    x
     
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  6. Gemarky

    Gemarky Type 1 · Member

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    Hi. I've been diabetic for 28 yrs and on a pump for 13. I can only see pro's and no cons with the pump. I'd never want to go back. It gives you much more freedom and control. I carry less "kit" with me, although I have put spares everywhere, at my mums, in the car, at work....you never know when you'll need them. Good luck with it.....
     
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  7. Dave24/7

    Dave24/7 Type 1 · Member

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    Silly question but how do the insight pumps get both insulins?
     
  8. rockape37

    rockape37 Type 1 · Well-Known Member

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    Hi Tori, the Dawn Phenomenon is why i was,recommended going on pump therapy and I'm really glad that I'm on it.

    The dawn phenomenon for me has been gone since i started on the pump on 29th June this year so I'm well pleased. If you read through a few of the posts on this forum you will see how I and others cope with our pumps and i would say most of us have positive views. It has to be said and I'm sure that you are aware is that you have to be prepared for more BG testing and have an active input in the running of your pump.
    So keep reading and posting as we all learn from each other irrespective of ones experience.

    Regards

    Martin
     
  9. Snapsy

    Snapsy Type 1 · Well-Known Member

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    Hi @Toriroge !

    I'm a relatively new pumper, having started pumping 29 years after I was diagnosed - I wouldn't go back to MDI, and have got a whole new lease of life. It's fabulous. Have a read around this pump sub forum and you'll find out so much!

    @Dave24/7 that's not a silly question. Pumps use solely short acting insulin - in my case a Novorapid cartridge in my Insight pump.

    Some of this I use to bolus for food, or correction doses, and there are specific settings for this.
    In addition to this, there is a continuous basal dose going on - again, of Novorapid - and because it's going in trickle trickle trickle it is providing a baseline level.

    The way this basal level differs to that of long-acting insulin once (or in some cases twice) a day is that different levels can be set for different times of day. This is particularly beneficial for dealing with dawn phenomenon. For illness or exercise, basal settings can be adjusted up or down. I have 8 different basal doses over the course of a day (this is all programmed in so happens automatically) but I also have the opportunity to make changes on the fly if, say, I'm going for a run and want to take less basal insulin over that period so as to avoid a hypo. It's magic.

    With MDI, and long acting insulin injected all in one go, there isn't any kind of adjustability. There is on a pump, using rapid acting insulin for its basal rate.

    Hope that makes sense!

    :)
     
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    #9 Snapsy, Aug 4, 2016 at 2:07 PM
    Last edited by a moderator: Aug 4, 2016
  10. Toriroge

    Toriroge Type 1 · Active Member

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    Hi Martin ,
    That's brilliant news that the dawn phenomenon seems to have stopped! That's my reason for a pump as every morning I wake up high! Which is annoying as I wake up and correct every day at the momment.

    Thanks for every ones reply I will be looking at some of the previous pump posts to help me out .
     
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  11. Davec2802

    Davec2802 Type 2 · Active Member

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    Welcome toriroge. Nice to see a new face.
     
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  12. rockape37

    rockape37 Type 1 · Well-Known Member

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    Tori, just to add to that my evening meal ratio was very high and was advised not to increase it and I needed a correction before I went to bed to bring it into target but as I've already mentioned the dreaded Dawn Phenomenon reared its ugly head.

    Also if you are not already aware there is a delivery option that can be used called Dual Wave, you can then deliver a % of your bolus straight away and the rest over a period of time.
    For example I have 50% of my bolus straight away followed by the other 50% over a period of 30 minuets.
    Apparently larger doses of insulin are harder to absorb by the body so effectively you could be giving yourself more insulin than you really need just to get enough in your system to do the job. The Dual Wave option I use has sorted this out and my Insulin/Carb Ratios have dropped, my basal has also dropped.
    So basically for me the pump has worked wonders and there is so much more that can be done with the pump that you just could not with MDI.
    Pump therapy is still new to me and I still have things to sort out but I'm taking everything step by step, the pump is making the future much brighter.

    Regards

    Martin
     
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  13. Dave24/7

    Dave24/7 Type 1 · Member

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    :)[/QUOTE]
    Hi everyone!

    Thank you for this Snapsy, yes it makes sense now that you have explained it for me! Thank you!

    Are you saying I will only be using Short Acting insulin to do all the work now.
    But on the machine its Called Basal for long acting, Levemir, and NovoRapid now set in 0.1 - 0.2 tricycles :) sorry i mean trickles lol typo!

    and for Bolus is for when you have meals, so the machine is programmed for both? or do you have to do the meal time slots yourself to the blood readings? I see Multiwave when reading about it.
    Basal - Long Acting
    Bolus - Short Acting
    ?



    I don't get dawn phenomenon anymore they are a nightmare! but do get it changing a lot in my blood readings for no reasons, which tend to be in the morning and then affects me for the rest of the day, so I'm hoping this will improve it has I'm getting hypos later in the day.
     
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    #13 Dave24/7, Aug 4, 2016 at 10:16 PM
    Last edited: Sep 11, 2016
  14. himtoo

    himtoo Type 1 · Well-Known Member
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    Hi @Dave24/7
    i would recommend you get the book pumping Insulin by John Walsh.
    it is an absolute encyclopaedia on all thing to do with being on a pump.
     
  15. Dave24/7

    Dave24/7 Type 1 · Member

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  16. Gary61

    Gary61 Type 1 · Well-Known Member

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    Hi Tori,
    I've been using an Animas Vibe pump for the last 8 weeks after being Type 1 for 37yrs. I can honestly say that my control has been exceptional and I would recommend any type 1 with giving it a try. There's a lot of groundwork to do before starting so that the pump can be programmed with the most suitable doses for you and I would say that I do test myself quite a bit every day, but it's a small price to pay. I certainly enjoy the freedom of not jabbing myself anymore which is another big plus.
    Hope your experience is as good as mine.
     
