first day with my pump, questions.

[yanki01]

tonight is my first night with my Animas OneTouch PING pump. i love it so far, ive been low all day but just not having to give shots is a plus. my sugars was 65 before i ate dinner and had 50carbs for dinner (ratio is 1:15 day, 1:10 night). i thought i wasnt setup for my basal untill tonight because last night i took my lantus but i guess not, its been showing in the history that its been giving myself the insulin. i guess now i know why i was low all day.

whats the normal BG level to be at before going to bed? right now my basal is set at .80/hr which i think might be too much for overnight? ill stick with it for now untill my doctor says otherwise. does it beep or anything when it gives my basal dose? does anyone snack before bed? do you "suspend" or just disconnect when showering? thanks for the help and i just wanted to say so far i love this pump!

[MoCoke]

Hi fellow Pinger...

At first when I took a shower I would disconnect and "suspend" the pump. After getting dressed, I'd sometimes forget where I'd put the pump so the beeping would help me locate it and remind me to put it back on. After awhile, I'd get another beep. Okay, so I'd reconnected the pump but I'd forgotten to hit "resume". Now, several months later, I just disconnect. The pump is so much more of a habit now.

I'm a Type 2 and my insulin needs are vastly different than yours so I'll not comment on how much you take or will need.

I will say that the best way to know what you're doing is to test, test, test. Those numbers will give you a better idea of your insulin needs.

[yanki01]

i got my carb ratio backwards, 1:10 day and 1:15 night. btw, does anyone give their full dose at night even though you still get a little overnight? i just took my first shower, just disconnect and plugged my inset.

[yanki01]

thanks MoCoke, yea before i was really lazy on testing. sometimes 1 time a day. the last 3-4 months its 5-6 times a day, now it will be 7-8 times a day. im slowly getting used to testing.

[telizas]

The Ping gives you your basal dose continuously. You'll hear a little "gear" sound from the pump every few minutes (if you're listening for it, its not very loud). So ditch the Lantus. The pump cannot work unless you have an active basal set up.

I can't speak to what your basal or bolus rates should be, but I wouldn't change anything until you're off the Lantus for a few days. I generally go to bed about 115, or if I'm lower than that I'll have a snack, but I used to wake up way high. I'm also a T2, so my needs are far different than yours.

I'm a little concerned your doc didn't explain how the basal works with your pump or told you to stop the Lantus. :(

And yeah, I just disconnect for showers. No biggie.

[xMenace]

I'd set an alarm for 2am to test and maybe again at 4am. Be safe! Do this until you are stable.

I leave my pump on while showering. I can hang mine from teh shower curtain and still reach everything. If I have to unhook, it;s no biggie.

I wouldn't suspend either. If I unhook for a shower, I set a 30 min temp basal for clsoe to zero percent.

[yanki01]

yea ill set my alarm to wake at 2am to test and see what im at. idk if i should give myself insulin right now that im 190 before bed. im going to leave it as is and see how i am at 2am.

when i was on the lantus pen, i was 22 units every night. so the .80 is a little less for 24hrs. i gave myself my bolus for lunch and heard the beep and gears move but have yet to hear or feel anything with the basal?

[SharpTail]

I've been on the Ping for about 2 weeks. My nurse trainer did a pretty good job explaining the operation of the pump and was very close when she calculated my I:C ratio and my basal rate. The surprising thing is the reduction in my total daily dose, dropping from 70-80 units on Lantus/Humalog to 40-50 units on the Novorapid in the Ping. So you should not be surprised that your basal rate of .80 U/hr is less than your previous dose of Lantus.
So far, like you, I am very pleased with the pump.
Pat

[telizas]

You are most obviously feeling something if you're going low! You are def. getting insulin. You shouldn't feel the insulin going in; it might sting with a large bolus, but otherwise you shouldn't feel it.

You use less insulin because it's all fast- acting and it works more efficiently in your system. You may find you need different basal rates during the day, too.

