honeymoon

[playgtar]

I've noticed each time I change the way I take my insulin, my numbers change. At first they're always good, and it seems by the time I go back to the doctor or the educators I'm running high numbers again. This happened when I went from 70/30 to mdi. When I started taking Lantis. From mdi to the pump. Is there a honeymoon for each new apparatus?

I really think I just need to raise my basal. Sometimes they just don't want to listen to me. They want me to go through a "trial" period. My thinking is if you have me on 26 units of lantis (26/24 hrs = 1.083) and you have me at .8 per hour on the pump and my numbers are high.........why wait, lets do this thing. But then again, the pump is fasting acting. I just get ticked about the numbers.

I've started using half of the fiber carbs when I go out to eat to try to lower my numbers. Anyone have any suggestions.

[spike]

I've noticed each time I change the way I take my insulin, my numbers change. At first they're always good, and it seems by the time I go back to the doctor or the educators I'm running high numbers again. This happened when I went from 70/30 to mdi. When I started taking Lantis. From mdi to the pump. Is there a honeymoon for each new apparatus?

I really think I just need to raise my basal. Sometimes they just don't want to listen to me. They want me to go through a "trial" period. My thinking is if you have me on 26 units of lantis (26/24 hrs = 1.083) and you have me at .8 per hour on the pump and my numbers are high.........why wait, lets do this thing. But then again, the pump is fasting acting. I just get ticked about the numbers.

I've started using half of the fiber carbs when I go out to eat to try to lower my numbers. Anyone have any suggestions.

A "rule of thumb" is to pump with about 80% of MDI basal amounts. so if you were taking 26U, I can see why the doc would START you at around .8U/hr, although more precisely, it would closer to .9U/hr. That "rule of thumb" does NOT preclude modifiying the basal to suit the patient, once it becomes apparent the basal rate is inadequate. Hopefully, you'll either "do your own thing", or have your doc get on the same page as you. Good luck!

[sbuff28@charter]

I got pissed off at my pump people too because they wouldn't let me do it on my own. I don't see anything wrong with taking what you think is accuate as long as you test constantly....correct as needed

[spike]

I got pissed off at my pump people too because they wouldn't let me do it on my own. I don't see anything wrong with taking what you think is accuate as long as you test constantly....correct as needed

Except for the first 2 weeks of pumping (in '96), I've been the ONLY person who decides how to adjust my pump. I can't really wrap my thinking around the idea of having someone else TELL ME how to pump. It seems that there are significant numbers of pumpers such as yourself that are in that situation. Can you please try to explain? I'm not being critical, believe me; I just don't UNDERSTAND. Pumping requires such IMMEDIATE decisions, that I don't see how a pumper would make contact in a timely fashion with a healthcare professional when changes need to be made. Or are you talking about long term basal settings? since I'm activity level changes dramatically each day, I make changes to my basals using the temp basal feature, pretty much every day.

[JediSkipdogg]

A few things you need to consider first. I use the rule of 3. If something happens 3 times in a row (for a basal rate that means 3 consecutive days) then you need to check/change something. Some for a basal rate prefer the week method, especial to first time pump users.

You can try and adjust your basal rate but I found out myself on the pump that I use about the same now as I use to use on MDI with NPH. The difference is during the morning hours I take 50% less than the evening hours. So it all balances out. I think when I was put on the pump they started me at around 1.25 units/hr. Now I'm on .9 during the night, 1.250 in the morning, and 1.875 in the evening, which in a sense all averages out to 1.25.

So you may need to tweak more and create a basal profile with changes in the day.

And like Spike, I make all my pumping changes. When I see my doctor she looks over my numbers and offers suggestions to try, which I gladly try since most are minor changes. But in between visits I make all of my own changes and just report to her what changes I made the next time I see her, which at times can be many changes over 4 months between visits.

[Lynne1]

I've noticed each time I change the way I take my insulin, my numbers change. At first they're always good, and it seems by the time I go back to the doctor or the educators I'm running high numbers again. This happened when I went from 70/30 to mdi. When I started taking Lantis. From mdi to the pump. Is there a honeymoon for each new apparatus?


I've only made one change....from MDI to the pump...and my insulin requirements went down dramatically and have not increased (I've only been on the pump for 2 weeks though)



I really think I just need to raise my basal. Sometimes they just don't want to listen to me. They want me to go through a "trial" period. My thinking is if you have me on 26 units of lantis (26/24 hrs = 1.083) and you have me at .8 per hour on the pump and my numbers are high.........why wait, lets do this thing. But then again, the pump is fasting acting. I just get ticked about the numbers.

I've started using half of the fiber carbs when I go out to eat to try to lower my numbers. Anyone have any suggestions.

My pump trainer likes to wait to see 3 days of results before changing anything. The first thing she did was adjust my basal rate to avoid my lunchtime lows. Then she had me do the basal testing by skipping meals. So far I've tested my am and afternoon basal rates. As far as I can tell, she is following the protocol described in the book Pumping Insulin to the tee. Perhaps you can get that book and try to tune the pump yourself? Just be conservative when making adjustments so you don't have any hypo surprises.

Also, I went to visit my Mom this w/e and ate out a couple of times. I tried to estimate my carbs but ate a really big meal on Sat night and my bg levels were wacky for the next day. My pump trainer said to eat meals where the carbs are really easy to measure and fat and protien are kept to a minimum during the tuning phase. After the Sat night meal I can see what she means. It's not just the post meal numbers that get messed up...it takes a while for the numbers to get back to normal. Could the increase in your insulin requirements be due to a change in diet?

[psilocybin]

I got pissed off at my pump people too because they wouldn't let me do it on my own. I don't see anything wrong with taking what you think is accuate as long as you test constantly....correct as needed

agree. i do it all on my own...and that rule with 80% of basel rate it not true for everyone...mines cut in half. i only do .25/hour and i was down 12 units of levemir a day. your doing a insulin change basically, maybe it depends on what type of insulin you were on while mdi