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Insulin Sensitivity Pump Setting

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#1
kgm0612

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According to my pump manual, Insulin Sensitivity is the amount your blood sugar level is reduced by one unit of insulin and that this value amount is used to calculate a suggested bolus insulin dose to correct your BS when it's above the target range.

I started on the MM-515 in mid-December with an insulin sensitivity setting of 133, set by my endo & pump trainer. After chatting with several pump users and asking what their level was set at, over the last several months I have lowered my level down to 45.

I guess what I'm trying to get to is this..........when I correct because my BS is above my target range, then my BS should be dropping 45 points for every unit I give myself to correct? This certainly wasn't happening when it was set at 133, or 90, or 75.

If someone could help me out and explain this all to me, I'd appreciate it!

Karen

#2
Funnygrl

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If your ISF really is 45, then yes, bs should drop 45 for every unit. I'm kinda surprised they didn't work with you to figure this out before starting pump, at least roughly, and explain it better.

So if your ISF was 45 and your target bs was 100, to correct a 190 you would take two units because:

(current-target)/ISF= correction

so:

190-100=90/45=2

#3
spike

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According to my pump manual, Insulin Sensitivity is the amount your blood sugar level is reduced by one unit of insulin and that this value amount is used to calculate a suggested bolus insulin dose to correct your BS when it's above the target range.

I started on the MM-515 in mid-December with an insulin sensitivity setting of 133, set by my endo & pump trainer. After chatting with several pump users and asking what their level was set at, over the last several months I have lowered my level down to 45.

I guess what I'm trying to get to is this..........when I correct because my BS is above my target range, then my BS should be dropping 45 points for every unit I give myself to correct? This certainly wasn't happening when it was set at 133, or 90, or 75.

If someone could help me out and explain this all to me, I'd appreciate it!

Karen


Wow! 133??? My number is between 22 and 38. 22 in the pre dawn hours, and closer to 38 during the day. Don't forget you have to wait the full 3.5-5 hours for your bg to drop the full amount. don't expect it to drop by your ISF within a hour or two...
T1 DM since '78
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Current Pump: Blue MM 522

#4
notme

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I have mine set at 40 Karen and that seems to work fine for me. 133 is one high number. Wonder what inspired that particular number for MM.
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#5
kgm0612

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Let me give you a little more info than I did in the original post. Before going on the pump in mid-December, I was taking 5 units of NPH in the morning and 10-14 units of Novolog 70/30 with dinner, along with Metformin. I averaged about 15 units per day. I did great BS-wise during the day but was constantly going low right before lunch and after my evening walk.

The first day I started pumping, the pump trainer gave me all the numbers to enter into the pump. Those numbers were on a sheet that came from my endo's office. I never thought to ask how those numbers came about and she never explained to me what the ISF was or how it worked/should work.

The following day, my younger brother and I were discussing pump settings. He's been pumping for 7 years and went on the MM-715 a week before I got my 515. When I told him (and showed him) my ISF set to 133, he told me that was way too high and that his was set at 40. My numbers certainly weren't dropping 133 points over the course of a few hours.........and were actually running much higher than I was used to. The endo (over the phone) told me to lower it to 90. Eight weeks later we tried 75, along with upping the basal rates. Finally, I took it upon myself and lowered it to 45 because most of the pumpers I know have theirs set between 40 and 50. I saw my endo two weeks ago. He went over the pump settings and I told him I had lowered the ISF to 45. He asked how that was working out and I told him I thought it was much better than 75. Again, I never thought to question him on what the ISF was really about.

Thanks for the info you've given so far.

Karen

#6
Funnygrl

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Ok, ISF is a setting your doctor needs to tell you. Just because your brother's is 40, doesn't mean that is a good number for yours to be set at.

The rule of 1500 can tell you roughly what your ISF should be around. At 15 units a day, yours should be around 100, so the 133 and the 40 are likely both way wrong. BUT, your doctor of course wants to start higher so you don't go low. Mine is set at 60, so just because most people fall someplace, doesn't mean everyone is.

Switching from 70/30 directly to the pump is very difficult as you have new insulins to deal with on top of learning how to use the pump. Conceptially pumping is entirely different from 70/30. So you have a lot to learn. Personally I think everyone should do mdi at least while waiting for insurance to approve pump, pump to ship, and training to happen, so they have a good 2 weeks of understanding concepts under their belt, but obviously, this doesn't happen for everyone.

#7
parrotletzoo

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karen, sounds like you did a good job of adjusting your ISF. You know your body best and it seems cde/pump trainers/endos like to start out conservatively with pumps which maybe be why the 133 ISF. IMO if you are going to pump you need to be able to tweak things like ISF, insulin to carb ratios, and basal rates on your own in order to get the whole system to work best for you. It seems like you are doing a good job at that.

That being said, your trainer should have explained what the different settings were about so that you could better understand how to adjust them. Bad trainer!! :)

If you still have questions about it check out www.diabetesnet.com 's sections on pumping and insulin or invest in a book about pumping insulin. There's one out there appropriatly called Pumping Insulin, but there are others too. Diabetesnet.com has a lot of good info on it, you just need to wade thru the "store" portion of the site.
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#8
Cyborg

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As already suggested, you can use the 1500 or 1800 rule to estimate your ISF. The actual test is a truly easy and fairly fast test. You can get the actual value by doing this test...

#9
psilocybin

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If your ISF really is 45, then yes, bs should drop 45 for every unit. I'm kinda surprised they didn't work with you to figure this out before starting pump, at least roughly, and explain it better.

So if your ISF was 45 and your target bs was 100, to correct a 190 you would take two units because:

(current-target)/ISF= correction

so:

190-100=90/45=2


i was never taught any of this as well...so your not the only one...the best was to learn is to figure it out yourself
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