[SGT Shoutmore]

Of course I am pleased to have had everything come together and get my insulin pump. After going over things with my trainer and going "Live", I was pretty happy, starting at 1:17p. A slow decline in BG was noticed within 2 hours by only 6 mg/dL, I felt pleased, my pump was clearly working, I went from 139 to 133 in that time. Later, at around 5:pm my BG was 111. Hey, one point above my max target, pleased again.

Fast forward a half hour, I am at 97 and feeling a downward trend. I get at the deli one quartered fried spicy potato, it is 26 grams of carbs, I load the BG value and carb values in the bolus wizard, I accepted the suggested bolus of 6, but I thought I would go slow, so, I assigned a dual wave with the first 3.0 units at square and the remaining 3.0 units given over a duration over 30 minutes. I get home, start getting dinner going and I felt a low trend again, I check my BG, and I am at 74, oops, no wonder I felt I was going lower. So, I pause, shut off the burners on the stove, I get a glass of regular coke, 4 ounces of it, I prepare to sit down to drink it when WHAM, crash hypo, I am dizzy, nausiated and felt like I was going to drop, felt very confused, disoriented and unable to concentrate. I stood there bracing myself against the wall trying to remember something, then, it came to me, suspend the pump, did that, then, reasoned that I was about to sit down, did that, hammered down the coke, 15 minutes later, my BG was 4 points LOWER and again, I am feeling BAD. Ok, been hypo before, quite a few times before, I am having a hard time reasoning, Ok, I am not alone, so, I am cool I ask the other half for a glass of milk, I slam that right along with a glass of tea, finally, I am on my way up, 15 minutes later, I am in my 90s, Ok, getting on with dinner, I ate a marinated chicken breast with spinach and a cup of steamed white rice. two hours later, my BG is only 134 and I did NOT bolus, so, I am concerned at this point, I call my trainer, she is not answering her phone, that's ok, it is Sunday evening, I call my endo, his exchange answers telling me he is out of town, the woman "Michelle" would NOT stop interrupting me as I am trying to ask her if ther is a doc that is on call for him, she is very snotty and tells me essentially what boiled down to I was bothering her and told me to go to the ER. Well, I don't want to go to the ER, all I want is a suggestion as to an alternative basal rate that won't get me into trouble so fast and so hard, no luck. Drank some more milk, laid down for 30 minutes, awoke feeling low again, BG check showed a lowering trend, another glass of milk with a slower sugar i.e. chocolate bar with nuts. BG back to 134.

Long ranger time. No one else to goto that is a part of my health care team, time to make reductions, obviously, pump therapy with fast acting insulin w/o using long acting insulin requires significantly LESS insulin since I ate a fairly heavy carb item, white rice and I didn't even have to bolus, I am convinced my basal is too much insulin. Ok, I am all for self sufficiency and I simply will NOT go to the ER while I am conscious when I feel I have the ability to correct this myself.

Jumping in now, I took the math from my my total daily insulin, subtracted 25 percent: 100 daily units -25% =75 /2 = 37.5/24 hrs = 1.56 round down to 1.55 for safety net 1.55 u/h x 24 = 37.2 u/24h (A formula given to me by my Medtronic rep to compute my own settings)

Set new basal from 1.70 u/h to 1/55 u/h and running with it.

I am confused by why my trainer had me in slightly more insulin than my MDI total daily insulin, but hey, this is NOT an exact science, every diabetic is different. I am not angry, in fact, it has given me confidence in my pump, it sure works! *ROFL* and being able to make such on the fly adjustments is great.

At present, I am testing HOURLY to watch trends with the new basal rates. Tomorrow is a new day and I am factoring in that I still have residual levemir on board that is probably complicating things. Will watch trends tonight and tomorrow to see if I need to increase back to my trainer's settings as I will not have the levemir on board.

NOW, despite all my drivel, there is actually a question in there. Has anyone else amongst the group had this happen when they first started pumping?

Feedback?

[Keezheekoni]

Um, the formula shouldn't have been 75% of your total daily units, it should have been 75% of your basal which was your Lantus/Levemir, with your carb ratio remaining the same.

You are pumping more insulin per hour than a lot of T2's do! No wonder you're low!

[Eddy]

Keezheekoni speaks truth. Ouch.

Additionally, I wonder if you still had some long-acting in your system. If so, double-ouch.

[Keezheekoni]

Originally Posted by Eddy

Keezheekoni speaks truth. Ouch.

Additionally, I wonder if you still had some long-acting in your system. If so, double-ouch.

Yeah, that's one thing I thought of, but by the time I ended my post I forgot! That's what being tired and hypo will do for you late at night... If you hadn't stopped your Lantus/Levemir 24 hours before being plugged in, then that was probably still working in your system as well.

