First 24 hours on the pump

[mortis505]

Well I started pumping yesterday, and so far I only seem to be a bit low. 60 at bkfast, 62 at lunch, and 72 at dinner. I feel great and the manual insertion of the silhouette didn't hurt much. But now I have some questions that I didnt think of during pump training.

Should I consider decreasing my basal? Or just carb up a bit more?

Also, I wasnt paying attention during training, but any insulin left in the reservoir
when I change sets, is no good right? (was a bit excited to be going on the pump in the first place)

What seems to be the best place to order supplies? Do you go through the manufacturer? Or from an outside source?

Needless to say I am VERY happy to be on the pump, but its late and I dont want to bug the Nurse practitioner with these questions right now. Plus I want honest answers, not the company answers from a Medtronic rep.

[catgalla]

Don't worry about bugging the nurse practitioner. That's what they get paid to do. Remember no question is a dumb one. I would wait until tomorrow to adjust your basal and see where you're at at the same time frame. If you find you're low again I would only decrease .05 increment at a time. I wouldn't eat more carbs because that's not what your basal is for. That would be your bolus rate. But you should definately be checking with your diabetes educator. Also any insulin left over I throw away and start fresh. I order my supplies through Minimed. My insurance covers it 100% but if yours doesn't I know there are discounted supplies. I would just google discounted diabetes supplies and a whole bunch of websites should come up. Good luck!! :D

[duck]

You will have many occasions when you change a set, and your old set has USEABLE insulin in it still--how you choose to handle that is up to you. Basically, if I have less then twenty units, I have stoppped caring. More than that, I use my judgment. Many of us have done things to rescue left-over insulin in a reservoir, some people here even reuse tubing and the insulin therein. We can go over all that if you want, when the time comes. No supplier is going to recommend you do that though, as it can increase the chance of something bad happening (and the more supplies you use, the better for them).

I've always used the manufacturer's supply system. But there are many different suppliers out there, actually. Before you make a decision, though, talk to your insurance company and get their take on what you should do, and if you are even allowed to use an non-manufacturer supplier.

[notme]

I wouldn't change your basal for a few days. Many times when you first start pumping your will have lows for various reasons. You didn't mention whether or not you stopped using your basal insulin 24hrs before you started the pump. If you did not, you may have some residual long term insulin still in your body. Give it a couple of days and then revisit the idea.

When I first started pumping, I worried about "running out" of insulin and changed my sets really early. Now I run my sets dry (except for what is left in the tubing). I don't rescue left over insulin. It isn't "bad", but just a hassle to recover. I use short tubing so there is only a small amount of insulin left.

Congratulations on your new pump.

[xMenace]

If your fasting numbers are low, I would ease off the basals a bit. Go slowly. But in order to set them propely, you need to start some strict basal testing. There's a good chance your DE knows nothing about it. I can give you some sources if you'd like.

If I have to change and I have insulin left, I find the easiest is to change the site but not reservoir or tubing. Simply hook it up and give a fixed prime. When the reservoir runs out, change it and fill the tubing, but don't give the fixed prime. Calculate how much insulin you'll need to the next change. There's no rule that says you have to change everything at once.

[Cyborg]

If your fasting numbers are low, I would ease off the basals a bit. Go slowly. But in order to set them propely, you need to start some strict basal testing. There's a good chance your DE knows nothing about it. I can give you some sources if you'd like.

If I have to change and I have insulin left, I find the easiest is to change the site but not reservoir or tubing. Simply hook it up and give a fixed prime. When the reservoir runs out, change it and fill the tubing, but don't give the fixed prime. Calculate how much insulin you'll need to the next change. There's no rule that says you have to change everything at once.

I agree... Get the basal testing done asap. Then you can move on to fine tuning the other settings.

I do the same with reservoirs and sets. I Often change one or the other, but not both at the same time.

[jenet]

Don't forget - your insurance may have some "say" (control :( ) over where you can get your supplies and be covered. For my pump-specific supplies, I order thru my pump company, but they actually supply them through a Nevada-based DME supplies middle-man that is the only company approved for coverage by my insurance. Be sure and ask first, as it could be a huge hit to your pocket book if not covered ($965 billed to my insurance for 3 mos. supplies, of which I thankfully only pay 20%).

cheers,
j

[ubergeek]

Well, I would never advise anyone to feed insulin. I would say until you get used to how the pump affects you, consult your Dr before making changes, unless they pretty much gave you free run like mine did. If it were me, I would drop my basal a bit before breakfast and I would have to make a judgement call on whether it's basal or carb ratio for the other meals...really depends on your 2 hour post prandial BG readings.

I order my supplied through minimed, but that's who my insurance company contracts for the fulfillment of my pump supplies.

As for the insulin in the reservoir, I always change my set when I need more insulin, so it works pretty well for me. A friend of mine will put a new set on a reservoir when she needs to change it.

[VinceF]

I think I'd watch the trend a little bit longer than 24 hours before changing your basal rate but test your basal rates soon.

I usually only fill the cartridge with enough to cover me until I plan on changing sets. anything left over I pitch.

My insurance contract with one supplier if I use someone else I pay a deductable. If I use ccs medical it's all covered...ask your insurance company

[mortis505]

Thanks for all the info. I plan on waiting at least another day or so before changing my basal. And then I only plan to do a 0.05 decrease. then another 3 days and possible change if necessary.

The only other problem I'm having at the moment is that I didn't shave the area before applying the set, so it seems as though thats effecting the sticky around the set. Either that or I didn't let the IV prep dry completely.

Do some of you leave your sets in longer than 3-4 days? Or am I just not understanding some of your responses properly?

[duck]

I shave the tops of my legs to make sure I get a good stick--It may look silly, but as far as I know, there is only one person who sees that part of me much anymore. :D

I leave my sets in no more than four days. From experience, that's about as long as I can go before my sugars will start to climb out of control.

[Cyborg]

3 to 3 1/2 days tops for me...

I refuse to shave anything except my face :eek:

[ubergeek]

I typically change out sets in 2-3 days. I find they start getting pretty sore if I don't.

[kgm0612]

Congratulations & Welcome to the Pumper's Club!

Depending on how comfortable my site is and how much insulin I have in the reservoir, I may leave it in a day longer and change it out on the 4th day. I also do not fill my reservoir to the max........I use under 30 units a day so I only fill it to about 110 units.

Every insurance company & plans are different. I have United Health and get my test strips & pump supplies from Focus Pharmacy. They accept the 80% United pays as full payment and I don't have to pay the 20%. But.......my brother also has United and his plan only allows him to go through Mini Med.

Good Luck and keep us posted!

Karen