Pumping: Is it right that my diabetes is still not under control after nine years.

Liz Leigh said:

I didn't have to bolus for extra food with injections. But the advice I got from this forum has really helped. I am confident in changing setting on the pump so I will try and be a lot more relaxed.
I had a hysterectomy 26 years ago and am now aged 57.
I honestly don't think I have been given the best advice or information in the past. Hopefully new year new start

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That rather sounds as if you had a lot of basal floating around whilst on MDI. Having a pump if your basal is correct then there is no room for snacks unless you bolus for them.

Do you have the book pumping insulin? If you don't then it has to be a priority for you to have it as what you will learn from it will set you on the straight and narrow

Liz Leigh said:

I didn't have to bolus for extra food with injections.

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Well that does sound like your basal was compensating for snacking when you were on MDI. Maybe if you didn't fancy extra food you were at risk of dropping low? That's not really what basal insulin is supposed to do.

Do get the book as a belated present to yourself.

It isvery true thatthereisn't any sneaky biscuit (without a bolus) if your levels on mdi or pump are balanced.

To be honest,I hadprobs after set changes. The pump manufacturer and I tried for a very long time to establish causes ofhiighs every two or 1 days...the set changeswere the problem. No consultant or medic realised this. It was me eventually.

You need to really log and monitor everything.i mean everything. Time of set changes, food, exercise... everything.

I think you can identify the cause... and hopefully get improvements...

Basal rates will unfortunately need to change as and when the body decides that more or less insulin is needed for whatever reason so to achieve perfection just basal rate test every day ibk

iHs said:

Basal rates will unfortunately need to change as and when the body decides that more or less insulin is needed for whatever reason so to achieve perfection just basal rate test every day ibk

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Hey!! Thats possible-lol... in donnellysdog world- thats my life!! ️

You need to do some regular testing but as you say your levels are chaning very frequently, ie after two days I am wondering about other issues...

Hi @Liz Leigh, yes we can. Eggs and Bacon have protein in them, and in the absence of carbs, our bodies convert a little of those protein to carbs. It's a process called gluconeogenesis. Eggs are especially bad in this respect and many of us need to bolus for them.

Tomatoes are also not carb free, with a normal tomato being around 4g of carbs.

Liz Leigh said:

I find it all confusing. I was told that all those foods were not to be counted. At least I know now. I also have to count for grapefruit.

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Indeed. Grapefruit contains sugars. Have you looked at www.bertieonline.org.uk yet, as that will help.

Have you done a DAFNE. course. This is brilliant and type 1 diabetics learn a lot. I have been typ1 for 50yrs and learnt a lot. It also can improve how you feel mentally once you get more in control. If you havent done it ask your DSN nurse to get .you on one

Liz Leigh said:

I have and it was there I was told not to count eggs. Any fruit, or meats.

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All they are doing on DAFNE is giving you advice. If you try it and it doesn't work for you, you'll just have to find a different way that does work for you. Advice not to carb count fruit is not the wisest idea in the world given that fruit is generally fairly carb and sugar heavy. Obviously you don't carb count for meat and eggs, because they don't have any carbs, but if you find you need to bolus for them so they aren't raising you you'll just have to figure our a way of doing that that works for you.

catapillar said:

Obviously you don't carb count for meat and eggs, because they don't have any carbs,

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If you only eat meat and eggs (protein) then most type 1's do need to bolus for them

CarbsRok said:

If you only eat meat and eggs (protein) then most type 1's do need to bolus for them

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Yep but if you're bolusing for them you aren't doing it by carb counting, because the carb count will be nil. You'll need to work out a way to bolus for protein that does actually work for you.

I do bolus for protein. But I do it by reference grams of protein not carb counting, obvious I suppose.

Liz Leigh said:

I had to go on the course before I could have a pump. The info they gave me is conflicting.

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What course are you talking about @Liz Leigh ? What conflicting info is causing a problem?

When I started eating a lower-carb diet I raised the question with my DSN a couple of years ago about how eggs in the absence of carbs raise my blood glucose and I was therefore counting them and having insulin with them.

Her reply was: 'We do not recommend taking bolus insulin if you are not having carbohydrate.'

I showed her pages of fasting, mid morning and pre lunch readings, showing clearly what my breakfast eggs were doing to my blood glucose when I didn't bolus for them. I just didn't get it.

The DSN simply repeated her previous sentence, but in such a way as to make me think that having insulin with them would be a good idea. But she couldn't say that.

A while later, after I had gone onto a pump and we were talking about basal rate testing, she was saying that although some clinics had in the past said that people could eat carb-free food such as ham or hard-boiled eggs during basal testing, now they recommend consumption of only water during basal testing periods.

'Oh,' I said, 'Is that because of the thing that happens to my blood glucose when I eat eggs?'!

I think I scored the point on that occasion.....

I have a lot of carb-free meals - bacon, eggs, mushrooms - in the form of fry-ups or omelettes, often with almost carb-free salad. For me*, this means 'pretending' to my pump handset's bolus calculator that I'm having 15-20g carbohydrate.

When I finally realised (fairly recently) that many foods not containing carbohydrate, and eaten without any carbohydrate, had the ability to do this to my numbers, it was a huge relief, as it explained a LOT of high blood sugars that had previously been inexplicable!

Love Snapsy


*this applies to my experience and shouldn't be considered as specific bolusing advice for others!

@catapillar I just saw your post - I might have to do some research into specific protein calculating rather than just winging it with 'faked' carb figures!

Snapsy said:

@catapillar I just saw your post - I might have to do some research into specific protein calculating rather than just winging it with 'faked' carb figures!

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I just use the grams of protein from myfitnesspal, if it's a meal with zero carbs I bolus for all the protein, if it's a meal with carbs, even minimal, I'll bolus for half the protein (I'm bolusing for all of it, but my ratio gets I halved cos I only tell the pump 50% of the protein grams), and extend the bolus for protein over a few hours.

Great tip - thanks, @catapillar !