Back-up insulin

[KAnderson]

Just curious - how many of ya'll keep some back up insulin like Lantus in case of pump failure? I kept a vile of Lantus from my MDI days just in case, but it expires this month. I hate to pay the cost of getting another vile, but on the other hand if my pump goes south...so I just thought I'd ask to see what most of you do.

Thanks,
Ken

[xMenace]

The protocol I was given is to take boluses every four hours to cover my basals until Mr. pump is back in order. I think taking Lantus is crazy. You have no idea how much to take as you've been off for quite awhile. You are used to a pumping regimine and your mindset is not in touch with Lantus and its risks, especially if you have a crazy basal pattern, and finally once you start pumping again, you have to somehow account for all this lantus flowing through you. I do prefer the short term uber-bolusing technique.

[morrisma]

Never even considered it in the 6 or so years I've been pumping. Just bolus a wee bit extra at meals. With minimed's replacement service I've never been without for more than a day. And if I expected to be without longer, I'd call my endo and get a dosage recommendation and a free sample:D
Mike

[KAnderson]

Thanks xMenace - that does make a lot more sense to me.
Back when I started pumping, I was instructed to keep some Lantus for back up should the pump have a failure. After thinking about what you said I could just imagine the cluster that it would be trying to use Lantus until a new pump is rolling again!

Ken

[Scratch]

The protocol I was given is to take boluses every four hours to cover my basals until Mr. pump is back in order. I think taking Lantus is crazy. You have no idea how much to take as you've been off for quite awhile. You are used to a pumping regimine and your mindset is not in touch with Lantus and its risks, especially if you have a crazy basal pattern, and finally once you start pumping again, you have to somehow account for all this lantus flowing through you. I do prefer the short term uber-bolusing technique.
If your pump is keeping track of how much basal it delivers and you know that your basals are working correctly, then it seems rather simple to have a decent estimate of how much Lantus to inject. Most likely, the estimated Lantus dose will tend to be a bit on the low side, but that's fine if one is checking blood sugars frequently as one would have to anyhow if injecting Novolog every few hours.

Furthermore, if you have your basal doses working correctly, you can easily estimate the variance. Let's say your basal pump dose per 24 hours is 18 units, so you inject 18u of Lantus to act as the basal. It should be around .75u/hr of basal insulin then, and you can simply look at your pump's basal profile to see when that hourly rate is exceeding, matching, or coming up short.

Of course, like anything, there can be some difficulty with Lantus duration between different individuals, but I really don't see why it would be so difficult to have a likely on the low side but decent estimate of a Lantus basal shot.

[kgm0612]

My endo writes me a new Rx once a year for Novolog pens as a back up for pump failure. I had to use them a year ago when my pump stopped working over a weekend and I couldn't get a replacement until Tuesday morning.

Karen

[notme]

I keep Lantus for backup. I travel a bit and have decided I don't want to pay Medtronic their $50.00 for a travel back-up pump. Usually when we travel, it is out of the country. I would not get a pump for days, if at all.

For an overnight wait for a pump, I would short term it.

[KAnderson]

Thanks for all of your thoughts regarding back up insulin. I rarely travel out of country, so I think I'll bag keeping the lantus unless the oportunity to go abroad comes up. I had trouble with the Lantus when I was on MDI - one of the reasons for going to the pump. I keep plenty of Humalog on hand, so doing a day or two of "uber-bolusing" would work in a pinch.

Ken

[NoelD]

I just inject Novolog every 2 hours to equal what my pump would have given me during those two hours. It's not perfect, but it works ok for me.

[Lloyd]

I got a sample of the 70/30 I used before pumping, from my doctor. Backup for a year.

[duck]

I've never been on Lantus, so my protocol is an injection every two to four hours if my pump takes a dive. I've never had to do this, though (knock on wood).