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  17. rockape37

    rockape37 Type 1 · Well-Known Member

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    Hi everyone!

    Thank you for this Snapsy, yes it makes sense now that you have explained it for me! Thank you!

    Are you saying I will only be using Short Acting insulin to do all the work now.
    But on the machine its Called Basal for long acting, Levemir, and NovoRapid now set in 0.1 - 0.2 tricycles :) sorry i mean trickles lol typo!

    and for Bolus is for when you have meals, so the machine is programmed for both? or do you have to do the meal time slots yourself to the blood readings? I see Multiwave when reading about it.
    Basal - Long Acting
    Bolus - Short Acting
    ?
    I'm not on one yet, just doing my homework too, before the go ahead with it.
    It's going to be weird not injecting! On 21 injections a day at mo! Had D since I was 2 so i don't know anything else.


    I don't get dawn phenomenon anymore they are nightmares! but do get it changing a lot in my blood readings for no reasons, which tend to be in the morning and then affects me for the rest of the day, so I'm hoping this will improve it has I'm getting hypos later in the day.[/QUOTE]



    Hi Dave24/7

    Only rapid acting insulin is used.
    Your Basal is your rapid acting insulin trickling into you all the time at various rates per hour during a 24 hr period.

    And again your bolus is the same Rapid acting insulin for meals as and when required.

    Regards

    Martin
     
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  18. catapillar

    catapillar Type 1 · Well-Known Member

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    Are you saying I will only be using Short Acting insulin to do all the work now.[/QUOTE]

    Yes. On a pump you only use fast acting insulin.

    But on the machine its Called Basal for long acting, Levemir, and NovoRapid now set in 0.1 - 0.2 tricycles :) sorry i mean trickles lol typo![/QUOTE]

    The pump covers two actions. You set a basal rate and all throughout the day the pump will deliver small increments of fast acting insulin in line with what ever basal rate you set. This is your basal or background insulin.

    Then, when you eat, you bolus and you tell the pump to give you another little wedge of fast acting insulin to cover the carbs you are going to eat.

    and for Bolus is for when you have meals, so the machine is programmed for both? or do you have to do the meal time slots yourself to the blood readings? .[/QUOTE]

    Yes, the bolus is the fast acting insulin to cover your food.

    It's not exactly correct to say the pump is "programmed" for both. Even though the pump is very clever, it is just a way of delivering insulin. You still have to do all the thinking for it.

    You have to decide what basal rates to set.

    Then when you eat, you test your blood sugar and tell the pump how many carbs you are going to eat. Pumps have a bolus calculator so they will feed your blood sugar and carbs into a formula (you will already have told it what your target blood sugar level is, what your insulin to carb ratio is, what your correction factor is and what your carb sensitivity is) and use all that information to decide how much insulin to give to bolus for that meal and keep you in target. But you will have to decide whether that's the right amount of insulin. The pump is clever, but you still know more than the pump!

    I see Multiwave when reading about it.
    Basal - Long Acting
    Bolus - Short Acting
    ?
    I'm not on one yet, just doing my homework too, before the go ahead with it.
    It's going to be weird not injecting! On 21 injections a day at mo! [/QUOTE]


    Ah! So you are currently on 2 shots of mixed insulin a day? You aren't on a basal/bolus multiple daily injection regime?

    If that's the case and you are interested in a pump, I would have thought that the first step would be moving on to a basal bolus regime. You really need to understand how that works and how to carb count before you get on to the pump.

    [Or, that isn't a typo and you are in fact on 21 injections a day and microbolusing like billio! So you would be very familiar with all this stuff in my post, sorry if that's the case - and how on earth are you doing 21 injections a day on MDI? I'm sure if that's the case there might be more ideas from forum members to help, so do post more about that if I am wrongly assuming 21 is a typo - correct me!]

    Basal = long acting or background insulin. The job of the basal insulin is to keep your blood sugar "flat" when you aren't eating, taking short acting or doing unusual exercise. Your liver is constantly giving you a trickle of glucose and that's why we always need some background insulin working to keep us steady. On a basal bolus regime the basal is given by one or two injection of basal insulin a day. On a pump the basal insulin is the basal rate of tiny amounts of fast acting insulin running all the time.

    Bolus = fast acting insulin. On a basal bolus regime the job of the bolus is to cover the carbs you eat. On multiple daily injections, you give yourself a bolus every time you eat carbs. You work out an insulin to carb ratio. For example, you might know that for every 10 grams of carbs you eat you need 1 unit of insulin to cover you, so if you were eating a meal with 40g of carbs, you would give yourself 4 units of insulin. On a pump, you bolus in much the same way, but the insulin is delivered through the pump.

    Multi wave = a feature on the pump where you can decide that you want to deliver your bolus in a split way. For example, you are eating a pizza with carbs but you know the fat in the pizza is going to slow down you absorption of the carbs so you decide you want to give yourself 50% of the bolus now and the other 50% over the next 3hours.
     
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    #18 catapillar, Aug 6, 2016 at 10:12 AM
    Last edited by a moderator: Aug 6, 2016
  19. catapillar

    catapillar Type 1 · Well-Known Member

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    Oh boo, quotes didn't work very well. Oops! But there are lots of smiley faces in my post, so, I'll take it :)
     
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  20. Snapsy

    Snapsy Type 1 · Well-Known Member

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