[barbarac]

Right now I am on the Animas pump, but seem to have little luck controlling my sugars. Today high all day for no reason--bolused for highs and food (of which there was little), but still over 300. Just changed set again--didn't see anything wrong, but never do. I was thinking that since this pump cannot seem to be regulated (we change basals about every 3-4 days and nothing seems to help much)--maybe it is time to take a break and go back to shots for a while. My last A1C was 9.9, and that is with checking 6-8 times a day, faxing readings every 3 days, changing basals, etc. I can do the same breakfast every morning, by lunch I am sometimes high, sometimes low.

When I was doing shots I took Lantus at night and Novalog for meals. Used a sliding scales to also cover highs. I read about other things on the forums. Am curious, do most take Lantus and Humulog/or Novalog, or are there new things out now. I haven't discussed this with either Dr., but am just thinking about it now. My GP doesn't do pumps at all and thinks I was better off on the shots. My endo. doesn't seem to care to tell the truth. I think either would be OK by her.

So what insulin do you all take? Any suggestions. I have tried basal testing, but not with much luck. Those days when I decide to test I seem to be very low or high--never normal. I am also tired of getting up at 3:00 am to test seeing how I also have to get up several times for trips to the bathroom. Just don't seem to sleep well anymore--think it is because of being high most of the night (except when it was 40 the other night for no reason I can think of).

Think maybe I am just strange!!

[JediSkipdogg]

There is Humalog, Novolog, and Apidra. Apidra is suppose to be the #1 recommended for pumpers but it's generally a tier 3 insulin whereas Humalog and Novolog are tier 2 on most insurance carriers. I have heard of people having terrible success with one or two of the priors and then miracles with the other(s).

My question for you though is have you ever done basal testing? That is where you skip meals and test every 30 minutes. You should not go up or down at all (within say maybe 10 mg/dl total) during the time period. If you do, then a change in basal needs to be made.

[xMenace]

It sounds like your basals need some serious fine tuning. I know it's a pain in the butt, but the better your basal rates are, the better your control will be.

[BlueSky]

Originally Posted by barbarac

... I have tried basal testing, but not with much luck. Those days when I decide to test I seem to be very low or high--never normal. ...

It sounds like your levels are very inconsistent. To me, that suggests absorption problems. Did you have similar problems with MDI?

[xMenace]

Originally Posted by BlueSky

It sounds like your levels are very inconsistent. To me, that suggests absorption problems. Did you have similar problems with MDI?

Do you have episodes of good control or are they all bad? If you have good and bad, then absorption is definately a suspect.

[barbarac]

I pretty much am high most of the time--unless it drops way down like to 40--and I am serious, for no reason. It just bottoms out. I was thinking maybe the absorption is bad. I just don't know. I am going to start over with the basal testing--the endo only had me try once and never mentioned it again. I tried on my own a couple of times, but it would either go way up and I would bolus, or drop down. I know that means the basals aren't right, but just can't seem to get them. We change them every 3 days--only pick one at a time and they only want me to go .1 up or down at a time. I have been doing this since '92 (on pump for 3 years and went back to shots because A1C's had gotten up to 10.2. Shots for a few years, then got this Animas 2 years ago. Have been "tweaking it" as they call it since. My husband and I both figure the carbs and all--so there are 2 of us working on it. I tried changing the basal myself once when I was visiting in NJ and they got all hyper about it--"well we'll just have to start over now!" I would switch endo's again (I am on my 4th now), but there is none in our town that do the pump. I drive to Indiana now. Just don't know who to switch to. My GP's answer is just "you are just one of those people I guess". He said he has no problems except with me and one other lady.

I got diabetes when I was 48--straight to Type I and on insulin.

Maybe it is the absorption. Thanks for listening though. I will try the basal tests again. Last night I went to bed at about 190 though and at 3:00 am it was 340 something--can't remember exactly. That isn't right I know, but just don't know what to do. The girl who trained me on my first pump tried to help me (she is great and could have done it I think), but got into trouble with endo. and called and said she couldn't help anymore.

Thanks though. Will keep trying. Just think maybe I should take a break for a while--very frustrated.

[xMenace]

Originally Posted by barbarac

My GP's answer is just "you are just one of those people I guess".

