New to forums and new pump user

[MarieD]

Hi, new to this site and a new pump user ( as from 4 days ago). Been Type 1 for just over two years now and have been on MDI. From the beginning my problem has been high bms post meals so I'm hoping that using a pump will sort this out for me. :)
Has anyone out there experienced high bms post meals but good bms at premeals and managed to sort it out?

[mike-munich]

Hi and welcome to DF. I'm T1 as well, for 38 years now. Had MDI's until 48 days ago, then I went on a pump. I have the "dawn phenomenon", even very late basal shots couldn't bring my high BG levels in the morning down. The pump did. Maybe that's the solution for your post meal problem too ?

The folks here are very knowledgeable, so I'm sure you'll have some competent answers shortly.

[MarieD]

Thanks for your reply.
Looks like I haven't got my basel dose rate sorted as I'm doing a carb fasting test this morning and my results have gone up. At breakfast I was 6.6 but now 2 hours later (after no carbs) I'm 9.5. Speaking to the nurse this afternoon so will discuss changing my basel for tomorrow.

[mike-munich]

Adjusting the basal rate sure takes awhile. I have my pump for a while now, and still play around with the rate(s). Even if it runs smooth one day there is some frequent adjusting of the rate necessary. Your need of insulin is not the same every day. The pump is great, but it will never replace the pancreas. ;)

[kgm0612]

Hi Marie & Welcome to the forum. Nice people and tons of information to be found here!

Karen

[DCaplinger]

MarieD:

Welcome to the forums. I'm not pumping, so I can't answer your question, but welcome aboard anyway!


mike-munich:

Greetings from an American brother! I'm following these pump threads very closely, I have a feeling I'll be on one eventually. I do have a question though, how high do you usually go over your normal with your dawn phenom? I have noticed that I'm usually higher at dawn than I am at mid-afternoon, usually by a rather significant amount. This morning, I was only 13 points higher (133) than my lowest reading yesterday afternoon (120). While the difference isn't much today, it was a much wider difference before I started on insulin.

Regards,

[Cyborg]

Eating high carb meals can be challenging, even while on a pump. One of the tricks I use successfully is to pre-bolus for my meals. This assumes I know exactly what I am going to eat and when the food will be available. I pre-bolus anywhere from 10-30 minutes in advance of eating based on my current bg. If I'm borderline low before a meal, I do not pre-bolus, nor do I pre-bolus at a restaurant, unless there's bread on the table.

I've also discovered that protein (http://www.insulin-pumpers.org/howto/pfandbs.html) affects my bg. Using a pump, I am able to bolus for the protein using a 30/70 combo bolus over 3 hours. If you find protein affects your bg, you'll need to determine to what extent before calculating the "equivalent carbs" for which to bolus.

Good luck and welcome aboard. :wavey:

[xMenace]

Hi, new to this site and a new pump user ( as from 4 days ago). Been Type 1 for just over two years now and have been on MDI. From the beginning my problem has been high bms post meals so I'm hoping that using a pump will sort this out for me. :)
Has anyone out there experienced high bms post meals but good bms at premeals and managed to sort it out?

It's a toughie. Welcome.

The first thing I'd look at is your basals. Search for basal testing. IMO it's a mandatory exercise. I suspect your basals have been and are off, so your bolus is doing it's job too, unsuccessfully of course. The reality is you can't get your bolus ratios correct until your basals are.

There's various ways to attack high pp's (in my order of effectiveness)
- cut back on carbs
- pre-bolus Insulin pump - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Insulin_pump#Bolus_Timing)
- spread out the carb intake - delay that dessert for 30 minutes
- superbolus Insulin pump - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Insulin_pump#Bolus_Shaping)
- lower your carb GI & mix in healthy fat & proteins (I've control tested different carbs, and my endo agrees that low gi carbs can still cause nasty spikes)

[morrisma]

Welcome!

Took me a year to sort out my basal rates on my minimed 715 pump. After struggling, endo suggested I wear the 3 day continuous monitor. (Waited a year - ugh!) Dawn effect showed up on those graphs loud & clear and made basals a lot easier to figure.

Pre-bolusing helps me as well. What 7 or 8 units will do 30 minutes prior to a meal might take 12-20 units after. (Hate when I forget to bolus!)

Mike

[MarieD]

Interesting to hear about the protein affecting your bg. I did DAFNE last year and during that time had to eat some carb free meals to see what was happening. I ate bacon and my bg went up by 3.0 to what it had been before I ate. Maybe protein is affecting me also - gives me something to think about and discuss with my care team thanks :)
I have tried pre-meal bolus during my time on MDI's but it didn't work. To try and see what was happening I'd test my blood when I got up in the morning, inject for my breakfast and then I waited 30-45 minutes and tested my blood again before I ate - what did I find? My bg was the same if not worse than the first test!
Maybe pre-meal bolus will work using the pump. I just hate the feeling I get with the highs after every meal - anything is worth a try!

[shabbie]

welcome marieD

i agree with everything the others have said so far.

get the basals sorted first then you can concentrate on the rest of it properly ;)

i had the same problem as you regards the normal pre-meal but spiked post-meals, then normal pre-meal again.

the only way i managed to knock it out of the system was to consume fewer carbs in one sitting, and eating better quality carbs to acheive that.
for example: ~ no more breakfast cereal with soya milk (43g carbs), hello to half tin of baked beans and a kefir yoghurt drink (total 30 grams). much more satisfying, sees me thru to lunch and no mid morning tiredness! success!!!

pre-meal bolus doesnt do it for me, i just end up higher later on. but now i pump i do use the extended bolus options for high fat meals ;) (yep even pizza!)

[Cyborg]

Interesting to hear about the protein affecting your bg. I did DAFNE last year and during that time had to eat some carb free meals to see what was happening. I ate bacon and my bg went up by 3.0 to what it had been before I ate. Maybe protein is affecting me also - gives me something to think about and discuss with my care team thanks :)
I have tried pre-meal bolus during my time on MDI's but it didn't work. To try and see what was happening I'd test my blood when I got up in the morning, inject for my breakfast and then I waited 30-45 minutes and tested my blood again before I ate - what did I find? My bg was the same if not worse than the first test!
Maybe pre-meal bolus will work using the pump. I just hate the feeling I get with the highs after every meal - anything is worth a try!

Once you get your basals nailed down, you discover that you have Dawn Phenomena...