Look who’s pumping.
Hi Everyone,
So we’re a week on the pump, and I have to say, it stinks!!!!! Ok, I’m
sure it will get better. Her rates are still being adjusted and the
nurse manager from Animas assures me, “these highs are normal”. In one
week her average BG has gone from 130 to almost 200. My child is very
happy and that’s all that matters. “No more shots!!!” she tells
everyone, and she likes her pretty pump pack.
I have a picture of the proud pumper with her pretty purple pump pack,
but have no idea how to attach it in one of these things, so just
imagine a very happy 6 year old, beaming from ear to ear.
Hope all of you are happy and well.
Stephanie
March 3rd, 2007 at 2:36 pm
I was constantly on the low side before starting the pump. Switching from NPH to Lantus helped quite a bit but I still had plenty of lows, and more highs than on NPH. The lows on Lantus were much easier to treat. My last EMT-assisted low on NPH was in February. I knew I was low and didn’t test. Instead, I drank a juice box I had in my office. A short time later I drank another one, and a third. I might have eaten some candy as well. I *still* passed out after all of that. With Lantus, one juice box (15g carbs) was enough to bring me up.
The insulin pump takes a lot of work and knowledge of carbohydrates, blood glucose, insulin, exercise, etc. and their interaction with one another. It is a constant balancing act to get it to work properly. The variables involved here are always fluctuating and you have to pay attention to every detail. Carbohydrates are sometimes difficult to figure out also. The glycemic index of some foods can really throw your blood glucose levels out of whack if you are not careful. Thirty grams of carbohydrates in the form of bread or fruit or potatoes or chocolate cake can have a significant effect on the timing of when your blood glucose will rise. A square wave or extended bolus as opposed to a regular bolus would come into play depending on the type of carbohydrates you are eating.
I’ve done some experimenting with the dual wave bolus. I know a lot of people swear by the glycemic index, but some people (like me) find that supposedly low glycemic foods raise their BG just as quickly as high foods. Same thing with the -ol sweeteners, like sorbitol. I’ve used sugarfree ice cream (sweetened with sorbitol) to raise my BG. I do know that anything with a lot of fat does slow down the carbs, but I’ve been staying away from fats as much as possible.
If your blood glucose levels are high within two hours after eating a meal, then you should be looking at adjusting your insulin to carbohydrate ratio for your meal bolus. If your blood glucose levels are high later than the two hours after your last meal and before your next meal, then you should be adjusting your basal rates. Always remember to make small adjustments one at a time over a period of a couple of days just to see the impact of your adjustments. Also don’t forget to take into account exercise, stress, illness, insulin age, body temperature, puberty, menstrual cycles, etc. as these will also affect your blood glucose levels.
My BG tends to be good 2 hours after eating, so the insulin:carb ratio seems to be set correctly. By hour 3, it’s going back up and by hour 4 it’s even higher. I’ve been raising basal rates by .05-.1 I’ve set my IOB to 3 hours, because by hour 3 I was ignoring any IOB the pump showed me anyway. I’m still adjusting and it’s taking awhile, because I am doing only one change at a time and giving each several days to see if it works.
Always remember that your doctor and nurse and diabetes educator are trying to help you with their knowledge and experience. But it is up to you to make the final decisions as to your own care or the care of your child. If you are unhappy with the high blood glucose levels, then do some detective work. Narrow down the clues to find your answer. Make your decisions based on solid facts.
Good luck and happy pumping.
Steve
I know they are, but in my case I’m the one testing 10 times a day, and seeing that their plan doesn’t work for me. When I complain to the nurse she acts as if I’m going to drive myself into hypoland if I change anything. She kept saying my numbers were fine, when I’d be at 230 several hours after lunch or dinner; or waking up over 200. She told me not to correct for anything under 160, but if I’m at 160 3 hours after lunch, you can be sure I’ll be at 200+ at four hours.
I go back near the end of August, and I’m hoping I’ll have most of my numbers worked out by then. I’m really trying to avoid any lows, because as soon as she sees a low she focuses on that even if days had passed without one.
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Liz
Type I dx 4/1987
MiniMed Paradigm 715 5/16/05
March 4th, 2007 at 7:38 pm
Hm….
My doc and nurse instructor turned me loose to adjust as I see fit. I don’t know if that is good or bad, but my last A1C was a 7.9. I know most of you in here will cringe at that, but, in the past, my A1C has been over 10.1. So. 7.9 is a vast improvement.
As far as the square wave goes, I love it when I remember to use it. Sometimes I bolus the whole thing, then realize I should have square waved. Too late then!
When I exercise, or just before, I just suspend the pump. My insulin requirements drop to 0 when I exercise intensely. Kick boxing has helped tremendously. I just have to find a way to stop bruising my knuckles! : )
have a great night!
Joan