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Thread: New to Insulin Pump!

  1. #1
    Join Date
    Oct 2008
    Location
    Toronto, Canada
    Posts
    24

    Default New to Insulin Pump!

    Good afternoon,

    This is my first post and I really need someones help. First, I've been diabetic for 18 years and recently went on the Animas 2020 pump here in Canada.

    My question is, typically how long does it take to figure out your basal rate(s) before it is stable? Also, how many basal rates should I have? Currently, I have 3. One at midnight, 4am, and 8am.

    I had my basal rate reduced on Friday and since Saturday, my BG have been around 11 mmol/L all day. I fasted from midnight till 1pm. And my BG rose throughout the day. Even at 1pm when I did an adjustment, my BG at dinner was still the same.

    Any suggestions?

    Thanks again,
    Jason.

  2. #2
    Join Date
    Nov 2005
    Location
    British Columbia
    Posts
    3,383

    Default

    When I went on the pump in 1998, my endo gave me 4 rates, and told me it should take me 5 months to a year to get my basals reasonably stable. It took me about 6 months, and I've tweaked them since, continuously. IF I fast, my basals keep my bg in the 5-6 mmol/L range. I've never fasted to test of adjust basal, for me that's not real life.

    I have been up to 12 basals, currently I have 8
    Last edited by Connie(BC)Type 1; 10-05-2008 at 05:22 PM.
    My 1st meter from the 70's

  3. #3

    Default

    When you fasted, did you check blood glucose every hour so you could figure out where it was rising or falling? Fasting basal checks can be very helpful. Once you get the basals straight, you can begin to work on the insulin:carb bolus ratios throughout the day. Many people need more insulin:carb at breakfast than at other times of the day.l

  4. #4
    Join Date
    Oct 2008
    Location
    Toronto, Canada
    Posts
    24

    Default Update on Insulin Pump

    Hi Ellen and others,

    I was fasting overnight into 1pm the next day because the previous day I had a BG around 11mmol/L range. I decided to fast because I wanted to see if my basal rate was rising or falling. I had the following rates for the following times.

    12am 0.65U/hr
    4am 0.75U/hr
    8am 0.70U/hr

    My BG was...

    12am 9.3
    4am 7.9
    10am 11.8
    12pm 11.5
    1pm 11.9

    As you can see, my BG was stable between 10am and 1pm. There was no change in my BG. Therefore, my basal rate between those times is fine. I'm thinking there was an issue between 12am and 8am when my BG started rising.

    What do you think?

  5. #5

    Default

    I'm NOT a doctor, nor a medical professional. From your data, it may be important to figure out when blood glucose started to rise between 4:00 am and 10:00 a.m. Yes it's stable fasting from 10 a.m.-1 p.m. but it was too high. If that pattern continues, you'll want to discuss it with your team to adjust the basal rate.

  6. #6

    Default

    I would recommend the book, Pumping Insulin by John Walsh. You can find it on Amazon.com, eBay or half.com.

    He goes into detailed explanations of how to basal test. There are Smart Logs that help you zero in on settings.

    It's a great read.
    GA Gov. Deal signs Diabetes Care in School Law


    Elissa, and Larry 33 years!
    Melissa - 14 (diagnosed 01/03/07)
    Non D-Bethany 26, Allen 24, AJ 20, Christina 13, Leah 9
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  7. #7
    Join Date
    Oct 2008
    Location
    Toronto, Canada
    Posts
    24

    Default Update!

    Thanks everyone,

    I'll be seeing my RN today to go over my readings. I'm just concerned about the patterns especially when I calculate 35g for an English Muffin at 7am and 4 hours later, my BG still goes up and holds till noon.

    I'm clueless.

    Thanks,
    Jason.

  8. #8
    Join Date
    Dec 2005
    Location
    Ontario, Canada
    Posts
    2,056

    Default

    You're on the right track! You're nice and steady between 10 and 1 (even though starting out too high), which is what your basal should do. Nighttime needs more tweaking.

    One thing to remember is it takes 1-2 hours for a basal rate change to make itself felt, so you need to change your basal a couple of hours BEFORE you have the problem. So if you figure out your BG starts to rise at 5 am, you want to up your basal starting at 4 or even 3 am.

    Do consult with your RN as you make these changes, especially at first. It's natural to feel impatient, but it's safer if you change your basal in small increments. You'll be surprised how much of a difference a tenth of a unit can make.

    It didn't actually take us long to get my son squared away when he started on the pump, but he was 13 at the time, growing, coming off his honeymoon, and in the thick of puberty, so we've been changing things ever since!

    As for how many, it's however many work for you. Some people only have one or two. Some people have ten!
    Holly

    mom to Aaron, 18, dx'd Sept 05

  9. #9
    Join Date
    Oct 2008
    Location
    Toronto, Canada
    Posts
    24

    Default Update!

    Hello everyone,

    After fasting from midnight till noon and see my BG rates hovering between 4 and 7, I ate. However, when I calcuated a peanut butter sandwich for 40g carbs my BG was as high as 11. It stayed that way for the entire afternoon.

    Do you guys think, my basal rate is fine? I'm miscalculated a sandwich? Or, my carb ratio is off?

    What have you guys experiences been? Even after dinner after giving myself a correction and bolus, my BG was 11 again at 8pm.

    HELP PLEASE.

    Jason.

  10. #10
    Join Date
    Dec 2005
    Location
    Ontario, Canada
    Posts
    2,056

    Default

    Hi Jason,

    It does sound like it might be your insulin to carb ratio that's off. It wouldn't be unusual to hit 11 after a meal, but then it should come down again, bringing you back to normal values in, say, 3.5 or 4 hours -- it's a whole other research adventure to see exactly how long the insulin keeps working in your body but about 4 hours for rapid is typical.

    So Aaron's guidelines are, he should be under 10 at 2 hours post-meal, and in normal range at 3-4 hours. Problem is, when he eats a really big meal he still has a lot of insulin on board at the 2-hour mark, so if he's running 8 or 9 at 2 hours he'll definitely be low by 3. So it also depends what you're eating.

    Which is a long way of saying, if you're back in normal range in about 4 hours, your I:C ratio is good. If you're getting a high spike before coming back down, you might look at strategies like pre-bolusing to help smooth out that peak. But if you're not coming down to normal at all, then you probably need to change your I:C ratio.

    Make sense?
    Holly

    mom to Aaron, 18, dx'd Sept 05

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