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Pump seems worse than injection

Discussion in 'Insulin Pump Forum' started by baggypenguin, Sep 14, 2016.

  1. baggypenguin

    baggypenguin Type 1 · Newbie

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    Hi Guys, first post on this forum (or any diabetes related one!). This is going to be a bit of a rant and a few questions in regards to my pump therapy vs injections. Firstly the rant!
    I've been on the pump nearly a year, it hasn't matched up well to life events, in the past year, my wife and I lost our baby, got married and I've changed career. All of this has affected my HbA1C result. I was around 65-70 and the past couple have been in the 80's and 90's, prompting my specialist doctor to tell me to get below 60 or he's taking the pump back. This initially angered me, due to the other factors that have been in my life, also affecting my sugars and lifestyle. To top this all off, my DSN has been non existent these past 6 months or so. She was brilliant in getting me the pump, and setting it up and then poof, I've been alone since. And this next meeting which will decide if I can keep the pump is due this month, with me not on track to keep it.

    I guess my question is, should I accept that maybe the pump just isn't for me and hand it back, or are there any ways of fighting the decision and trying to make this work for me.

    Many thanks for any advice you guys may give!

    Baggypenguin, a very downbeat type 1
     
  2. dancer

    dancer Type 1 · Well-Known Member

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    We all know stress causes havoc with our blood sugars, so make sure they know about absolutely everything you've been through.

    Not having contact with your DSN certainly wouldn't have helped matters. I know that mine was very helpful on many occasions, sometimes reminding me of things I'd forgotten, or suggesting something else. Make sure they also know about you not being able to speak to your DSN for necessary support.

    If you want to stay on the pump, fight for it. Things may not be as bad as you think. Your doctor perhaps just gave you a verbal kick up the backside, to ensure you started using your pump effectively.

    Are your blood sugars OK now, or are they still acting up? If they're not OK, start off with basal testing to get them sorted. Then check your carb ratios to make sure you're taking enough insulin for all your meals. New job, or not, make sure you test two hours after eating, to find out how things are.

    Are there particular times when your blood sugar is high? Would a temporary basal help?

    I hope this all works out well for you.
     
    #2 dancer, Sep 14, 2016 at 3:22 PM
    Last edited: Sep 14, 2016
  3. catapillar

    catapillar Type 1 · Well-Known Member

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    Gosh @baggypenguin it certainly sounds like you have had a difficult year and had a lot more to focus on than getting to grips with your pump. It does take some focus to get to grips with it and I think that work is worth while, but then I don't have the other issues you mention to balance.

    If you would like to get to grips with your pump there will be plenty of help on the forum. Maybe you could share how you are using it now? What pump is it? Are you confident using it and adjusting settings? Do you know where to find the user guide & call pump technical support?

    There is book called "pumping insulin" which is a great resource on how to get the best out of your pump - worth getting a copy if you want to stick with it.
     
    • Like Like x 1
  4. baggypenguin

    baggypenguin Type 1 · Newbie

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    Thanks for the reply! While at work I find they're ok, it's the evening and overnight I find they creep up. Checking 2 hours after my meals is something I've gotten slack with, so I'll make sure I'm on that! And I'll take your advice and get the basel rate sorted and then work on my carb ratios.

    Many thanks for reassuring me, today I've just tipped over the edge and wanted to give up on trying all together (I know this always a terrible idea, but emotions do that!)

    I'll make sure to bring up that my DSN has gone AWOL, he may be able to help with that! Fingers crossed I start to move in the right direction
     
  5. baggypenguin

    baggypenguin Type 1 · Newbie

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    THanks for the comment, I'll be sure to look at the book!

    I'm using the Accu-Check spirit combo. My ratios at the moment are 1.5:1 for all meals, 1 unit to bring me down roughly 1.5 mmol/l for a correction and I'm on 40 units for my basel,

    I'm always spiking in the evening at the moment and creeping up over night. Always had an issue in the morning with high readings, but seem to be getting them under control so far
     
  6. alaska

    alaska · Well-Known Member

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    Sounds like a lot has gone on and your diabetes aren't giving you a fair chance from the sounds of things.

    With your HbA1c that high it sounds like you're struggling overall. 80 mmol/mol works out as keeping average sugar levels of 12.5 mmol/l.

    Have you done a carbohydrate counting course? If not, ask to go on one of these.

    If you have, give yourself some 'you' time, revise what you learned in the course and make getting back into the swing of things a high priority.

    Make you give yourself time to manage your diabetes anyway. At minimum, find 10 mins a day to look over your results and ask yourself what things you could do to help out.

