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New to pump - advice please!!

AlexandraMarnie89

Well-Known Member
Messages
98
Type of diabetes
Type 1
Treatment type
Pump
Hi

So I started on the accu check combo pump yesterday afternoon and my sugars have been pretty amazing compared to usual. (See mysugr photo above!) However, I have been up several times in the night to test bg levels and have had to bolus a very small amount of insulin (0.7u split as 0.4 at 00:16 and 0.3 at 04:45) in order to counter my dawn rise - I know from the past that of I'm around 7 at 3am I'll wake up at 13/14 feeling awful which is why I've done it. I've woken up at 5.3 yay! So does this mean that I need to increase my basal amount by 0.7u? Or how so I change it to give me a little bit more at these times? Does it have to be done by hcp?? My DN isn't available to speak to until this afternoon as she is on the ward on a morning so seeing if any of you lovely people can help!!

Also, on another note, ladies, where do you where your pumps if wearing dressed/tight fitting tops and leggings etc without a pocket?!! I tried everything last night and anywhere I put it it's visiable under my clothes with just a huge bump :/

Thanks
 
After several CGM tests in the past, I learnt that I had to whack up my basal at 2am from 0.25u/hr to 1.3u/hr to counter a massive drop in BGs and a subsequent rebound. I agree with iHs though, and do lots of testing to be sure of where things are going and make your adjustments in very small increments/reductions, then retest again and again! It'll take a while, and changes in life/diet/weight etc, will all require further reviews and adjustments in time ^.^
 
The way I got round adjusting the correct basal rate time slot on the Combo was to do the bg testing on the half hour so allowing 90mins before doing an acjustment. How much you nred to adjust depends on yr bg is when you do the tests but start at the 10pm one and test at 10.30pm and then again at midnight. Get those right first before adjusting any others

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Sorry, should have said adjust the 10pm but wait 90mins so test again at 11.30pm to see what bg is, do the adjustment if necessary and then test again at 1am and if necessary, adjust the 11pm basal

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Yes.....just look in the training manual for the instructions.. It can be done using the handset or from the pump. Easier to do it from handset though. Just remembrr to pres the ok button to confirm the change

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How long have you had your pump? If you are very new to it I'd wouldn't be changing anything unless under guidance of the DSN to be honest. Yes, we can adjust it ourselves, but being new to it myself, I like to chat to the DSN to double check where changes need to be made and by how much.
 
Hi again

Ive just looked at yr msg again and saw that you only started yestrrday with the pump. You should really wait a few days before changing bssal rates as it is thought that it takes about 4 days before all the long acting lantus or levemir has left. For now just do corrections for the highs and treat the lows with some carb. Try to get an appt with the pump dsn if you can if you feel unsure of what to do

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If you have a follow up appointment with your DSN in a couple of weeks that would be a great time to review these findings and tweak your basal settings. In the long run you may program a different basal insulin dose rate every couple of hours, to match your basal needs.

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Thanks for the help everyone! Yeah I only started on it yesterday. Spoke to DSN around 2pm and she told me to change it - I already had but by more than she said so put it back down to her suggestion hopefully tonight I won't need extra!
 
You would never want to do an immediate increase of 0.7 at anytime
for a an hours insulin dosage.....even if it was split down into 2 hourly doses....especially as we are not even aware what levels of basal you were set up on.



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