[cynthiazinn]

I too am a pinger! When I shower I wear a rubber necklace which I clip my pump too, using the belt clip. I have never suspended it. I love the water proof technology.
As a nurse I can give a few formulas to help you help yourself. Remember that Doc's don't always have all the answers.
To find your basal take your weight, divide by 4. Your basal should be 40-50% of your daily insulin intake. So I divide that last number by 2. Then I divide by 24 hours so that I am able to calculate my hourly rate which you can set under advanced settings. This is a good starting place. You should check your fingerstick BG every 2 hrs. the first week and look for patterns when it is higher or lower and adjust your hourly basal accordingly.
To find your insulin sensitivity factor you must fast 4-5 hours and begin with a BG near 150. Give a 1 unit bolus, don't eat, then calculate the difference at 2.5 to 3 hours. This is your ISF.
To find your insulin carb ratio fast for 4 hours, start with a BG near 75-120. Most people start at around 1 unit/9carbs. So, bolus 1 unit and eat 9 carbs. Do finger stick at 2 hours. If the difference is >50 use a lower I/C ratio like 1/8. If the difference is <50 use a higher I/C ratio like 1/10.

[yanki01]

well last night was a little frustrating. I went to bed without giving my bolus for dinner which should have been 3-4 units for what I ate. I tested 2hrs after dinner and was at 210. I fell asleep and woke at 3am with my sugars at 55. I ate a PB&J with a small glass of orange juice, woke up at 7:30am with my sugars at 310!?!? I ate one pop-tart which is 38 carbs = 3.80 units, I gave myself 6.75 units for my pop-tart and to bring my sugars down. Im at work now and started felling funny, 9:30am my sugars are 39!?!?! drank a dr.pepper, I cant stand non-diet drinks now, I can taste the sugars but for this one time I needed it. I guess its all trial and error for the first week or so. its great that I don’t have to inject myself all the time and I know these ups and downs come with the pleasure of having this nice little machine. I hope I can fine tune it to where it needs to be. Its only 1 night so im not going to adjust anything. thanks for the feedback peeps!

[yanki01]

does anyone re-use the insulin if you have some left over. as of right now ill change my inset tomorrow night and right now I have 140units left. im guessing ill have around 80units when im ready to change give or take 10units? I know its wasting but heard some reuse and some don’t just because its been sitting there for a little while? does anyone reuse the cartridges also?

[Cluck]

well last night was a little frustrating. I went to bed without giving my bolus for dinner which should have been 3-4 units for what I ate. I tested 2hrs after dinner and was at 210. I fell asleep and woke at 3am with my sugars at 55. I ate a PB&J with a small glass of orange juice, woke up at 7:30am with my sugars at 310!?!? I ate one pop-tart which is 38 carbs = 3.80 units, I gave myself 6.75 units for my pop-tart and to bring my sugars down. Im at work now and started felling funny, 9:30am my sugars are 39!?!?! drank a dr.pepper, I cant stand non-diet drinks now, I can taste the sugars but for this one time I needed it. I guess its all trial and error for the first week or so. its great that I don’t have to inject myself all the time and I know these ups and downs come with the pleasure of having this nice little machine. I hope I can fine tune it to where it needs to be. Its only 1 night so im not going to adjust anything. thanks for the feedback peeps!

I am type I and have started on the Ping in the last week. I am still struggling with getting my basal right, mostly because I just haven't had the time to do the fasting that it requires. So I do have some understanding of the amount of insulin you are talking about as my TDD, basal, I:C and ISF are roughly the same as yours.

It's not clear whether you are still taking Lantus as well. You should not be if your pump is providing your full basal insulin.

Did you correct after dinner when you found your BG at 210? If you did then you bolused too much and your I:C ratio is off. If you didn't then either your basal is way too high at night and/or your Lantus shot is overlapping during the night with the basal insulin from your pump.