I'm just one of those people too, and now my basals are near perfect! It does make a world of difference.

Making small changes is recommended. I didn't because I'm confident in my insulin math, and I was very careful to follow up my chnages with close monitoring.

Here's some reading.

Getting Down to Basals :: Diabetes Self-Management

HOWTO profile your Basal Rates.

PDF workbook

PDF worksheet

Index of Diabetes Technology pages: Insulin Pumps, Insulin Pump Comparison, Blood Sugar Meters, continuous glucose monitoring devices, noninvasive monitoring, diabetes software.

Integrated Diabetes Services - Diabetes Management

You may question some of my links which is fine. A couple are inteded for broad understanding. It is a broad topic.

[bluesgirl102]

While I do agree your basals need adjusting, I am also wondering about absorption issues as well. What type of infusion set are you using?? I have found the proper set for you is very important and could impact your absorption greatly. Also what areas are you using for sites???

[barbarac]

I use the Unimedical Quick Sets 9 mm. I know it is bad, but usually use lower abdomen. Try to move it around as much as possible there though. I sometimes use upper, but it seems to bother me there more and feel sore. I have read here about people using their bottoms and arms and stuff, but seems awkward, and to tell the truth, I wouldn't be able to reach around there to disconnect for shower--either arms too short of middle and side too big!! I tried my thigh once, seemed OK to me, the nurse educator told me not to do it anymore there because I could hit muscle--that seemed strange, but I usually listen.

I was high most of the day yesterday, changed set and it has been good all day today. Hit a low once last night, ate, and it was good today. So I am pretty sure yesterday was a bad site. I hesitate to change after 2 bad readings though because I have so many I would be changing everyday almost.

Anyway to know if site is really bad other than just changing it?

I will look at the reading materials. I don't know if it is just my age or what, but much of this confuses me. I am not good at technology and stuff--fought getting a computer until school went to computer everything--attendance, grades, etc. Had to then, still not good at it, but love it. I also have never been told to figure in proteins and all that, just do carbs.

Thanks for replies. Maybe my next question should be which sites work best for other people.

[bluesgirl102]

Why don't you ask your trainer or nurse educator for samples of different sets?? I,for one, could not use those insets. Also, if you like the idea of an inserter why not ask for a sample of the inset 30's that go in at an angle??

Also, why do you feel your lower abdomen is a bad place for a set?? I use my lower abdomen often and find it to be a great place for a set as long as you are rotating your sites. I have also found my hips, upper buttocks and love handles to work fine as well and are not hard to reach.

Unfortunately, sometimes there is no way to tell if a set is bad until you pull it and sometimes not even then. If I have readings of over 200 2 times in a row I pull the set and insert a new one. Since I switched to the comfort set shorts I have had very few bad sets.

Oh and as for the thighs, I have used them and have had success, but again, you won't know till you try.

[barbarac]

The ones you mentioned -- inset 30's that go in at an angle-- they have an inserter that shoots it in? Not sure I could manually do it. I just meant that I think I use the lower abdomen too often (like almost always). It is good and my most comfortable area, but just thought I should probably find a different area.

The comfort short sets--do they have an inserter?

[JediSkipdogg]

Originally Posted by barbarac

The comfort short sets--do they have an inserter?

Nope, those must be inserted by hand.

THe Inset 30s are pretty much the exact same thing and they do have an inserter built into each infusion set.

[Deltagirl1976]

It almost sounds like you have some insulin resistance going on. Maybe could you be type 1.5? or maybe even type 2 and just got misdiagnoised? I seem to be having the same type of issues as you do with my blood sugars except mine go real high 600 plus then go low. So I'm seeking the opnion of another endo because the one I have now just pretty much sees me every 3 months to make sure I'm still breathng and to tell me my only hope is weight loss surgery.I wish my PCP did pumps becaue she is a AWSOME doctor.

[bluesgirl102]

Like Jedi said, the comfort sets have no inserter. If you can give yourself an injection by syringe then you can insert a comfort short. It doesn't hurt at all.

[lilituc]

I would try to get samples of some different infusion sets and try them out. Sounds like an absorption issue to me, too.

Another question - do you have scar tissue or bumpy areas from MDI? If you try to insert the set there, the same thing can happen.