new to pump- cannot get control

[deansreef]

Hello all, I am 39 yrs old- diagnosed at age 20. On shots till oCTOBER 30TH 2007. since starting on pumping my sugars are crazy. they jump around all day from 80 to 30 up to 250+. I am entering the carbs and BS and taking the recommended doses.

the 250+ is always around 2:00 am and good control during the day 80-150 or so- sometimes falls to 35.

i am very upset and want to get control.

Dean

[Gordonm]

Have you adjusted your basal rates at all. What about you carb to insulin ratio. These will change. My numbers changed quite a bit from the first settings I was on. My first week was horrible. Graually I started working out the basal ratio and then nailed down my carb to insulin ratio. It takes time but you have to be testing frequently and making small adjustments.

[sbuff28@charter]

You need to adjust your basal rates for specific times of the day. If you see trends of high blood sugars at night, raise your basal rate at night about 10-20% for three days, if that doesn't work then raise it again.

There is nothing magical about the pump. You still need to use the empirical data to get your sugars in control.


Basically, the only thing different between the pump and MDIs are Different basals rates. all your Bolusing should remain constant and shouldn't alter too much from the amounts you injected before to cover meals. especially if you had prior good control.

[deansreef]

ok- thank you. My A1C's while on shots (humulin 70/30) were always 5.1 to 5.5- but that was becuae of a staggering amount of hypo's. I will try and increase basal. Tks

[Cyborg]

You may find this information (http://www.insulin-pumpers.org/howto/baslr.html) useful. The Pumping Insulin book by John Walsh is also great.

[xMenace]

It takes time. Have patience. It took me several months, but I finally got mine tweaked to where I can skip any meal and go to bed comfortably without worry, even with low BGs. There are of course exceptions. I'll post some other sources when I switch puters.

[kgm0612]

I went through the same thing, Dean. It took a good 4-6 weeks of "tweaking" for me to get things where they should be.

Karen

[Raisin]

I agree with everyone's suggestion regarding basal rates and carb:insulin ratio. Since the body absorbs varying degrees of insulin from shots, when you switch to a pump, your doctor should have started you on a basal rate that was probably too low to ensure you don't have any lows. You will then have to spend several weeks to months to get your basal rates right (expect to be tired for a while when you start checking-adjusting your overnight basal /BG). After you have your basal rates correct, you can focus on your carb:insulin ratio for each meal/snack. It is worth all the effort.

[xMenace]

Getting Down to Basals :: Diabetes Self-Management (http://www.diabetesselfmanagement.com/articles/Insulin/Getting_Down_to_Basals)
http://www.centremedsurg.com/Forms/Basal%20Rate%20Worksheets.pdf
Integrated Diabetes Services - Diabetes Management (http://www.integrateddiabetes.com/pump_bt.shtml)

[deansreef]

thanks all. I went to the DBE and she changed my basal rates from 12:00 am to 7:00 am and this has helped with the highs at night. now I am getting a little higher readings during the day and still getting lows!!! back to the drawing board (DBE)

[Cyborg]

It's an ongoing process. You may end up with several basal rates that change throughout the day. You could even end up with several different profiles based on whether it's a weekday or weekend, drinking, exercising, etc. It does take awhile. Good luck...

[shabbie6247]

You may find this information (http://www.insulin-pumpers.org/howto/baslr.html) useful. The Pumping Insulin book by John Walsh is also great.

this book should be given out to every new pumper! it helped me get to grips very quickly, as did the DF crew!