    When I was in your position back in 2009, my life was all over the place. Sleep was disrupted, meals were being taken at random times, I was continually hungry and tired and it was really tough staying positive and dealing with day to day life.

    Two things changed my life around. I spent a month looking closely at my sugar levels wondering what I could do better and secondly I went on a low carb diet -which took away the massive spikes and drops that had been running and ruining my life.

    Since then, my control got much better to the point whereby I've had an HbA1c of 42 mmol/mol or under for the last 6 years.

    The one other recent further step was taking the plunge of getting a FreeStyle Libre which tells you at little more than a glance what your sugar levels are and, importantly whether your sugar levels are trending up or down -something that blood tests simply can't tell us.

    If you can afford £50 a month, it's well worth getting a Libre as you can wear the sensor for two weeks. You might find find that you love it enough to pay just over £100 each month to have a sensor on the whole month through.

    Hope some of this helps inspire you Baggypenguin

    Ed
     
  7. tim2000s

    tim2000s Type 1 · Expert
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    @CarbsRok and @iHs might be able to advise on this. Whilst your consultant might be having a go about removing the pump, they aren't supposed to do so and may not be allowed to. Especially with life as its been.
     
  8. noblehead

    noblehead Type 1 · Guru
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    I would give it a while longer as you've had a very stressful year, order the book Pumping Insulin and work on getting your basal rates right, once you get them sorted you can then look at things like your I:C ratio and carb counting skills.

    However if you do go back to injections (by your own choosing not your diabetes teams) don't see that as failure, I remember around 2 years ago there was 2 members on this forum who went back to MDI, one had been pumping for at least 5 years and the other around 2 years, both were very knowledgeable people and give the pump their best shot.

    Should you need any help & support to keep your pump then the good people at INPUT should be able to help, here is a link to their website:

    http://www.inputdiabetes.org.uk/

    Good luck and best wishes.
     
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  9. CarbsRok

    CarbsRok Type 1 · Well-Known Member

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    Firstly I'm very sorry to hear about the loss of your baby.

    Secondly your consultant is within his rights to remove the pump due to your increasing A1c. So you do need to do a lot of work to sort it out.
    Buy yourself the book pumping insulin for starters.
    Sort your basal out by doing some basal testing and keep detailed logs/diary of what you are doing, eating, exercise etc.

    Also point out that you have had no help or support in your quest to gain control.
    Bottom line is you only get out of the pump what you put in. Changing jobs isn't a reason to increase your A1c as you should be adjusting your pump to suit your needs for the day to day life changes.

    So sit down write out a plan of action as to what you are going to do to help yourself present it to your consultant and ask for some basic help in implementing it if unable to do it all yourself.
    Good luck.
     
  10. baggypenguin

    baggypenguin Type 1 · Newbie

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    firstly this forum is awesome. It great having so many of you on here trying to help me out. I really appreciate it! I'll try and take on board all the things you guys are saying. I'll make the changes now and hope that my doctor gives me a little more time to prove I can sort this out and escape the rut I'm in!

    First step for me is to order " Pumping insulin". Next is to spend the time swating up on my DAFNE book, i took the course way back in 2012. I will also try spending 10 mins of my evenings just checking out my sugars, explaining my results and trying to make sense of it all.

    I'll be sure to keep you updated on my progress!
     
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  11. catapillar

    catapillar Type 1 · Well-Known Member

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    I think I'd be looking to do some evening and overnight basal testing to figure that out.

    Here is some info on basal testing - https://mysugr.com/basal-rate-testing/
     
  12. purleypete

    purleypete Type 1 · Member

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    I agree totally with @CarbsRok. Life has thrown some terrible things at you which is really difficult. But many of us here have had varied life challenges thrown at them; that is not to try and take away anything of what you have been through, just to say you are not alone in adversity coupled with diabetes.

    Success or failure with pumping ends up being in the hands of the user. The consultant or DSN are only there once every few months if you are lucky, but you are attached to this thing 24x7. Read the books recommended and change one thing at a time figuring out what works for you. Don't forget that settings need to be reviewed as situations change.

    Stay positive!
     
    • Agree Agree x 1
  13. MushyPeaBrain

    MushyPeaBrain Type 1 · Well-Known Member

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    Have you considered using a Freestyle Libre to support getting your BG down? A lot of clinics will now let you trial this for 2 weeks so worth asking first. It would really help you get a better idea of what's happening and help you respond quicker to rising levels. Also much less stressful than hourly fingerpricks etc
     
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