Pump basics

[donnellysdogs]

Good point ref switching off, I do this if my levels aren't above 6 before I drive, but at other times I try to battle it out to try and find out what is happening.

Pretty good day yesterday and levels pretty well up and I did a set change yesterday too. Didn't alter anything, as thought would give it time as citilopram is working out of my body and this new duloxitine has just started. This morning I have dipped back down low again, despite disconnecting for an hour for my bath pre massage this afternoon. At least my GP is at the moment giving me enough strips to be able to check so regularly!!!

Quite happy though, as for the last couple of days my brain is more active during the day-despite last night accidentally giving my hubby my medication to take with his vitamin tablets!!!!-Fortunately he noticed!!!! So my stupid, incidents of daftness haven't changed yet!!! This morning as well, first the first time in many years, the pulling sensation in my legs from the fibromyalgia has eased considerably. Under review from GP for the fibro in 3 weeks, but he will not look at or discuss my diabetes as he does not understand the pumping aspect of it, so the help here has been marvellous and reassuring as well. He does realise highs/lows ref pumping etc, but not actually how to manage them, the only thing he has done once, is to look at my pump because he had never seen one....help here has been great, so thank you (again).

 

[squeeze321]

I change my infusion site every 3 days too, as infections can set in otherwise.

A guy on the same pump course as me decided to leave his in for 5 days because he wanted to see what would happen! He showed me his site, (the set had already been previously removed) and it was this big red sore looking mess urghhhhhh. He was luckier than some people as abscesses can set in and cause no end of pain.

I'm particular about my site and prep my skin with neat TCP before inserting then set. When pulling out the old set I cover it with cream and a plaster.

My sets have been brilliant, I forget it is there most of the time!

 

[derya]

so, does a pump mean you can eat when you like what you like?

 

[Trina]

Hi I'm also fairly new to the pump, just over a month. That said I soon learnt to change the cannula every 2 days and tube every 4 days. I was finding if I left it any longer the results were getting higher. Good luck. I wouldn't be without this forum

 

[petitepommedeterre]

in fact, how this pump works? I guess the needle is somehow attach to the body? is this difficult to move around? just wonder whether the machines will limit movement? I need to travel a bit, when one pass through those defective machines at the customs, it will beep? how to tackle this issue?

 

[Spiker]

A canula (small tube) is inserted into the skin using a mechanical device that shoots it under the skin using a retractable needle. This hurts the same or less as a pen injection. The needle is thrown away and the canula stays in your skin for a few days until you replace it with a new one at a different site.

The pump can be removed briefly if required just by unclipping the tube connector from the canula. This takes a second or two. Reattaching is nearly as quick. This is useful for showering, etc. However airport staff will know what it is, so you probably won't need to remove it for airport security.

Sent from the Diabetes Forum App

 

[lizzie29]

I've had two different pumps in the last seven years. Like everyone has been saying it changes a lot depending on the pump you use.
However, for both, I have been originally told to change the site every 3 days. In recent years I have been told that the pump often has less effectiveness later on so I have been told to change mine every two days. I changed the insulin in my old (Animas) pump roughly every six days but as I've grown it has often run out sooner. My new (Omnipod) pump is wireless (yay) and so requires an insulin change every time I change my site. Sometimes my insulin runs out first but that doesn't happen too often.

To change the insulin.
In my experience: you have your regular vial of insulin, you use a syringe screwed onto another vial. You pierce the lid of the insulin with the syringe and pull back the ...plunger I guess? To fill the second vial with insulin. You kind of look like an evil doctor giving out vaccines at this stage.
Now, you either unscrew the syringe and put the vial inside your pump or you inject this directly into your pump, it depends.

You usually have:
Your pump,
A spare pump,
A package with the syringe and vial in,
Individual vials of insulin,
A package containing the tubing
The sites,
Injections for emergencies,
Spare batteries.


I'd be happy to help if you need any other questions answering.

 

[lizzie29]

in fact, how this pump works? I guess the needle is somehow attach to the body? is this difficult to move around? just wonder whether the machines will limit movement? I need to travel a bit, when one pass through those defective machines at the customs, it will beep? how to tackle this issue?

There is a very small cannula just beneath the surface of the skin. It doesn't limit movement though you might need to test which area is most comfortable for you to have your site on. You can unattach the pump if you are doing exercise. As for airport security it depends where you go. You just need a doctor's not. Some pumps are affected by normal airport scanners so you may need to go through a seperate one or just be patted down. Usually they've needed to swab my site so you need to make sure it's in a less embarrassing place than normal (higher up on your back/stomach).

