Pump troubles...pls help!!!

[mma2charlie]

I am recently pregnant (6 weeks along) and was previously using Lantus and Novolog until 3 days ago when my new pump arrived. I had great control with the L & N but figured a pump would be that much better during pregnancy from everything I've read/heard (plus, Lantus isn't technically approved for use during pregnancy). Problem is this...since switching over, my premeal blood sugars have been normal but higher than before with L & N (~95) but more importantly my postprandials (after meal) blood sugars are ridiculously high (~175). And they stay up there hours after I've eaten AND bolused a correction. WTF. I'm starting to get very nervous about the health of my baby...I'm doing everything the same...counting carbs correctly, bolusing appropriately (even earlier than normal) and i'm not eating excessively hard-to-digest long-acting foods. Has anyone else has less than perfect success on the pump vs shots? Any advice as to when to jump pump ship?:confused:

[Subby]

Moving to the pump requires tweaking all the settings until they work. Settings and doses may or may not correlate completely with your MDI settings.

What was the process you went through to determine your
- basal rates
- I:C ratios
- correction factor
?

As for jumping pump ship, at 3 days - no way is that giving it the beginning of a chance. You should be in the very thick of getting your settings right, and it can take weeks.

[psilocybin]

most likely all your ratios and basals are going to change while switching to the pump. mine did...which pump are you on?

[mma2charlie]

Subby-

As far as setting basals, I:C ratios and correction factors, I worked with a woman from Medtronic who has been training people on the pump for years. Everything was very logical and scientific...

and I can totally appreciate the fact that these adjustments take time EXCEPT for the fact that I'm pregnant and don't have a lot of time to spend tweaking while my blood sugars remain so high after meals...it's just not healthy for the pregnancy. This is my dilemma. :(

[mma2charlie]

Psilocybin-

I am on the Medtronic Paradigm 722. Right now i have one basal for the whole day, set at 0.9 and my I:C ratio is 1:10. I have even tried taking my insulin 20 min before eating...crazy as it sounds, the Novolog just doesn't seem to be taking effect as quickly as it did when I was taking shots...unless it was the Lantus that was assisting there...

[Subby]

Subby-

As far as setting basals, I:C ratios and correction factors, I worked with a woman from Medtronic who has been training people on the pump for years. Everything was very logical and scientific...


... which is extremely imperfect when it comes to matching individual bodies, and will never replace the need for real world tweaking (sometimes extensive). If they gave you the impression they would "Get it all right for you" in a couple of days, guaranteed, they were lying. Sorry for being so blunt.... but...


and I can totally appreciate the fact that these adjustments take time EXCEPT for the fact that I'm pregnant and don't have a lot of time to spend tweaking while my blood sugars remain so high after meals...it's just not healthy for the pregnancy. This is my dilemma. :(

The you need to decide on a course of action to return to good levels as soon as possible. I can see 2 alternatives for you.

1). Educate yourself on how to tweak your settings so that you can start seeing improvements quickly. We are here to help (ask specific questions for feedback). The book "pumping insulin" is incredibly useful. The process of learning and tweaking may go on some time, (for some of us with tricky basals, it really never stops), but if you put some time and effort in you can start seeing improvement quickly I am sure.

2). Go back to injections.

It has to be your choice, of course.

[Stace629]

I totally understand. It took about 2-3 weeks for me to get all of my settings tweaked just right. I'm not sure that the beginning of your pregnancy was the best time to start your pump therapy tho. I love my pump and would hate hate hate going back to injections, but that is me thinking of myself. You have another life growing inside of you right now, and you are right to think about that first. If you feel like you had and will have better control on the injections, try again with your pump after delivery. You won't regret it. The hard work and sticking it out is so beyond worth it.
Best of Luck!

[Jan B]

FWIW, I think you should go back to MDI until after your little one is born.

It takes about a month before you will have better control pumping than not. Right now, you need to relax and enjoy the pregnancy instead of stressing over this change.

Congratulations!

[Lizzie G]

FWIW, I think you should go back to MDI until after your little one is born.

It takes about a month before you will have better control pumping than not. Right now, you need to relax and enjoy the pregnancy instead of stressing over this change.

Congratulations!

i agree....i started pumping on march 17 and my control has been worse than it has ever been whilst i get used to things,and i realise it is going to take quite a bit more time to get things right....i have always worked hard on my control and been very clued into whats going on with my body and how different things effect me; if im honest i did expect the transition to be easier than it has been, it is hard hard work; right now you need to be using a method that you are 100% comfortable with to ensure your pregnancy goes as well as possible....good luck with whatever you decide x

[mma2charlie]

THANK YOU to everyone for your replies, especially you Lizzie...you're the first person who I've read about/heard from who says that they too have been in worse control on the pump vs shots. I thought I was the one case in the world. Unfortunately, Lantus is not technically approved for pregnancy so while there are moms out there who gave birth to perfectly healthy babies, there are others who didn't and now I am forced to pick the lesser of two evils: use Lantus and take my chances, stay on the pump and experience unhealthy high blood sugars and take my chances. This is the most stressful experience of my entire life. I'll be talking with my ob/gyn on Monday—I'll see what she says and keep this thread updated.

One other question for Lizzie—what was your treatment method before you started on the pump? What are your basal rates (I know everyone is different but I'm curious to find out what your conversions ended up being). If you wouldn't mind sharing...

