Anyone use long acting insulin for basal while on pump?

I have a Ping pump, which I used successfully until I gained about 40 pounds on it. I have had this problem with all insulin except Levemir. With the weight gain I am suddenly insulin resistant as well. I had to switch to MDI because otherwise I had to change out the cartridge every day (!!)

Has anyone used Levemir for basal in conjunction with the pump? I just can’t stay in range with MDI. Especially because I have big time issues with dawn phenomenon.

drmom777

Have you considered trying metformin to help with insulin resistance? I gained a lot of weight using the PING and it made me insulin resistant. Metformin helped with hunger issues I had and made me more sensitive to the insulin. I successfully lost 15 pounds using it and still take a small dose. I am also using Victoza - after being on Symlin for a while. (off-label for metformin and Victoza.) The Victoza has helped me a lot too - so I was able to cut back.

My Endo has said that her patients have overall been able to cut back on their insulin 60-75% using the Victoza. Symlin worked for me but it was a lot of work. A shot before every meal.... where as the Victoza is just one shot a day. I go to Dartmouth-Hitchcock in NH - so the med school is always trying the type 2 drugs on type ones.

I also had my thyroid checked and I was hypothyroid - which can also contribute to insulin resistance. I have lost over 40 pounds - some wiht metformin, some with Victoza, some with exercise. Also getting my thyroid levels in check has helped me keep the weight off.

Unfortunately this does not directly answer your question, but might b something to consider or ask your Doc about.

I recall reading of someone who did something similar. They would use the pump (Novolog/Humalog/Apidra in it, not Levemir though) for their basal and then do shots (Novolog/Humalog/Apidra) to bolus for carbs and corrections. I will keep trying to recall who it was.

I use Symlin to help with post meal spikes, which helps to keep the amount of insulin use down. I've heard the same thing of Metformin and Victoza that Susan mentions.

Indeed, I have very happily combined long-lasting insulin with a pump for what I think is the best of both worlds! Its not common, and it gives a lot of people pause when you try to explain it, but I thought it worked out very nicely! I suppose there are a couple different ways to go about it, but I opted for about 75% of my basal as a once-a-day injection via Lantus, and that still left room for adjusting basal rates during the day a little higher and lower as needed, and then I used the pump for all of my bolus needs. Check out Steve Edelmen's "un-tethered" approach for basic details on how and why this can be a pretty slick way to go!

Also though, I second the use of metformin and symlin/victoza for lowering insulin needs in general, which in theory at least helps with weight in addition to BG management. Both are technically off-label uses, but both also helped me in different ways. I used metformin ER (which is a once a day pill, instead of the regular metformin which is a twice a day pill) for about a year pretty happily, but then it started causing heartburn and I switched to Symlin, which also isn't perfect but once I figured out my response to it its become almost as useful as Humalog in lowering my BG. I haven't tried Victoza yet, but its on the slate for this summer pending insurance coverage.

I've gained about 40 pounds since getting my BG "under control" with a pump, and while I haven't had any fast success, I've managed to whittle off a few pounds here and there presumably because of the decreased insulin usage from adding different meds in the mix. I also recently saw a new endo who suggested an annual thyroid check, as well as vit D screening in addition to the regular comprehensive annual lab work because its important to make sure the "other" systems are fully operational too, because those all play a role to some degree and can affect weight, insulin resistance, etc.