Hope this helped

 

[Victorri]

Hi I have started my insulin pump today and so far my sugars have risen with every two hours of testing. The latest at 12.00 was 13.5 mmol and I took a correction via pump. Would you expect this when first starting and coming off lantus or do u think I need to think about cannula site. I put the cannula in at about 8.30. Or should I just monitor and see what happens
Thanks for your help x

 

[noblehead]

@Victorri, it will take some time to get your basal rates right, I expect they started you on flat basal rate which they did with myself, you will have to do some basal testing so that you can have multiple basal rates which will work much better, have a read of the following which explains how to do a basal test:

http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

However, best check that cannula is inserted right and your pump is working normally, if in doubt contact your hospital.

 

[Victorri]

I'm on the insight pump and if you mean flat rate the graph is all at the same level then no its been set to the algorithm for my age. I think I will stick with it and see what happens. No carbs eaten yet today but now thinking about lunch so will see what happens. Thanks

 

[Victorri]

The testing time e.g. between breakfast and lunch is that a set time like 5 hrs or is it just your normal eating times

 

[noblehead]

The testing time e.g. between breakfast and lunch is that a set time like 5 hrs or is it just your normal eating times

Not sure what you mean, but basically you would eat breakfast and start your bg testing 4 hours after your previous bolus dose, so you would miss lunch and test up until your evening meal, it explains all this in the Salford article posted before.

 

[Spiker]

Hi I have started my insulin pump today and so far my sugars have risen with every two hours of testing. The latest at 12.00 was 13.5 mmol and I took a correction via pump. Would you expect this when first starting and coming off lantus or do u think I need to think about cannula site. I put the cannula in at about 8.30. Or should I just monitor and see what happens
Thanks for your help x

Keep monitoring but it's possible you have got some kind of pump problem as it's your first time. Is your DSN on call for you this first weekend?

 

[iHs]

@Victorri

Hi the cause of high bg at the moment might be because yr basal need is not quite correct or yr carb ratio isnt right.

My basal wasnt correct and neither was the carb ratio. I ended up using the MDI carb ratio which made my bg drop a bit better so I then started to adjust the daytime basals using the advice that DDs consultant gave her when she started pumping Sept 2010.

 

[Victorri]

The dsn is not on call was actually not meant to start till Monday but couldn't wait any longer. The nurse on Friday did say if I had taken my insulin with me she would of started me then and there. The pump is all set up with the basel and bolus rates which she did Friday so though I would give it a go. The carb ratio she has set it less than me mdi carb ratio so wonder if that is the problem. Mdi ratio 1.5 u to 10g pump ratio 1u to 10g.

 

[donnellysdogs]

Did you have breakfast this morning? Or did you fast?

Have you been given accuchek phone numbers and your account number? Accuchek work 24/7/365.
What have been your times of testing and the bg levels at those times.

Have you had your pump training to know how to change your basal rates and by how muc and the time before the rises to change them? Because if you haven't you should only carry on correcting and wait to speak to your nurse.

 

[donnellysdogs]

As a rule with a pump if your levels rise uncontrollably high and your first correction doesn't work to bring your levels down then it is likely to be a pump failure of some sort, ie you didn't fill the cannula ir it is in a bad site, or a blockage of some sort.

However, as you have just been set up then it is more likely to be your basal rates etc.. Even your correction factor may be wrong.

So initially it is hard to tell and a little unwise to be honest to have started off with your pump without back up of a nurse to phone etc...however what is done is done.

Have you been given training how much you should change things by? Or was that going to be done Monday?

 

[Victorri]

Started pump at 8.30 bg 10.30 mmol breakfast cheese omelette correction 1.40u
10.00 bg 11.3 mmol correction 0.60u
12.00 bg 13.5 mmol correction 1.85u
13.10 bg 10.5 mmol lunch 85g carbs 8.50 u
14.10 bg 12.4 mmol correction 0.05u
15.10 bg 14.5 mmol correction 1.65u
16.10 bg 14.4 mmol correction 0.90u
My correction is 3:1
We spoke about tbr but didn't set specific amounts. We also spoke about testing basal and about change the amount 2 hrs before. E.g. if hypo at 13.00pm change basel at 11.00am.
Was thinking do I need to correct with pen or should I wait the 5 hours for lunch effect to finish.

 

[iHs]

The dsn is not on call was actually not meant to start till Monday but couldn't wait any longer. The nurse on Friday did say if I had taken my insulin with me she would of started me then and there. The pump is all set up with the basel and bolus rates which she did Friday so though I would give it a go. The carb ratio she has set it less than me mdi carb ratio so wonder if that is the problem. Mdi ratio 1.5 u to 10g pump ratio 1u to 10g.

My pump carb ratio was 1u to 20g carb. MDI ratio was 1u to 8g carb.
The MDI ratio was correct for the pump so I just got the basals ok.