Day one on the pump:

After the trainer left and had me all hooked up on my new animas pump I checked in with a cool 125 on the bg scale.

Not too bad considering it was 11:30 and I hadn't had my lantus yet nor breakfast and it was fast approaching

lunchtime. Here are the results so far on the pump.

7:07 - 78
11:37 - 125
12:04 - 148 (30 g carb for lunch, homemade chicken veggie soup - bolus taken)
1:47 - 174
3:27 - 145
5:45 - 111 (33 g carb for snack, yoplait yorgurt - bolus taken)
6:58 - 59 (70 g carb for dinner, taco bell crunchwrap supreme - bolus taken)
7:17 - 45 (15 g gluscose taken for low)
7:30 - 71
7:58 - 172
7:59 - 188 (10 g carb for snack, peanuts - bolus taken) only took this one for verification of the last one

It sure looks like we have some fine tuning to do. At first glance, I really have no clue what is wrong. I will hopefully fix the bg levels during the next bolus in an hour. No more food for the day. Got 3 more readings today. 1 at 10::00 for the bolus (assuming it is still needed), 1 at 12:00 before bed, and 1 at 3:00 am.

[JediSkipdogg]

You look pretty good so far for a first day. What you really need to do is try not to eat for say 6-8 hours and do testing constantly during that period. Then you can fine tune your basal rate by the hour. But so far so good.

I haven't eaten since 8 pm. I can probably hold off till about noon tomorrow. Would that be helpful information, or would the nighttme throw a monkey wrench into the mix?

[JediSkipdogg]

You would want nighttime too. Except that's the hardest one to do. If you can wake up anywhere throught the night and test that would be great. The nightime is where most pumpers (not all) have to cut their basal rate down so they don't bottom out. And with numerous testings, we can try to figure out if you should lower it and how much at what times.

Well, I just tested at 95. Hope another low isn't coming. Guess I'll have to be aware for it. My endo is going to have to write my next script to text 15 times a day! My goal was to reduce the swings in bg readings, not widen them... I guess it will take time for that to happen.

I was asked by my trainer to take 2 more readings tonight. 1 at bedtime in about 2 hours and 1 at about 3 am. I will do that until friday. I think I will also hold off on breakfast if you think it will help fine tune the basal rates. Should I really be trying to adjust the night time basals and the morning basals at the same time?

[JediSkipdogg]

They might all be hand in hand. It's hard to tell at this time. If say you test in 2 hours and you are running 70, you may need to drop your evening basal rate. If you eat say 2 glucose tabs and then at 3 am are running 50, you will definitely need to change your nightime rate. Basically you know you don't need to change a rate at all when you run the same thing 2 different hours without eating. So if at midnight you run 95 again. Then you have your basal rate from now till midnight pretty much perfect.

If you could go 36 hours without eating at all, you could adjust all your basal rates at once. But first being on the pump I know that won't happen because you will drop at times.

But just check your blood sugars often and if you see yourself running steady or no more than a +/- 10 mg/dl change, then you are perfect for that time. If you notice a higher change, then look about 90 minutes before and see what your basal rate is and change it slightly. I assume for now you are on one steady basal? You would need to start breaking it up into hour blocks then.

The trainer did start me on a single basal rate for the entire day. The goal was to fine tune the night time basal rate initially. She did mention breaking the basal rate into 4 blocks during the day, but the animas pump supports 12 blocks with 4 different programs making it quite versatile. I was given permission to tweak the basal rate myself my 1 or 2 points. And I am aggressive with my diabetes. I hate lows and highs and the sooner I get through this the better. I really do appreciate your help...

[duck]

Get this:

http://www.amazon.com/gp/product/188...Fencoding=UTF8

[mwalt2]

The Pumping Insulin book is good. It explains a lot on how to set up different basal levels depending on the time of day - bicyclic patterns, etc. It took me a good couple of weeks to get everything worked out when I started on the IR1250. The Animas trainer was good about calling me everyday and I emailed her my reports. I initially started off with a lot of lows because my basal was too high. It was set for a dawn phenomenon and I don't seem to have one. Your numbers aren't too bad and you're probably heading in the right direction. It will be good to have fasting glucose levels to ensure that your basal is set correctly. Skipping breakfast is a good way to find out if your morning basal is right. For daytime fasting basal rates, it is good start testing when you haven't eaten/bolused for 3.5 hours. Test for 5 hours, about every hour. If your bg doesn't drop more than 30 mg/dL during the 5 hours, it is considered to be a good basal rate. The 30 mg/dL change is also used over the 8 hours while you are sleeping to judge night basals. It is good to get up during the middle of the night and test until you're sure everything is set properly (which it sounds like you are doing). Good luck

Well, just did the 12:25 pm test. and it was another low, 57. Now I've got to correct before I can go to sleep. Should I adjust my 3 am test time or just scrap the test tonight altogether? Maybe I should delay it until 3 hours after I decide to go to sleep. Which won't be until I get my bg up near 100.

And my idiot vp of engineer asks gets irked that i'm working at home this week!

Your tips are my peace of mind tonight...

[mwalt2]

If it was me, I would just log what you eat and when. Then continue testing as normal. Even if it isn't a good fasting basal check, the info still be useful to your trainer. I was testing around 15 times a day for the first few days. Now that my basals, I:C ratios, ISF's, etc are set, I probably only test around 6-8 or so.

[JediSkipdogg]

I would maybe start by bringing your entire basal rate down 10% and see what happens then. It seems like you are running low throughout the entire day. So dropping it by 10% total will help, then we can try working on breaking up your day into segments. I have mine in 4 segments I believe.