[gobbly2100]

Hey all,

I don't get it, I have been pumping for a couple of months now but I find that I can get everything settled and running very good blood suagrs but then I can suddenl start seeing BG's up to 19 and it feels like I need to constantly adjust my insulin doses.

One minute 1 unit of insulin will cover 7 carbs and then it will change and I either have highs or lows after eating.

I have done all the fasting to get my basal right but it seems pointless when my insulin ressistance/sensetivety changes from one minute to the next.

Seeing high readings just really depresses me.

It does not seem to be related to the infusion sets either as I have tried changing them and such.

Any thoughts or ideas people?

[Gary_W]

Hi Shane,

I'm not pumping yet, but a couple of questions / suggestions.

Have you got different carb ratios dialed in for different times of the day? For me on MDI at the moment, I need around 1:9 in the mornings, 1:10 at lunch and 1:12 for the evening meal. Most people need a lot more insulin in the morning to cover breakfast than they would for food later in the day. Some here do the 'super bolus' (I believe John Walsh of 'pumping insulin' fame came up with it). Apparantly very good at controling the 2 hour spike for certain foods / troublesome times of day.

Second, when do the highs and lows occur in relation to the bolus dose? Are you testing at hour 2 and correcting with food / correction insulin / suspending your basal for a while?

Third, are you aware of glycemic index and the profile of your insulin? Could it be that certain foods are working much quicker than your insulin (hence the highs) and other foods may be too slow hence sending you hypo early and higher later?

Gary

[Jan B]

A few ideas . . . .

If I overeat, even when matching insulin to carbs, my bgs will be higher than normal for several hours. Smaller meals/fewer carbs keep me much more level.

A decent sized bubble in the resevoir can make you go high. I work real hard on getting all air out when I load a new resevoir. Lots of thumping!

When I disconnect for a shower, bits of insulin seem to come out of the tube, so I always do a fixed prime to watch insulin come out before I reattach. Now I hang it so insulin can't fall out, but still do a fixed prime to verify.

If my bg is up to 200 or so, I take more insulin that my normal correction factor would suggest. Always follow up after corrections to see if you have come down far enough.

Nearly every time I change infusion sets, I go UP for a couple hours. Now that I know this, I bolus an extra unit when I put in a new set and it works for me. I've never gone low doing that.

[Gary_W]

Originally Posted by Jan B

A few ideas . . . .



If my bg is up to 200 or so, I take more insulin that my normal correction factor would suggest. Always follow up after corrections to see if you have come down far enough.

That one is particularly true for me; the higher I am, the less I can rely on my ratios. Corrections work as advertised until I get to 10+ (180 US) at which point the rule book seems to catch some serious ammendments.

[Clint]

One thing to look at to, is what you ate when you BS rises or drops abnormally. The types of carbs that you eat can really affect how your sugars act. Last but not least, our disease is not exact and likes to not follow the rules at random times..

[johgn]

Originally Posted by Jan B

Nearly every time I change infusion sets, I go UP for a couple hours. Now that I know this, I bolus an extra unit when I put in a new set and it works for me. I've never gone low doing that.

I've had the same experience.

[MinimedPumper07]

i was wondering about the correction factor thing. if i am super high corrections dont do ****. what is ur guys ISF btw?

[xMenace]

If I have unexplained highs, a set change usually fixes it.

[Subby]

What kind of sets do you use? Have you tried other another type? Eg, if straight, have you tried angled, or vice versa. It seems that people including myself have found that certain sets have a better strike rate and better absorption, over others.

For example, for me 2 in 3 times the quicksets will not work great, where the sillhouettes are more like 1 in 5 times, and the absorption is generally much better. This is with the same site areas.

Definitely worth trying another set type if you haven't.

[Subby]

Originally Posted by MinimedPumper07

i was wondering about the correction factor thing. if i am super high corrections dont do ****. what is ur guys ISF btw?

There's a thread with a few of these here: just interested. what correction