Pumping parameters

[BlueSky]

I got this pump hooked up at the diabetes clinic today. Using the manual and based on my MDI experiences, I did the set-up over the weekend. The diabetes nurse and the pump rep reviewed these parameters and changed them in line with John Walsh's algorthms. What struck me was how different they are to what I expected.

I thought that an insulin:carb ratio of about 1:5 would be about right, perhaps even 1:3 in the morning. They changed the ratio to 1:23, which seems way out to me. I entered a correction factor 1:1mmol/l, which they insisted on changing 1:4,5mmol/l. After some discussion, I agreed to use these rates as a starting point.

I was wondering if others have also found such big differences in terms of pump requirements and MDI based expectations.

[RobiJo]

I got this pump hooked up at the diabetes clinic today. Using the manual and based on my MDI experiences, I did the set-up over the weekend. The diabetes nurse and the pump rep reviewed these parameters and changed them in line with John Walsh's algorthms. What struck me was how different they are to what I expected.

I thought that an insulin:carb ratio of about 1:5 would be about right, perhaps even 1:3 in the morning. They changed the ratio to 1:23, which seems way out to me. I entered a correction factor 1:1mmol/l, which they insisted on changing 1:4,5mmol/l. After some discussion, I agreed to use these rates as a starting point.

I was wondering if others have also found such big differences in terms of pump requirements and MDI based expectations.

An insulin to carb ratio of 1:3 would mean you'd take 3units for an 8oz glass of milk. That's a lot of insulin--you'd need to be pretty insulin resistant for that kind of ratio. If they put you at 1:23.. this sounds like 23grams. Were you used to counting carbs in Exchanges? 1 exchange=15 grams...????

As for the correction dose (well actually all of it)..you'll just have to test and see. Remember the pump can partially correct, say 0.4units for a number slightly above target.

[xMenace]

They changed the ratio to 1:23, which seems way out to me. I entered a correction factor 1:1mmol/l, which they insisted on changing 1:4,5mmol/l. After some discussion, I agreed to use these rates as a starting point.


One of my pet peeves is the separation of these factors. An I:C and a correction factor are directly related and should be identical. An I:C of 1:23 is equal to a correction factor of 1:6.44. They want you to take more insulin for the sugar that's in your body that for sugar going in.

My rates were pretty close. My endo actually droped them a bit. Either you or your helpers are way off. It'll be interesting to see your numbers.

[NoelD]

They started mine out like that, but after the first day, I set my own settings and have changed them on my own ever since. I think they are conservative in the beginning for fear of hypos.

Mine now:
I:C is 1:4 for the morning hours, 1:5 for the rest of the day.
correction factor is 1:10

[BlueSky]

I seem to have been given very bad advice. It surprises me as the diabetes nurse has been doing this for many years. And the pump rep is a T1 and has been using a pump for 9 years. I am having to override the pump to drive high blood glucose down, using substantial corrections - 7 units so far today, and it isn't even lunchtime! They also insisted that I don't cover a no-carb breakfast with insulin, which really messed things up. My BG went up to 14.5 (261). Anyway, logically the first priority is to get the basal sorted out. I will skip breakfast tomorrow and adjust the basal rate if necessary. And I suspect that I will be covering carbless meals again from Thursday onwards.

[Cyborg]

Congratulations on the pump. Hope it works well for you. My trainer also played it extremely safe with the initial settings. Like another poster, I also took things into my own hands rather quickly and got to the testing required to fine tune the pump. It takes awhile, but is well worth the effort once you have it. Good luck!

You have been assimilated ;)