Pump Users-Did you fast?

[donnellysdogs]

Hi Everyone

Going on to pump Sept 13th. When I spoke to nurse about it, I asked whether I would have to fast and when?, and she said no.

I see alot about fasting to get basal levels right, so when did users do their fasting?

Nurse also said to 1/2 my glargine the night before and do not take my morning glargine. She said that they need 1/2 levels of longterm insulin prior to going on it.....but what she told me is actually 1/4ing my dosage.

Can anybody let me know about fasting and what they did the 34hr prior to going on to it. I have glargine at 7am and 7pm.

Many thanks
Sharon

 

[jopar]

When I started on my pump, the protcal was that dependant on your background insulin regim though..

If you inject background in one nightly shot, then you 1/2 this dose the night before..

As I used to split my Levimer, I inject my normal amount the night before, and the morning injection the day I went onto the pump...

I think you are jumping the gun with fasting tests, these come after you get off the ground with the pump, so that you can fine tune your basal profiles. The pump clinic will work out a starting point for you from your previous couple days of TDD's, they might also use your BG testing data to create a couple of adjustments, or they might just split your background evenly over the 24 hour period to start...

Best advice I can give concerning pumping, make on adjustment at a time, if you make more then you won't know what has or hasn't worked.. Be aware that for the first couple of days your last dose of background can still be having a slight effect on your BG's... Takes a couple of days for it to filter fully out the system...

 

[sugar2]

Hi,

Don't confuse the fasting thing with the actual going on the pump bit! From memory, what you nurse suggested was what I did..but this was only teh night before going on teh pump. Basically, you are going to get insulin fro teh pump...and if you get this, combined with you long term insulin, you are going to hypo quickly. It did make my blood sugar very high that morning...but it was just one morning. I thihnk the first thing I di was a correction bolus!

The fasting thing is something that you can do when you are onl the pump. when they set you up, they "err on the side of caution, and seem not to give you enough insulin", and you then adjust it as you get used to teh pump. the fasting allows you to set your back ground level. Typically, when you start, they have you on a certain lvel that is teh same all day and all night. For me, I knew that this was never going to work, as I always go high in teh mmorning. Sure enough, this is what happened. So, teh next night, I fasted and measured my blood sugar every 2 hours, while the pump did its normal back ground rate. thsi allowed me to look at what time I needed to increases my rate, and also decrease it...as what youare seeing is what you body needs, without food, to maintain a good blood glucose reading. They say that you should try and do a few 8 hour fasts, to get each section of the day correct for you. Of course, if teh rate they set you on works..there is no need to fast and test.

Best of luck in september!

 

[donnellysdogs]

Thanks to both of you for replying - very helpful. Interesting to know how the basics will start and actually when I may have to fast. I will be glad to sort out my morning levels from going up so much.

I have done the accu chek tutorial on line, have bought some insulin pump books over the net, and feel quite confident now. Just haven't worked out how I will sleep with it yet, as I move so much (unknown to me in my sleep). Apparently I switch and turn all night, hoping that some of the medicine for my newly diagnosed fibromyalgia may hopefully kick in within the next two weeks so that I am getting more restful sleeps, which will help with getting myself sorted with the pump at night.

Thank you so much fo ryour help. It has settled my mind greatly.
Sharon

 

[sugar2]

Hi Sharon...well, it depends what, if anything you wear in bed! I am in the (not very sexy but it seems to work ) "sew a baby sock to my pyjama trousers and put the pump in that " club.... works a treat....but I know of other people who just let the pump"roam free"!

 

[iHs]

Hi

On the day I started on my pump I was told by my dsn to give myself my usual bedtime dose of Levemir but to leave the morning Levemir off and just use my bolus. So I just gave myself my morning bolus but added 2 extra units onto it to make up for the lack of Levemir. I wasn't too bad bg wise and when finally hooked up at 11am, my bg level was on about 9 so everyone was happy and I just left the pump on the beginner settings - 500 and 100 rule and came home and then looked in the manual to find out how to alter the insulin to carb ratios.

Regarding basal testing; I haven't done any yet Reason being that I got my pump at the beginning of the heatwave and hot weather usually makes my bg go lower so I wanted to wait until the weather temperature remained even before I started fasting and setting basal rates, otherwise I would be forever going into the basal settings and adjusting them according to the weather temperature.

Looks like hot weather is now over so I will start to fine tune the basal a bit more. I think I've more or less got my carb ratios okish now and decided to use my bolus/basal carb ratios and just deduct 30% off my 1 unit and add 1gm carb. So instead of using 1:4 at bkfast, I now use 0.7:5 and that appears to be fine. Appear to be able to stay on a steady bg reading of 6 or 7 every 3hrs.