You can do boluses for food using your I:C ratio, or boluses for high BGS using your ISF factor. You can also factor in your BG when calculating a bolus for food. Your meter will do all this for you if your basic numbers (I:C, ISF) have been set correctly.

A PB&J sandwich plus orange juice is at least 45g of carbs (probably more depending on the bread type [at least 15g per slice] and actual amount of OJ [15g per 8oz]) and that would most likely be enough to bring your BG to over 300. Have you received education for carb counting? It's easier when the carbs on on the packaging but if you make something from scratch it becomes more complicated.

When you get the ping there is a great pump workbook which explains how to test your basals, I:Cs and ISF factors. I really suggest you start using these as your numbers are clearly not right at the moment.

You could also call Animas and/or your pump educator to get some more help.

Good luck! This is complicated but I am hoping it will all be worth it ;)

[telizas]

I always just change what needs changing. Unhook the pump (no need to suspend). Change the inset without involving the cartridge whatsoever, disconnect the dangling tubing and set aside for the next cartridge change. Reconnect the old tubing to the new inset. On the pump, go to Prime/Rewind, scroll down to fill cannula, input .50 units and fill. You're done.

Then, when the cartridge is dry, JUST change the cartridge and leave the inset in, using the tubing from the last inset change. Prime as normal but DO NOT fill the cannula. The cannula was already filled when you put that inset in.

Sometimes they line up so you'll do both at the same time, about every third one lines up with a change of the other.

HTH!

[Lizzy]

Telizas,

Since I only use about 15 units of insulin a day, I only fill my cartridge with about 70 units every three days. I am in the habit of changing everything out every three days.

As for showering, I just unhook, lay the pump on my bed till I get dressed and then hook back up. I do not use the plug since there is really no use to it. If I swam I would use it then.

I bolus for any food that I eat, except if I am correcting a low. Then I usually have to correct for over treating.

It can take time to get things adjusted. I find that my rates change very often no matter if I do the same things all the time!

[cynthiazinn]

I only change my cartridges when they are totally empty. Never waste a drop! Every 3 days I insert my new set and disconnect the pump from the old one, I dont even bother suspending, I just hook the new tubing right up and prime, connect it to me and fill the cannula. Sometimes my catridge change falls on the same day as my site change, sometimes not. No biggie!

[yanki01]

my GF's co-worker gave her a box of cartridges for my PING pump that she didnt use since she switched to MiniMed. Only thing is they expired 6-2008. is it too old to use? what exactly expires in the cartridge?

i adjusted my basal from .80 to .50 and so far its been pretty good. my sugars have been between 120-150 which was better since i was having plenty of lows. ill see how it plays out tonight.

[jammer13]

My daughter has been on the Ping for about 4 months and when we first started the diabetes educator nurse worked with us in the office first and then had a daily tagup phone call every day for about 5 days to adjust the carb ratios and basal rates. It involved her eating just three meals a day with no snacks and no pre-bedtime meal. Also, we did BG tests about 8-10 times a day. It probably could have been done in 2-3 days but we had a few issues and really tweaked the numbers. I've made a few adjustments since but not too bad so far. It's not unusual for people to have basal profiles with many different rates for different times of the day and even during sleep times.

If you're not lucky enough to have the educator support, I'd recommend reading "Pumping Insulin" by John Walsh which many other pumpers have also recommended. Excellent book on pumping and while you may not use every technique he offers, at least you'll understand what you're doing and why. "Think Like a Pancreas" by Gary Scheiner was another very helpful book for pumping (helpful for MDI as well).

Keep at it, once you work it out, you'll enjoy added lifestyle flexibility and hopefully tighter BG control.

Re: cartridges and shelf life - there is some sort of lubricant in the cartridges to help the plunger move evenly and also to prevent insulin leaks past the o-rings. I would assume that there is a concern of it drying out over time.

[yanki01]

man, i love this pump! i really cant feel that im attached to a machine. my sugar levels have never been better. i havent seen these normal numbers since.....never?!?! pump lover right now!