The "Un-Tethered" Regimen

[CarlyesHope]

I was on the Children with diabetes site, and I came across this very interesting article regarding pumping (for active adults) and thought I would share in case some of you didn't see it.

Un-tethered regimen (http://www.childrenwithdiabetes.com/clinic/untethered.htm)

[am1977]

I actually was on the "Untethered Regimen" for awhile in the past and it has been discussed here in the forums. My reasons for trying this regimen were mainly for security. I felt I needed the extra security of having Lantus work as a background insulin should my pump not work as it should (I had had a lot of past problems witha that occuring :rolleyes: ). There are definitely good things about it and I can't say there is really any negatives, aside from having to take another shot during the day and having to spend extra money on the Lantus. It's definitely an option that should be explored.

Thanks for bringing this up...it's a good refresher ;)

[nantomsuethom]

Just a thought.....

If you stop an IV for any lenght of time the site goes bad (clots). I know it is a lot different in a vein but do the infusion sites last as long as if you had a continuous infusion or do you have to change it sooner?

[am1977]

I haven't found that to be a problem, Nancy. However, I never disconnected for that long...so I don't know. It's a good question, maybe someone else will know the answer. :)

[Funnygrl]

I doubt it. IV sites go bad because the blood clots. An infusion set goes into subcutaneous tissue, where there isn't nearly as much blood, only some capillaries, so nothing to cause it to clot.

[Dewey]

Thank you for posting it, Kelly. This is a method I'm interested in trying, as I've experienced some issues with (stand-alone) Humalog lately. Like Am, I'm interested in using it as a supplemental measure. That's the beauty of having more (and newer) meds available. If one way doesn't work, we're not stuck to just one regime. :thumbsup: Thanks again! :)

[ricardo]

I actually was on the "Untethered Regimen" for awhile in the past and it has been discussed here in the forums. My reasons for trying this regimen were mainly for security. I felt I needed the extra security of having Lantus work as a background insulin should my pump not work as it should (I had had a lot of past problems witha that occuring :rolleyes: ).

Thanks for bringing this up...it's a good refresher ;)

What sorts of non-delivery problems have you had? I'm well into my 9th year of pumping, and have had less than 20 hours TOTAL non delivery time due to set problems spread out over 4 episodes. Hardly worth writing home about. Has your pump been failing, or your sets? I don't even carry extra sets with me any more.
Ricardo

[HeatherP]

Thanks for posting that Kelly! Up til now I didn't really understand how that worked. Very interesting.

[am1977]

What sorts of non-delivery problems have you had? I'm well into my 9th year of pumping, and have had less than 20 hours TOTAL non delivery time due to set problems spread out over 4 episodes. Hardly worth writing home about. Has your pump been failing, or your sets? I don't even carry extra sets with me any more.
Ricardo


Well, Ricardo...I started off on the Silhouette infusion sets, and throughout my experience using them I had problems. Many times, I didn't receive a "no delivery" alarm, but in the meantime I had sky high numbers that would not come down no matter what. I remember one week in particular...I had changed the site after finding that it was not delivering insulin, inserted the new one and still had extremely high numbers. I didn't know what was the problem. At that point, I thought it couldn't be the site again, so I left it in (stupid me :rolleyes: ) and continued to have one high after another. I was so frustrated, didn't know what to do, and was extremely upset. Not to mention, I was emotionally spent and exhausted from dealing with all of it. I finally called Mini-med's 24 hour support line. They sent me out a new pump (b/c of me never getting a "no delivery" alarm) and also sent me some quick sets and the quickserter. The person I spoke to thought the Sils might not be the right set for me and I was in total agreement. I didn't like the sils at all, I didn't like having to insert on an angle and also I found that they hurt. However, I was at my wit's end, I wasn't sure of whether I wanted to continue pumping. I was sick of playing detective trying to figure out what exactly was the problem (one of the problems with pumping) and I didn't feel completely comfortable with being on the pump. Someone here at the forums posted at the "Untethered Regimen" and I decided to go for it. I knew there wasn't much of a chance of going into DKA or something scary like that with Lantus working as a background insulin, so that made me feel better about pumping. Well, back in January, I decided to try the pump alone again and thing are going ok. I have had problems with the quicksets, unfortunately, but I think I am managing for the most part.

That's my story ;)

[ricardo]

Well, Ricardo...I started off on the Silhouette infusion sets, and throughout my experience using them I had problems. Many times, I didn't receive a "no delivery" alarm, but in the meantime I had sky high numbers that would not come down no matter what. I remember one week in particular...I had changed the site after finding that it was not delivering insulin, inserted the new one and still had extremely high numbers. I didn't know what was the problem. At that point, I thought it couldn't be the site again, so I left it in (stupid me :rolleyes: ) and continued to have one high after another. I was so frustrated, didn't know what to do, and was extremely upset. Not to mention, I was emotionally spent and exhausted from dealing with all of it. I finally called Mini-med's 24 hour support line. They sent me out a new pump (b/c of me never getting a "no delivery" alarm) and also sent me some quick sets and the quickserter. The person I spoke to thought the Sils might not be the right set for me and I was in total agreement. I didn't like the sils at all, I didn't like having to insert on an angle and also I found that they hurt. However, I was at my wit's end, I wasn't sure of whether I wanted to continue pumping. I was sick of playing detective trying to figure out what exactly was the problem (one of the problems with pumping) and I didn't feel completely comfortable with being on the pump. Someone here at the forums posted at the "Untethered Regimen" and I decided to go for it. I knew there wasn't much of a chance of going into DKA or something scary like that with Lantus working as a background insulin, so that made me feel better about pumping. Well, back in January, I decided to try the pump alone again and thing are going ok. I have had problems with the quicksets, unfortunately, but I think I am managing for the most part.

That's my story ;)

Which model pump? 511?

HOW high was "sky high"?

The SIL's suck (at least for me).

I've not had a single problem with a Quick Set. Years ago, the Soft sets would leak at the fitting. They'd sometimes even come apart (elastomer plug that receives the needle that's attached to the tubing). MM clearly had mfgr'ing problems in the late 90's. I didn't get involved in the defective Quick Set fiasco--I've been using them only since Feb.

Glad you are now doing better

Ricardo

[duck]

"Untethered"...Be gone with you, all you blasphemers! (Blasphemours? Blasphemurs?--Whatever!)

[am1977]

Yes, I'm using the MM 511 (haven't upgraded). I guess I consider 300's and 400's sky high and I think that's what I was running during that great period in my life. I think the lowest I went down was in the 200s. Things are better now, but not perfect. I have my moments where I want to chuck my pump against the wall and forget it, but then I'm really not too excited with the idea of going back to MDI. Guess I'm going to stick w/ pumping and hope I don't run into too many more problems. :)

[ricardo]

Yes, I'm using the MM 511 (haven't upgraded). I guess I consider 300's and 400's sky high and I think that's what I was running during that great period in my life. I think the lowest I went down was in the 200s. Things are better now, but not perfect. I have my moments where I want to chuck my pump against the wall and forget it, but then I'm really not too excited with the idea of going back to MDI. Guess I'm going to stick w/ pumping and hope I don't run into too many more problems. :)

I also consider 300-400 "sky high". :) On the rare occasion when i break 300 I feel it. It's hard for me to put the sensation into words. Have you been in contact with your endo regarding your numbers while pumping? Glad you are doing better.

Ricardo