The swings and arrows of outrageous pumping

By | 10 November, 2010
A pump, the day before yesterday

Well, it’s been just over a week on the pump and how are things going?

To begin with I got off to a flying start with some outrageously good results for the first three or four days. However, this turned out to be beginner’s luck and since then my levels have been far too high. Not dangerously high but certainly outwith the parameters I’m happy with. Not that I’m anal or anything.

So I’m going through the usual pump start processes of testing, logging, testing, logging and reviewing data to see where things are going wrong. I’ve tried to do this systematically and only change one thing at a time so I can more accurately measure the effects of the change. Today, for example, I have decided to look at my morning basal rates and so have not eaten anything since last night. As I write this I have to confess I’m rather peckish, but I think I can safely live off my hump for the next few hours.

My results this morning have been highish – hovering around the 12’s – but, more pleasingly, they have remained consistently around 12, varying up or down 1 mmol/l or so. Given meter readings are generally as perfectly accurate as US troops rescuing British hostages; I’m taking this as nicely consistent. All I need to do now is start at a lower level in the first place. This is my theory and if I’m completely wrong then do comment below.

Aside from the banalities of blood glucose levels, I’ve been enjoying the pump (if one can ever said to “enjoy” a piece of medical equipment). Stuffing in insulin for meals is far easier & unobtrusive than injections and being attached to something all day and all night is – surprisingly – considerably less of a problem than I thought it would be. Insulin delivery also seems to be a lot more consistent. If you put in x units of insulin and you expect your BG to be at y in a few hours time, then it usually is. In retrospect Lantus, to name names, seems to have been almost entirely random in the way it squirted out its long-acting goodness.

So I continue to test and log and get suitably annoyed and frustrated when things don’t work as I expect them to. But with the help of my DSN and the book “Pumping Insulin” (which I’ve taken to reading on the bus to work) we seem to be slowly but surely getting there. Huzzah!

p.s. –  readers who have no interest in pumps while be pleased to hear that before long I will write some more general articles and will stop banging on about the damned thing.

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About Tim

Diagnosed with Type One when he was 28, Tim founded Shoot Up in 2009. For the diabetes geeks, he wears a Medtronic 640G insulin pump filled with Humalog and uses Abbott's Libre flash glucose monitor.

11 thoughts on “The swings and arrows of outrageous pumping

  1. Annette A

    That first few days may just have been the lantus taking its time getting totally out of your system – my DSN told me when I started not to try and test basal for changes for at least 3 days, to ensure I was only running on the pump insulin.

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  2. Tim Post author

    I strongly suspect it was the lantus too. While on MDI it always took about three days (certainly two) for changes to lantus doses to take effect; so I think it hangs about for quite a while.

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  3. Helen

    Hi Tim …..sounds like you have also been on a big Journey – I am not liking quicksets at the moment – silhouette suiting me much better amazingly – seen a big difference in my bs last 2 days since I have been sampling a silhouette (coincidence?!)
    Hope your bs starts to come down soon – mines was like yours up until Monday – but no full guarantees that Im on the right path yet!
    (how are you getting on Ross?)
    Helz xx

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  4. Gillian

    I have finally got some information on the insulin pump and even got to touch one! I’ve decided against going for one at the minute but have had a new burst of energy where I am getting my finger out and tightening my control on my bm’s again. I went through a wee phase there where I had fallen away from my habitual testing but since visiting the dietician at Stirling I have been injected with a new lease of life.
    My main concern about wearing a pump was – where do I put it when I’m out dancing my weekends (yes and weekdays) away?! Apparently the answer is simple…in my bra. Is this where you keep yours when you’re dancing Tim?

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  5. Tim Post author

    @gillian – yes, yes I do. I was told that when I got a pump that I would have to start wearing bra so I could store said pump in it. At first I was a little put out by this but I’ve since got used to it. I’m now thinking about keeping it in my over-knee shiny PVC boots.

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  6. Barry M

    Tim et Al – I know I’m a bit late on this forum but give me a break I’ve only been a member a few days.

    Pumps and Beware the Liver!

    Sorry if that sounds odd and I have to admit I know NOTHING about pumps. I still use syringes and bovine insulin! I can hear you saying who’s this prehistoric idiot and what’s the liver got to do with pumps? Bear with me a few lines and I’ll try to explain.

    Trying to balance three variables; carbs, insulin and exercise can be a nightmare. So I use a standard insulin dose which means I only have two to balance. But I found a problem, if I’m working hard I can keep my bs right by eating a lot. If I then spend several days doing not much I find my bs stays low and I still have to eat a good deal more than ‘normal’.

    I’ll just be getting used to it when WHAM! bs shoots up and I virtually have to starve myself to get back on the level.

    This happened time and time again – problem of working hard weekends and sitting in an office in the week.

    Gradually the light dawned. When I’m working hard and pushing my system, even when I’m eating ‘enough’ somehow my system finds some of the energy I need from somewhere. As soon as I slow down, that somewhere steals carbs from the food I’m eating and leaves my normal balance short. Guess what, as soon as that somewhere has replenished itself it stops stealing carbs (almost instantaneously) and WHAM my bs shoots up because I can’t predict when it’ll stop. (And yes, reducing insulin dose when I’m working helps a bit but doesn’t prevent it.)

    After years of enquiry discussion and disagreement with just about every specialist I asked, I concluded that the liver as a major energy store is the culprit. It’s desperately trying to help out but doesn’t realise the pancreas isn’t in control of bs any more and it takes almost NO notice of what my insulin dose is.

    So beware, even if you’re taking account of the fact that you’re working hard ‘today’ and your pump/calculator etc., is keeping your bs at e.g. 6, don’t ignore your liver’s intent to help out ‘today’ and to be full of reserve as soon as possible afterward.

    There follows a disclaimer! – I have no medical training (except for being diabetic for 50 years). The above is a simplified version of the actual variations I experience. The culprit may not be my liver and the effect will vary from person to person. BUT I achieve much better bs control if I take account of the above logic.

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  7. Annette A

    @bazza49 – I agree, this seems to fit my patterns also. I’m quite active – I work out at the gym, I cycle, etc. So I am almost always either feeding or stealing from my liver, so it’s on a pretty even keel most of the time. But if I stop for more than about 4 days, and dont do anything, my bgs will shoot up out of sync with everything else, and I have to increase my basals (similar to your starving yourself) to match.

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  8. Barry M

    Thanks Annette,

    Your note is wellcome. I’m confident enough with my ‘diagnosis’ to go into print with the hope that it helps explain some of swings we have to deal with. But I’ve had little if any corroboration from others, just raised eyebrows from ‘specialists’. Has anyone else out there had similar experience?

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  9. Barry M

    Thanks Teloz

    You saying I’m OLD and have loads of experience??? – You might be right of course 🙂 . A guy I worked with years ago used to say experience is what you get when you don’t get what you want. I’ve had lots of that!

    Reply

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