[xMenace]

Subby-

As far as setting basals, I:C ratios and correction factors, I worked with a woman from Medtronic who has been training people on the pump for years. Everything was very logical and scientific...

and I can totally appreciate the fact that these adjustments take time EXCEPT for the fact that I'm pregnant and don't have a lot of time to spend tweaking while my blood sugars remain so high after meals...it's just not healthy for the pregnancy. This is my dilemma. :(



Psilocybin-

i have one basal for the whole day, set at 0.9 and my I:C ratio is 1:10. I have even tried taking my insulin 20 min before eating...crazy as it sounds, the Novolog just doesn't seem to be taking effect as quickly as it did when I was taking shots...unless it was the Lantus that was assisting there...

Your settings are not very logical and scientific. Hardly anybody has one basal setting. Some of us have many. I use hourly settings and I have 16 changes.

I agree that you should go back to MDI. It'll take months to get good pump numbers with a steady metabolism, but being pregnant ... no way.

[Fraida]

I dont agree that you should go back to injections. yes, it will take time to tweak your basals and boluses, but if your doctor or pump coach can work with you on a daily basis to get your numbers closer to target, then i think in a short amount of time your numbers will imporve. your numbers are not ideal for pregnancy, but they are not horrible, and as long as you lower them soon, i think it will be ok. of course ask your doctor what he/she says. my thought is that the benefits of the pump far surpass what injections can achieve. even for those of us on pumps for years before becoming pregnant, there is a lot of tweaking along the way to adjust to the growing baby. i fax my doctor logs twice a week, and she usually suggests some amount of tweaking based on my logs. whatever you decide, it will be the right choice for you- try and relax- stress is not good for your blood sugar- its gona be ok!

[mazea]

Sorry your having such a difficult time with your blood sugars and the pump. I'm also having difficulties with unstable blood sugars during my pregnancy (12 weeks), my blood sugar keeps dropping to 1.8mmol (twice in the last few days) and 7th time in the last 3 months because of the hormones changing my insulin requirements without warning and I seem to drop for no reason since I became pregnant. Sometimes I am even dropping when there is no novorapid in my system.

Lantus is not technically approved for pregnancy so while there are moms out there who gave birth to perfectly healthy babies, there are others who didn't
I was just wondering where have you had heard about babies being born with health problems after Lantus? I've only heard that Lantus and Levemir was untested and that the only problems were in the animal studies that were done.:o ? I've been taking Levemir.

[mma2charlie]

mazea-

Here's where i read about the instance of a baby being born with significant problems after the mom took Lantus during her pregnancy. Although, it does seem odd that the baby had so many issues...they almost seem genetic and not necessarily a side effect of the Lantus. The story is about 4 entries down by Julie Kohler:

Lantus and Pregnancy - Diabetic Mommies - BabyCenter (http://community.babycenter.com/talk/a2838215/lantus_and_pregnancy)

And to everyone else who has been giving advice...thanks again. I stuck with the pump and adjusted basals and insulin:carb ratio dramatically and it worked! numbers are completely in normal range and i feel A LOT better. My A1c is not horrible either—6.7—and i'm working hard to get it even lower next time.

[Meghann0409]

Girl, deep breaths. You're gonna drive yourself crazy with worry!!

Medronic = NOT A DR! Good place to start, then be done with them.

I call my Endo (download to Carelink, did you get the USB to download your pump to the site?) 2x/week with adjustments.

And ditto to PP - I have a setting at 12a, 4a, 6a, 9a, 8, 10:30p. All different.

Another thing to consider, if insurance allows, is the CGMS - it is invaluable during pregnancy to help you adjust when you aren't testing (like on the overnight - that is how I knew I needed more insulin at 4a, less at 6a, even less at 9a.)

HTH!! Congratulations and remember to be calm. It's not worth stressing over! Call your Endo when you have questions. :)

[angel007]

I am recently pregnant (6 weeks along) and was previously using Lantus and Novolog until 3 days ago when my new pump arrived. I had great control with the L & N but figured a pump would be that much better during pregnancy from everything I've read/heard (plus, Lantus isn't technically approved for use during pregnancy). Problem is this...since switching over, my premeal blood sugars have been normal but higher than before with L & N (~95) but more importantly my postprandials (after meal) blood sugars are ridiculously high (~175). And they stay up there hours after I've eaten AND bolused a correction. WTF. I'm starting to get very nervous about the health of my baby...I'm doing everything the same...counting carbs correctly, bolusing appropriately (even earlier than normal) and i'm not eating excessively hard-to-digest long-acting foods. Has anyone else has less than perfect success on the pump vs shots? Any advice as to when to jump pump ship?:confused:
HI..I have been on a pump for 8 yrs now ( I have had diabetes for 13 yrs)..I am currently 28 weeks pregnant and I have had good times and bad times with my blood sugars through the journey. My pre A1c was 7.3 after finding out I was pregnant I really cracked down and my next A1c was 5.9 never had I had a A1c that low..I gained about 10 lbs in the first 2 and 1/2 months of my pregnancy from the increase of insulin..I was going to my endo every 2 weeks and he would increase my basal and my meal bolus, I have different basal patterns for different parts of the day..expecially when I was working. My endo kept warning me as I got further along my bc's will spike and we will have to redo everything we had accomplished, boy he was right..I went from premeal 70 to premeal 200 because the increase of hormones and the baby..It's a vicious cycle but you have to stay positive and except the highs and lows-keep working with your dr and the important thing is learn your pump so you feel comfortable changing your basal's and bolus's to see if different settings work for you, of course with your dr's approval of doing so. Don't jump ship :) You will find that in the end having the pump makes life much easier. I have had a few times my pump broke and I had to go back to injections, until i got a new one, I was so happy when I got it back.Good luck!!
Angel