- advertisement -

So The Pump Died, need Advice on Switching to Lantus for a Day or Two

Discussion in 'Parents of Children with Type 1' started by sszyszkiewicz, May 25, 2016.

  1. sszyszkiewicz

    sszyszkiewicz Approved members

    Joined:
    Dec 24, 2013
    Messages:
    842
    So our pump died last night. One will be here tomorrow morning, but we have to switch back to lantus for a day or two.

    His basal profile was about 29.35 units. Do i just give 29 units of lantus this morning? A little more? a little less?

    thank you in advance.
     
  2. rgcainmd

    rgcainmd Approved members

    Joined:
    Feb 6, 2014
    Messages:
    1,371
    I'd err on the side of less. You can always correct more often with rapid-acting insulin.

    ETA: I'm not offering medical advice (because only your son's endo should do this), but if it were my daughter, I'd give her no more than 25 units... Remember, once you inject basal insulin, you can't take it back; no option of a lowered temporary basal.
     
  3. MEVsmom

    MEVsmom Approved members

    Joined:
    Aug 2, 2013
    Messages:
    255
    Our endo suggested taking 75% of the Total daily dose of basal when we took a short pump break.
     
  4. Mimikins

    Mimikins Approved members

    Joined:
    Jun 22, 2014
    Messages:
    203
    Can you contact the endo and see what they recommend?

    Personally, I would err on the side of caution and use less Lantus (some basal insulin is better than none). I can always give a rapid-acting correction as needed to help fill in some of the missed basal, while taking too much Lantus can cause up to 24 hours of pure hell.
     
  5. BrendaK

    BrendaK Neonatal Diabetes Registry

    Joined:
    Oct 29, 2005
    Messages:
    3,835
    From personal experience and per endo recommendation both my son and I have needed about 30% more lantus than pump basal insulin. Definitely check with the endo.
     
  6. sszyszkiewicz

    sszyszkiewicz Approved members

    Joined:
    Dec 24, 2013
    Messages:
    842
    So I wanted to circle back and let everyone know how this eventually played out. We went with a lantus dose=basal profile from the previous day. We were on Lantus for two days. The pumped arrived 10Am the morning following the post. Both of those days we were correcting highs all day and one night (the first night). It was a struggle to keep him less than 200. The pump went back on the afternoon of day #2 with a 0% temp basal until 7AM on Day 3 (when lantus would have expired). The fun began soon AFTER that. We were battling lows (<60) for the next like 15-20 hours. It seemed like the lantus had a bit of a memory/took more than a day to finally stop working. We went back to 0 basal for like 6 hours with what seemed like tons of uncovered carbs and he was steady between 60 and 70 most of that time. The next night even with a 30% basal, he was still fighting lows, then BOOM he skyrocketed.

    Then we finally settled back into the day to day. I am so thankful for the Dexcom. Both for the highs and for the lows. Neither last very long (relatively speaking) when you see it happening.

    One thing that surfaced during this was my son was feeling down because of the high numbers for the first couple of days. I had not seen that before. I talked to him and said that high numbers mean exactly one, and only one, thing.

    More insulin.

    Thats it.

    He smiled and said "thanks" and went on with his day.

    So that was our deviation.
     
  7. msschiel

    msschiel Approved members

    Joined:
    Oct 21, 2013
    Messages:
    227
    Glad things worked out okay. I was worried we would have to go back to shots for a few days due to lack of insets, but we found a few and animas replaced 2 that had gone bad recently. Now I will be asking for more on the prescription so we can have a few extra. I am not sure how people stock pile things! We are always lucky to have just enough sets and insulin. We are good on cartridges.

    Since being on the pump, my son realizes how crappy he feels when he is high. Dexcom has been a huge help, especially since this is our first summer on the pump and he has had quite a few lows, especially over night.
     
  8. sarahspins

    sarahspins Approved members

    Joined:
    May 5, 2009
    Messages:
    2,205
    I've had more than one CDE basically tell me that there's still "some" of it working in your system for up to 72 hours after injecting... even if the bulk of it seems to be "done" much sooner (which for many of us, is well under 24 hours). My experience flip-flopping between 100% pump and untethered/POLI strongly supports this. I always knock my basals back by about 30% for a couple of days when I am transitioning back to full pumping.. when I start chasing highs I crank it back up to "full strength" :)

    Unlike Brenda though, I actually seem to need significantly less Lantus than I need as basal in my pump (and I actually need much less insulin on MDI as well, all of my ratios and correction factors are different), but obviously that is a YMMV thing too.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice