The Pump sucks!!!!I wish I never went off of mdi

[Bobby T]

So I am a type 1 diabetic of 4 years.The first year I was on MDI and a1c of 7s.Then I went on the pump and my a1c was 8s for 2 years.Now im running out of fresh site areas and keep getting highs.My sugar will some times go into the 300 and ketones will start due to lack of insulin.My a1c is 10 now and I dont know what to due.I have tried every type of set and nothing is working.Im verry thin and mucular witch is a bad combo for the pump.My doctors wont listen and think that Im not having site issue wtf?They just put me on a 72hr sensor and i had 2 bad sets today.Should I just go back to mdi or what?THANKS

[Bobby T]

O when I pull the set out there is blood?:mad:

[lorilei]

not a pumper...but maybe you need a pump break...see what the smart ppl offer as advice for staying on it...either way, no decision is ever permanent...

[Subby]

Bobby, I think from eveything you have said, Lori is bang on the money... a fantastic path for you is to get back to MDI for a while! This seems to go beyond pumping advice - the amount of understandable frustration and annoyance you are obviously feeling - it's not good, whether it's pumping or anything else. And you can control the situation and move back to what you know will give you relief.

You mention your doctor - if they don't listen and you have tried to get along it is simply time to find a new one. And if they don't support the idea of a pump holiday (why not start with a few weeks, eh?) and help you get back to injections for a while, again you need a new one.

As others wisely said to me when I was having some issues, I'd say have a pump break, get some stability, then consider down the track whether you want to return to pumping and take your time considering whether there are new things you can try when you come back somewhat refreshed.

[Bobby T]

My basal is 24 units on the pump,what would you think would be a good safe starting point on lantus 24 units?My doc said to give 20 units,but that seems very low?

[Joeprep4820]

I have to say that this is the only time I have ever heard this problem. Also, any endo worth his salt would tell you that pumps work just as well for thin and muscular people as they do for those with some chub. I've seen it work for the aforementioned. Did you try testing once an hour for 24 hours to target the area? Who ever told you that being in shape is a bad combination for the pump? That is the most ludicrous thing I've heard.

[butterflykisses]

My basal is 24 units on the pump,what would you think would be a good safe starting point on lantus 24 units?My doc said to give 20 units,but that seems very low?

When beginning on the pump they usually start basals about 20% less than what was injected before so if you reverse that and add 20% what your doctor said sounds about right.

By the way, are you sure that your insulin needs have not been going up over the years? Maybe you were a slow onset and for a while had some of your own insulin helping out??? Just a thought. A pump holiday not only will give you a break from the frustration, but will answer that question too. Good luck.

Did you try Sure T sets? I had a friend who has very little body fat and they work best for her.

[AngelKitty]

Hi Bobby,

Sorry to hear you're still having trouble with your infusion sites and pumping.
I agree with the others, if you are finding pumping so frustruting and unsatisfactory you really should give it a break and just revert to MDI.
When you switch from pump to MDI, make sure you test your BGLs every couple of hours to help you tweak your doses (as mentioned above, usually need approx 20% less insulin on a pump due to the constant infusion).
Hopefully you can tighten control of your BGLs in a couple of days and start to feel better again sooner.

[Bobby T]

I have to say that this is the only time I have ever heard this problem. Also, any endo worth his salt would tell you that pumps work just as well for thin and muscular people as they do for those with some chub. I've seen it work for the aforementioned. Did you try testing once an hour for 24 hours to target the area? Who ever told you that being in shape is a bad combination for the pump? That is the most ludicrous thing I've heard.

With quick sets they would fail by going into the mucle,being thin is a common problem.For a pump to work it needs fat,insulin does not due well with muscle.So if it goes past the layer of fat it will fail.So I have been useing the same areas over and over.I may have scare tissue?

[Bobby T]

My glucose is finally decent!!!!!!!!160mgdl and it only took a day and 3 set changes!All day my glucose would not move even with boluses due to bad site after site.

[AngelKitty]

My glucose is finally decent!!!!!!!!160mgdl and it only took a day and 3 set changes!All day my glucose would not move even with boluses due to bad site after site.

Hi Bobby - just a quick tip - even if you have an infusion set in and you think it may be playing up - you should do a correction bolus with a needle / syringe if your BGLs are climbing and a bolus from your pump doesn't do the trick. You should always have needles / syringes for back-up :)

Glad to hear you're on the mend.

[SCC]

If pumping doesn't work right now and you are so teed off at it, then stop for a while. Take a break. Good grief, quit tormenting yourself. You clearly know how to do MDI, so just fall back on that and take it easy.

