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'untethered' Regimen - Has Anyone Tried?

K

KateMeg

Member
Messages
18
Type of diabetes
Type 1
Treatment type
Pump
Hello all!

Has anyone tried the 'untethered' regimen (https://en.wikipedia.org/wiki/Untethered_regimen)? I've been doing it for a month and getting the best consistent blood sugars I've had in my 13 years diagnosed. I find that when I'm solely on the pump (novorapid) I gain silly amounts of weight very quickly, have little energy and am prone to massively high BGs when things go wrong with my canula. When doing basal/bolus my Levemir never seems to quite get it right and I end up having to take lots of extra injections for morning-time highs etc. This is brilliant as I just have a basal rate on my pump delivering the extra novorapid that I need for these periods plus for my boluses but the levemir doing the main basal work. Also nice not to feel like you have to plug back in the minute you get out of the shower etc.!

Has anyone else tried/considered trying?
 
Hi @KateMeg I can certainly appreciate the need to cover the periods of exercise with this method, I find I prefer to exercise without wearing my pump but it becomes a time limited exercise as otherwise I have to deal with the post high.
 
This sounds fantastic; are you in the UK? I expect it's not encouraged/supported by the NHS but would be happy to be told otherwise.
 
pinewood said:
This sounds fantastic; are you in the UK? I expect it's not encouraged/supported by the NHS but would be happy to be told otherwise.
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It's not, I am going a bit off piste on this. I have a stash of leftover Levemir from when I was on basal/bolus injections so will may be in trouble when that runs out!
 
Hi KateMeg. Am on a pump and had to have a pump vacation when the device broke down over a weekend.
I loved being untethered but found it hard to get the levemir dose right and ended up using much more insulin thaan when on the pump to do corrections which is something I want to avoid because of the likely weight gain and the possibility of becoming a double D. If I alreadydisconnect for showers or if going low during exercise (rare) what are the advantages that balance out the afore mentioned difficulties. Other than being able to wear skimpy stuff more easily!
 
Hi Nicole,

I think for me the main advantage for me - apart from much better control - is more about being able to depend on Levemir for the majority of my basal needs which I'm a huge fan of mainly because I have much, much more energy on it (particularly for exercise), fewer sugar cravings and my weight is typically a lot lower. That could well be just me though! I still wear my pump 70–80% of the time. I have a basal of 0.65 u/h in the morning, down through the day to 0.2 u/h - so have essentially just knocked off a unit of novorapid/hour - and bolus as normal.
 

Yes, it makes the most sense to me of all the treatment options available. I think the key to good control is breaking whatever guidelines the NHS or the medical community comes up with. I use Actrapid in combination with NovoRapid when I'm on MDI for example (for delayed spikes caused by protein/fat digestion, simulating temporary basals on MDI in a way, and covering periods when Levemir is fading out when I first wake up and in the evening) and have been told the NHS only like people to have one type of bolus insulin! I wonder if the untethered method it would work even better with Tresiba. I haven't gotten good results with Tresiba on MDI since 1 dose/24 hours doesn't suit me, but I would think with pump adjustments to compensate it could work even better than Levemir.
 
KateMeg said:
It's not, I am going a bit off piste on this. I have a stash of leftover Levemir from when I was on basal/bolus injections so will may be in trouble when that runs out!
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I have a "stash" of Lantus.
The purpose of this is a backup if my pump breaks down.
I hope you don't intend to completely use up your Levemir stash ... or have an option to restock (when you run out or when it goes out of date).
In my mind I must have a backup to my pump.

As for using long acting insulin as the basal when on a pump, this is interesting but I found the biggest advantage by far is being able to adjust my basal by the hour.
Not only do I have very different basal needs at different times of the day, I often use the temporary basal.
Usually this is when exercising. However, I found a great advantage recently when I had to have some steroids to calm down an inflammation: I was able to tweak my basal up and down until I had the right amount at the start and the end of the three days of steroids.
I would love to be untethered but I guess I will be strapped in for a long time yet.
 
You can still adjust basal using this method. You simply take a much lower dose of Levemir/Lantus or whatever than you would need without the pump.
 
scotteric said:
You can still adjust basal using this method. You simply take a much lower dose of Levemir/Lantus or whatever than you would need without the pump.
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Doesn't that only work if your basal adjustments are usually positive?
When I exercise, I often reduce my basal to 50%. So I could only take 50% long acting insulin but would need to wear my pump for the 23 hours I am not exercising.
 
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