Nothing but site issues!

[Bobby T]

Im thinking of going off the pump due to site issues!My basal is a unit per hour,so would I take 24units of Lantus for my basal?

[Dogen]

I'm going to recommend talking to your endo, naturally, because I'm not a doctor... but when I switched to the bump my basal went down about 20%. In theory, switching off the bump would have the reverse effect - you'd bump your basal up. But I'm not an expert.

[SCC]

Yes, there was a formula they used for me....I used less with the pump. It's probably all in the pumping insulin book. (John Walsh one).

[morrisma]

Lantus absorption curve is different, so more is needed to equal the pump's more 'life-like' response.

Sorry the infusion site issues are so bad. I had sites falling off all the time my first summer with the pump. I switched to quicksets with IV prep and I've lost only a handful in 5 years.
Mike

[Cormac_Doyle]

Especially if you have absorption problems, Id suggest increasing the amount of basal by 5-10%, and spliting it into two doses (morning and evening), this should most closely mirror the basal provision from the pump

[Subby]

Especially if you have absorption problems, Id suggest increasing the amount of basal by 5-10%, and spliting it into two doses (morning and evening), this should most closely mirror the basal provision from the pump

a) people's basal requirements can be different, some people are very different through the day to what you think you know. Take me for example: my basal rates on the pump are a completely different picture to "flat". On my break, I am needing the curviness of 2x Levemir shots placed strategically through the day, and even then the correlation to my pump settings are pretty poor. If I was to be on Lantus, 1x at the right time would be far preferable to 2x, but would be much poorer again.

b) increased basal dosage straight of the bat is probably not the safest idea. The phenomenon of people finding that basal dosage is reduced on going to the pump (and ergo, increased on going off the pump) is NOT universal. I for example did not have a reduction - at all - on going from Lantus to the pump. If I was to follow the advice to up my basal "just because" someone on the internet told me to, I may well be suffering staggering lows.

Upshot: giving such specific advice to people about a dosage change so major as moving from one insulin delivery system to another: well, it's not like I can stop anyone but I can say, Bobby, BEWARE.

[Subby]

Although Cormac Doyle, I do understand your basal recommendation is based on the current 1u p/h Bobby mentions. I'm not trying to have a go with my above post at all. I just think extreme caution and user understanding and confidence is absolutely paramount here. (and preferable, a doc or de with understanding of the case at hand, on the end of a phone to help with such a transition).

[Subby]

Speaking of that basal rate. Bobby, I was glancing back over your posts over the past while, and this issue where you put a set in and find your control is bad overnight or for some time, seems to have been going on. I just had a quick glance, but nowhere did I see a discussion of your basal rates.

Have you basal tested? I have a little potential light go off when I see 1 rate of 1 u/h. It's not that unusual to need a couple, or four, or 'eck I have about 12 rates through the day. You may well be "perfectly flat", basal requirements can seem as individual as fingerprints. But if your basal needs have changed, and you have not adjusted to cater for that (which is not always an easy or intuitive thing to do), it could well explain long term, repeating issues with the pump, that could come across as absorption or set issues.

Have you fully explored whether your basal rate/rates are up to scratch? Thing is, if this is indeed contributing to your ongoing instability and you need a specific basal pattern, you could well be moving away from the solution by going to the comparatively clumsy long acting, not towards it.

I have no idea if this idea or information helps at all or is basically irrelevant and your 1u/h is perfectly valid for current needs. Just laying out impressions, in case it does provide a lead.

[Oradev]

Im thinking of going off the pump due to site issues!My basal is a unit per hour,so would I take 24units of Lantus for my basal?

Bobby, I haven't been on here for a while because of personal issues, but I've had similar issues with the infusion sets. I have literally been on and off the pump numerous times. Fortunately, I have found ways to mitigate the infusion set problems. Please PM me.

Adam

[Subby]

Bobby, I haven't been on here for a while because of personal issues, but I've had similar issues with the infusion sets. I have literally been on and off the pump numerous times. Fortunately, I have found ways to mitigate the infusion set problems. Please PM me.

Adam

Why not share the information here? Your info could be useful to lots of people...

[Oradev]

Why not share the information here? Your info could be useful to lots of people...

Subby, you are right. Don't understand my logic sometimes. Maybe I was hypo. :)

I've been on and off of the Animas pump for over 4 years. Listed below are some of the problems I’ve had with the pump:
- Stinging bolus. I attribute this to the fast Animas bolus. I will be going to MM soon.
- Infusion sets generally being uncomfortable. This is probably related to me being very lean.
- Because I can only use my abdomen (only area that has fat), I’ve had some problems with absorption. I don’t know if this is necessarily scar tissue, I think it has more to do with lack of rotation. If the area isn’t 100% healed, it’s not as efficient.

Here are some of the things I've done (with the help of yall) to make my pump experience a little better.
1. You might think I’m nuts, but I’ve actually grown to like/love the untethered regimen. I use my pump for my basals and MDI for my boluses. This gives me great flexibility (can use areas that I can’t with the infusion set) when taking a bolus.
2. Gaining 10 pounds. I notice that when I have an extra 5 to 10 pounds on my body, my sets seem to be less finicky.
3. Because I am skinny, I have to use the Inset 30 infusion set. When I insert the set, I usually grab a handful of skin/fat and lift it up before I inject the set. This guarantees that I do not hit the abdomen wall, which causes big problems. i.e. bleeding
4. Trying new things and never giving up hope. Trust me when I say that I’ve had 100’s of issues with the pump, or should I say the infusion sets. It’s taken me a long time to get to this point, but it hasn’t come without many trials and tribulations. I understand that I still have a ways to go.

Adam

[butterflykisses]

I've been on and off of the Animas pump for over 4 years. Listed below are some of the problems I’ve had with the pump:
- Stinging bolus. I attribute this to the fast Animas bolus. I will be going to MM soon.

Adam

Adam,
I solved my stinging bolus by using the combo bolus. I change the delivery time to .1 and the ratio to 0:100%. That way it delivers over about 6 minutes and no more sting.

[Bobby T]

I have lost 10lbs due to ketones from site failures over the last month:mad: I know I need to gain weight,but how can I when I have small ketones all the time?Should I go back to MDI?Gaine weight and then try the pump again?

[Bobby T]

Adam did you go back to MDI ever and if you did what was your basal from the pump to mdi?

[Oradev]

I have lost 10lbs due to ketones from site failures over the last month:mad: I know I need to gain weight,but how can I when I have small ketones all the time?Should I go back to MDI?Gaine weight and then try the pump again?

Yes, that might resolve some of the issues. I seem to do a lot better when I have some fat around my waist.

Adam

[Oradev]

Adam did you go back to MDI ever and if you did what was your basal from the pump to mdi?

Well, everyone is different. To determine your basal dosage on MDI, it is recommended to take your total basal and multiply 0.25 to it.

Remember, that if you are under the 25 units per day threshold with Lantus, you will probably need to split your dose. For the DP, I used a tiny bit of NPH at night. (4 units)

Please please please notify your endo before making any kind of regimen switch.