[UpNorth]

Yep, i went low a few times the first couple of days of pumping, due to having Lantus still in my body and not having my basal rates set right...

[palefacegirl03]

I took my lantus the night before I went live with my pump. My trainer did something to my basal(suspended?) where it was not running that day, I hooked up at 11 am and did not turn the basal on till I talked to her that night at 9pm. So I was still going on the Lantus and just bolusing for what I ate for the first 10 hours or so that I was pumping.

[mortis505]

My trainer had me set a temp basal of 0.0 until my normal shot time. And then over the next few weeks, I lowered the basal myself. It's good when the trainer tells you that he/she is confident in your abilities. Diligence is the key Sgt.

[SGT Shoutmore]

All is well with the lowered basal and the levemir now 33 hours since last injection. So, that was my fly in the ointment. I called my doc and gave them my current basal rates for his info they were good to go for a start, so, we'll peak and tweak it as we go along.



Guess what I didn't have to do?

I didn't have to take 5 SHOTS in the last 24 hours! (I didn't take ANY shots at all)

[davef]

Originally Posted by SGT Shoutmore

I called my doc and gave them my current basal rates for his info they were good to go for a start, so, we'll peak and tweak it as we go along.

Did you happen to mention how you were treated by Michelle and her telling you to go to the ER?

Glad your pump is working out, I'm just taking Metformin, so don't fully understand the hassle of MDI but by the sounds of it your pump is making a big difference to you.

[Eddy]

Originally Posted by SGT Shoutmore

we'll peak and tweak it as we go along.

I hope you mean "peek" instead of "peak".

[Alice]

Sorry this happened to you but am thankful you are willing to share this "learning curve" with us...I have to ask...why didn't you continue to drink more Coke? Milk doesn't have near the carbs (or as fast acting) as Coke...

When I've had those crashing lows (luckily not very often on MDI) I usually drink Coke to work around any food in my stomach and then add glucose tabs to mix with the Coke to get a double wallop of glucose. That seems to help.

I hate lows when I have a tummy full of food. I don't think you had much of those potatoes left, but maybe a little.

I know you'll be a great pumper...yes, I was wondering how your total units had been figured too.

[notme]

I did a lot of tweaking the first few weeks. I went "live" on my pump on Christmas Day. Originally, I thought is was a dumb idea, but in reality, I ate so much that day it helped with all the potential lows. My A1C took a dive the first time after I started the pump, then it slowly creeped back up a bit.

It just takes time. Your doing great.

[SGT Shoutmore]

Originally Posted by davef

Did you happen to mention how you were treated by Michelle and her telling you to go to the ER?

Glad your pump is working out, I'm just taking Metformin, so don't fully understand the hassle of MDI but by the sounds of it your pump is making a big difference to you.

Dave,

When I spoke with the office manager at my endo, I raised he issue I had with Michelle and that experience, I was assured that this issue would be brought to the exchange supervisor.

I sure like he people at my new endo, of course, it was cool getting a call from my Medtronic rep and my trainer this morning to make sure that everything was alright in follow up about my hypo events. It's funny how when one has a fairly mediocre doc, the hassles to get anything done, and then when you get a new doc that has it together, a good pump rep and then trainer, everything just comes together and pretty quickly and nearly hassle free. It's a nice feeling knowing there is now much that existed previously that I either don't have to deal with or now won't have to deal with it alone. This has been a good experience in the end.

[SGT Shoutmore]

Originally Posted by Alice

Sorry this happened to you but am thankful you are willing to share this "learning curve" with us...I have to ask...why didn't you continue to drink more Coke? Milk doesn't have near the carbs (or as fast acting) as Coke...

When I've had those crashing lows (luckily not very often on MDI) I usually drink Coke to work around any food in my stomach and then add glucose tabs to mix with the Coke to get a double wallop of glucose. That seems to help.

I hate lows when I have a tummy full of food. I don't think you had much of those potatoes left, but maybe a little.

I know you'll be a great pumper...yes, I was wondering how your total units had been figured too.

Alice,

Why didn't I drink more coke instead of the milk? To be frank, and I am embarrassed to admit, my hypo was such that I was pretty confused and at several points, unable to reason quickly, it was more of a mindset "Me Mongo! (Blazing Saddles) Mongo must have carbs, mongo grab milk, milk is yummy". It was more of an inability to think with clarity and just going on "instinct". I was experiencing a moment where I had the I.Q. of the average garden turnip.

[SGT Shoutmore]

Originally Posted by Eddy

I hope you mean "peek" instead of "peak".

*chuckle* Yup. You got me.