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Need Some Advice, New To Pump LinkBack Thread Tools Display Modes
  #1 (permalink)  
Old 03-10-2008, 06:52 PM
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Question Need Some Advice, New To Pump

Hey,

I have only been on the pump a month or so, I have been running on 0.9 units an hour and I have been having what I would call perfect control to where I could test my blood no matter when and would always be between 4.5 and 7.5.

The past few days though my numbers are creeping up and hitting a few highs now, I seem to be hitting between 10 and 14 which I don't like.

I feel like I am really high though as I just can't stop peeing.

I put my pump up to 1.2 units an hour but the blood is still creeping up even 4-5 hours after food so I now have it set to 1.5 because am getting frustrated.

Any ideas or suggestions fellow pumpers?
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Old 03-11-2008, 12:14 AM
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Are you rotating sites enough? How often are you changing your site? What sites are you using? What sets are you using? How old is the insulin?

NEVER jump your basal from 0.9 to 1.2. It seems small, but that's a change of over 7 units over the course of the day. You would have upped your Lantus-or whatever the heck you were on before pumping-dose by 7 units at once, would you?
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Old 03-11-2008, 12:34 AM
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If your blood glucose is still going up after such a big increase, either the insulin is bad or maybe you are getting sick.
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Old 03-11-2008, 02:51 AM
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Yes, more details needed... when was your last set change? It could be just a problem with your current site. And could the insulin be bad? I do find insulin can suddenly lose potency, despite al claims of weeks and months stability etc. Try replacing it ASAP.
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Old 03-11-2008, 04:33 AM
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hi gobbly, are you coming down with something?

you can use temporary basal settings on the pump, trying 10% increases until your bg are stable would help you.

(well done on getting a pump btw )
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Old 03-11-2008, 06:53 AM
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I have the same thoughts as everyone else. Either Gobbly's coming down with something or needs a site change.

Karen
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Old 03-11-2008, 07:07 AM
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Agree: insulin may have lost potency, site may not be as receptive as previous, stress or sickness, and only increase basals slowly with extra testing
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Obesity and Type 2 are strongly associated. Most people assume that Obesity is the cause and Diabetes the effect. It is equally valid to suggest that the underlying metabolic disorder which leads to the Type 2 causes the Obesity.
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Old 03-11-2008, 08:35 AM
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Thanks for the replies guys, here are answers to your questions if it helps, I am still fighting going high today so still need some ideas.

Are you rotating sites enough?I change my site every 3 days

What sites are you using?I am using my abdomen

What sets are you using?I use the Paradigm Quick-Sets

How old is the insulin?It is all within a month old as I have not been on the pump long

When was your last set change?This morning

I am due to start on a a complete new bottle of insulin tonight right from the fridge so maybe that will help me sort this problem out.

I have been fighting the highs for the last 3 days and I don't feel ill really, only while I am high it makes me feel a bit rubbish.
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Old 03-11-2008, 09:05 AM
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When you pull the site, check the canula before tossing. It may be kinked or otherwise obstructed. If that's the case, you'll know to replace quickly when that happens in future.

I agree with the suggestion to limit changes to basal rates to 10% or less. Also, pumpers often have basal rates that change throughout the day. Mine is high for a few hours before dawn, lower through the morning, a little higher in the afternoon. This was a result of lots of testing and the occasional 3-day cgms.
Good luck,
Mike
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Old 03-11-2008, 09:13 AM
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This won't fix everything, but it might help a tiny bit!

I was noticing every other time (approx) I changed my cannula set, my bgs would go up. It was really bothering me. I think I finally figured out what was going on. I think every time I disconnect for a shower I might lose a bit of insulin out of the tubing. However, since I pre "bolus" 20 minutes worth of basal before disconnecting, I was only going high after changing the cannula set.

Make sure your tubing is totally primed before you attach and do the Fixed Prime to fill the cannula. I'd rather "waste" a bit of insulin that go high. A problem I was having was a little insulin coming out of the tubing when I was disconnected (in the shower). Last time I changed the set on my body, I did a fixed prime without attaching and watched for insulin to come out of the tubing . . . not one bit of insulin came out . . . so I did it again and saw some finally come out. Then I attached and did one last fixed prime.

If you continue with quicksets, you might do better with the 9mm instead of 6mm needle length. (The 9's hurt me a bit.)
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Old 03-11-2008, 09:24 AM
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Quick-sets are well known for infusion problems. I can't think of a single person who has used them successfully. True story. I would ditch those in favor of silhouettes or sure-ts.

I would also rotate sites through more than just your abdomen. I use arms, thighs, abdomen, sides of abdomen, and upper butt.
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Old 03-11-2008, 11:41 AM
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Good luck. I know how frustrating it can be when it could be 5+ causes, and many of them take a while to work out.

With the insulin. I recieved an entire batch fresh from the chemist that had all lost it's potency somehow. (Not out of date). Wouldn't you know I went camping for 4 days afterwards and the entire time I ran high and felt lousy. eventually deciding it was the insulin. Got back to civilisation, new insulin, and bam in 2 hours it all started working again.

The point to my story, is never ever assume anything about insulin potency, always have options or backups. It may not be the problem for you at the moment, but keep it in mind for later. I also prefer buying 3 ml penfils to suck out of because that way much less is unsealed and less to carry out of the fridge (emergency supply).
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Old 03-11-2008, 11:56 AM
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Did you see this thread with someone else's experience using Quick-Sets: Trying the silhouettes.
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Metabolic Syndrome Dx'd March 2003. Pumping since April 2004. VSG 20th October 2008
Obesity and Type 2 are strongly associated. Most people assume that Obesity is the cause and Diabetes the effect. It is equally valid to suggest that the underlying metabolic disorder which leads to the Type 2 causes the Obesity.
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Old 03-11-2008, 12:04 PM
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Quote:
Originally Posted by Funnygrl View Post
Quick-sets are well known for infusion problems. I can't think of a single person who has used them successfully. True story. I would ditch those in favor of silhouettes or sure-ts.
I agree. If it's the last thre days, it's likely a set problem: scar tissue, bent canula, tennelling, occlusion, or whatever, it just didn't work well. When I get unexplained highs like that, I change sets asap.
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HDL - 1.74 (67)
LDL - 1.89 (73)
Triglicerides - 0.52 (47.0)


7/08
A1C 7/08 5.9%
HDL - 1.55 (59.9)
LDL - 1.76 (68.1)
Triglicerides - 0.44 (40.0)

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Old 03-11-2008, 05:51 PM
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Quote:
Originally Posted by gobbly2100 View Post
Hey,

I have only been on the pump a month or so, I have been running on 0.9 units an hour and I have been having what I would call perfect control to where I could test my blood no matter when and would always be between 4.5 and 7.5.

The past few days though my numbers are creeping up and hitting a few highs now, I seem to be hitting between 10 and 14 which I don't like.

I feel like I am really high though as I just can't stop peeing.

I put my pump up to 1.2 units an hour but the blood is still creeping up even 4-5 hours after food so I now have it set to 1.5 because am getting frustrated.

Any ideas or suggestions fellow pumpers?
Being your blood sugars were good in the beginning, I am wondering if you are Bolusing enough insulin to match the carbohydrates you are eating.
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