I'm pretty thin and I use silhouettes (the shorter ones). If they are inserted correctly and not in an area that "moves" (twists) a lot, they are no deeper than a short needle for insulin. I'm sure there are other sets the same. I'm saying if you can inject insulin, there are sets that work.

But really - let it go for now. Don't leave the forum though! Just take a break and get happier and when you are ready, try again. Meantime, did you ever get different sets? Maybe during the break when your BG isn't so crazed you can gather supplies etc?

[lorilei]

When beginning on the pump they usually start basals about 20% less than what was injected before so if you reverse that and add 20% what your doctor said sounds about right.

By the way, are you sure that your insulin needs have not been going up over the years? Maybe you were a slow onset and for a while had some of your own insulin helping out??? Just a thought. A pump holiday not only will give you a break from the frustration, but will answer that question too. Good luck.

Did you try Sure T sets? I had a friend who has very little body fat and they work best for her.

Boy, i am confused..shouldn't he add 20 %? so that would be 28 units? however, i do think to start a tad low in basal would be ok and easily fixed...good luck! hope you enjoy better numbers soon:)

[Subby]

I think Bobby's asked before about translating a dose for coming off and I think I've said it before, but I guess I'll say it again... my advice is this is one thing to have doctor on board to discuss tactics and approaches, and at hand to call if any issues!

Any rule about relative difference in pump vs mdi dosage either up and down, may well apply to many or most, but if there is one thing that being a diabetic has taught me, it is to never assume I fall in the majority with anything, and never to assume it on someone else's behalf either, especially when it comes to a medication like insulin. I am just a bit concerned you have been looking for a definitive answer from the forum on this one a few times, Bobby! Seek (good) face to face medical help if there is just not the feeling of confidence about it (which would be completely understandable as it has been a time since MDI...)

[butterflykisses]

Boy, i am confused..shouldn't he add 20 %? so that would be 28 units? however, i do think to start a tad low in basal would be ok and easily fixed...good luck! hope you enjoy better numbers soon:)

Doh, yeah, he should ADD 20% which is what I way saying!!! I just reversed his doctors advice as being 24 in my head when responding.:o That would be a little less than 29 units.

Bobby, glad you're getting some better numbers. Still recommend you try the Sure T's. They would be easier to use in alternate places, like your upper butt. I can't imagine trying to put a Sil in that area. Other than that, I would highly recommend that pump break. Seems like you've been here a lot lately complaining about your set problems and wanting to go on a break, asking the same question about how much Lantus to use. I think you'll much happier if you just go ahead and take that pump break, give yourself and your body some time rest.

[mortis505]

What length canula are you using with your Quicks/sils etc?

Seriously though, if you arent happy on the pump, give it a break and go back to MDI.

[Bobby T]

What length canula are you using with your Quicks/sils etc?

Seriously though, if you arent happy on the pump, give it a break and go back to MDI.

6mm and 13mm for siloutes,the only thing that I could try is sure t for my butt area.I have a 72 hour sensor on so I do know if I should make the switch back to mdi yet.When I take a corrective bolus with the pump it does nothing when things are high.When I follow uo with a shot and set change my sugar come down.So it is for sure a site or set issue.

[Subby]

I have a 72 hour sensor on so I do know if I should make the switch back to mdi yet.

If your pump setup is not acting as it should, and you want to take a break from the pump within a few days for a few days, the sensor results are not going to do you a lot of good as far as helping you make control decisions from the data.

Then again, if you are on the sensor to show your healthcare team what is actually going on, (or can indeed do that) then I guess stick it out at least for a while to provide backing for what you have been saying - that corrections don't work, etc. Some independent record of food, boluses and corrections are also going to go a long way towards strengthening your cases.

Bobby, providing backing for my suspicions and control issues is EXACTLY what the CGMS gave for me lately. If you can show black and white evidence that you are indeed having particular troubles, your medical team may re-align themselves to taking you seriously and working alongside you not away from you. Whether it is tackle pump issues, or agree you have the issues and take a break.

[Joeprep4820]

Ever think of trying the angled sets?

[telizas]

Ever think of trying the angled sets?

He *is* using angled sets. The Sils are angled at 35*.

[jenb]

Bobby - go back to MDI if that's what works best for you. There's no law that says you have to stick with a pump once you start with one - no harm, no foul. Life's too short to be frustrated over tools that don't fit properly.

As for adjusting your basal for MDI, both "Think Like a Pancreas" by Gary Scheiner and "Using Insulin" by John Walsh have excellent suggestions about setting basal doses. This information might help you address the issue with your doctor.

Jen