Three weeks of pumping

By | 24 November, 2010

So here we are, three weeks after being cybernetically transmogrified into one of the Borg / Cybermen / Culture (delete as applicable depending on your personal science fiction preferences), how have I found my initial weeks of pumping?

In general, not bad at all. To begin with a pump is certainly a very steep learning curve. As I mentioned in an earlier article, we set all my usual basal rates, carb ratios and so on back to bog-standard default levels and have worked them out again from scratch to allow for the greater flexibility that a pump affords. I also think on MDI I had too much favouritism towards a high background level of Lantus and relatively low boluses, so I’ve used this as an opportunity to get the basal / bolus ratio closer to 50 / 50.

The primary consequence of this is that instead of automatically putting in, say, 8 units for a plate of whatever I now put in, say, 11 units. After years of guestimating my insulin amounts this takes quite a lot of re-training to get used to the new amounts. However, this transition has been helped a great deal through the wonderful bolus wizard.

I’ve been using the Bayer Contour blood glucose meter which beams its results to the pump by radio frequency (cool, I know!), I then dial up the amount of carbs I’m stuffing down my neck and said wizard works out how much insulin I should put in. I can, of course, disagree with it and change the amount, but usually I just do what the computer tells me to (that’ll be that Borg / Cyberman / Culture thing kicking in). When I accurately carb count this has resulted in bang-on accurate levels two or three hours after eating. Top stuff!

Of course, the pump itself is just an expensive paperweight unless it’s fancy bolus wizard and flexible basal levels are tailored exactly to me and this is what I’ve been doing for the last three weeks. I’ve been doing the usual logging, testing, logging, testing, logging, testing and looking at results.

At the beginning I was testing about 15 times throughout the day and night (this, dear readers, is an astonishing amount of fun – try it!) but I’m now doing a good 6 or 7 tests a day. I’ve been using the results to gradually adjust my basal levels, bolus ratios and so on Β pretty much every day and then looking at the resulting results.

After about three weeks this is starting to get some nicely consistent levels throughout the day; but it’s still not perfect – I’m going high first thing (waking up at about 9.0) and low in the late afternoon (dropping down to about 4.0). This doesn’t sound too bad but the pump allows me to further fine tune its settings to ultimately (I hope) get it pretty much perfect.

In terms of other, more general stuff, the pump has been great. It’s not a problem being connected to something all the time. After a week I hardly noticed it during the day and after a couple of weeks I don’t notice it during the night. Set changes are easy after a bit of practice and I can almost do them blindfold (now, there’s a party piece!)

I love the fact bolusing is so convenient. I now bother to stuff in half a unit for that small biscuit I shovel down my gaping maw, whereas before I wouldn’t have bothered. In restaurants I’ve also found it easier to discreetly fiddle around with the pump rather than get out the pens and inject. Equally, I can shove half my estimated bolus in before food arrives so it starts working and the remaining half when food arrives. Previously on MDI I wouldn’t have bothered with two injections.

So there we have it. Pumps certainly are hard work and can be frustrating to set up, but even though I still haven’t got it configured perfectly I think I will and life will be that wee bit easier as a result. So double thumbs up for pumps!

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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 “Three weeks of pumping

  1. Stephen

    Good article, thanks for the update. My burning question is though, have you had a night out on the Scottish water as yet with the pump in tow?

    My Xmas do is in three weeks (putting me just about where you are now) and this is where I think it’s going to get interesting due to my particular love of the Russian water derivatives πŸ™‚

    Oh and have you managed to snag it on anything yet (like door handles, appendages. etc?)

    Oh and one more, do you find the active insulin actually means bugger all to your calculations? I can still have the pump say I’ve got 5u active say 5 hours after bolusing (yes I do have to have some large shots still) yet if I factor it in my BG goes through the roof again.

  2. Tim Post author

    I stress tested the pump a week ago by staying up drinking with my brothers until 4.30am. This was purely for scientific reasons. It was absolutely fine – I just tested as always and remembered the effects booze has on my BG, which is of course the same as it was on injections.

    I managed to snag it once on the kitchen door handle – which brought me to an abrupt halt but didn’t hurt or damage the set.

    I’ve reduced the active insulin time down to four hours from the default six hours as I found it wasn’t doing much after about four hours. It’s certainly worth tweaking to see how it might work for you.

  3. Stephen

    Now there’s a setting I didn’t know existed cheers! (It took me a few days to find the Max Bolus setting too lol)

  4. Angie

    “three weeks after being cybernetically transmogrified into one of the Borg / Cybermen / Culture (delete as applicable depending on your personal science fiction preferences)”

    Now you have me actually sitting here pondering which of these I prefer…I’ve always gone with the Borg thing, but I’m thinking actually Culture might be a little bit less…intimidating? πŸ˜‰

    There were so many little things about the pump that I didn’t even think about before I started that are so useful – especially things like being able to do a pre-bolus before a meal to try and combat spikes. I think it’s these little things that end up making a big difference to your overall control on the pump!

  5. Tim Post author

    I think if if we were in the Culture, we’d just grow a new pancreas or gland some insulin, or something. A pump would be a little old-tech for them.

    Couldn’t agree more about the little things – bolusing for small amounts where you wouldn’t normally bother must make a huge difference over a period of time.

  6. aileen

    Great to hear how it’s going Tim : ) Marc changed his duration to 4 hrs pretty quickly too. It’s the fine tuning and the ability to take insulin whenever that makes all the difference I think. There will be a huge difference over time and you’ll have a longer, healthier life as a result… so pleased things are going well!

  7. Alison

    Hurrah, your assimilation into the Borg sounds like it is nearly complete. You just need to accidentally rip out an infusion set whilst miles away from home to become a fully fledged member (please tell me you have a spare syringe in your manbag incase of such calamity).

    This is all very nice, but now you’re raving about the joys of being able to bolus for half a biscuit and adjust your basals throughout the night that leaves me with nothing to write about!

    I have my active insulin set to 3 hours, but you do need to fiddle with it to find out how long it likes to linger in your system.

  8. Tim Post author

    @alison – I know junk-carrying is an anathema to you, but I actually have both a syringe and a spare infusion set in my man bag!

  9. Annette A

    I just declared myself Bionic, and left it at that.
    I also carry both infusion set and syringe in my bag – and am glad I did, cos the last time I changed my set, it didnt take, but by the time I realised, I was at work, and its a long journey home to get one – but I had one in my everyready emergency kit, so I just nipped off, changed it (and on taking the duff one out, spurted blood everywhere – obviously why it didnt take!) – so am pleased to be a fully paid up member of the girly swot team!
    My active insulin is on 3.5 hours – its another one of those YDMV things, isnt it?


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