So I'm excited to be getting an Animas Ping pretty soon, but the company providing the insulin pump is requiring 21 days of my blood glucose readings. Since I rarely check mine, should I make them up? I don't want to wait 21 days before sending out this paperwork so I can actually do the readings, I'm moving in January and I want to get started in this pump before that. My last A1C was 9 or 12, so what readings should I be putting?
It's probably the insurance company requiring the readings. BC/BS required at least 2 weeks from me, showing at least 2 lows under 50. I can't tell you that you can make up your readings, but who would know if you did? Before submitting any log, though, I'd check your ins.co. requirements.
Part of the reason they want you to show logs, besides to qualify you for a pump, is to show that you DO in fact log. Once you're on the pump you really have to, at least at first, to figure out your boluses, ratios, etc.
Having 21 days worth of readings are needed for your training. Don't make things up. I recommend six readings per day - before and after each meal. Don't be in a hurry to get on a pump. Discuss this with your doctor. Read as much as you can about the pump and don't turn it on unless your trainer says so. Most likely for the first few days you will be pumping saline solution and not insulin. You can do serious harm to yourself. You MUST BE TRAINED by a professional.
The pump will not be particularly helpful if you don't test. It's not magic - it's just an alternative insulin delivery system. You will need to be able to carb count to give it the numbers to calculate the bolus. And frequent testing will be needed to tune the I:C ratios and the basal rates. And unlike using injections and long-acting insulin, things can go south fast on a pump. If you aren't testing you won't catch it until things are very wrong.
I agree with the general message here: Don't make up your numbers. You need to be patient and do the work they are asking for. Yes, it is a pain, but it is really for your own good. You will most definitely need the numbers to work out basil rates and bolus calculations. When you say your last A1C was 9 or 12 - that worries me. There is a big difference between 9 and 12 (and both are pretty high). BTW, even with the pump you will need to do finger sticks and keep a log - especially in the beginning. Good luck with this! The pump will change your diabetic life significantly.
I agree with what others are saying, the BIG important factor for having an accurate log IS to set your basal's correctly and fine tune your insulin/carb ration, and your correction factor. If you are using just any number that may or may not even be accurate, there is no way to come close to getting your settings right. It can be a slow process, but there is a reason for that, for one the pump is an expensive piece of medical equipment that your insurance company is going to be forking over the majority of the money for, there are reasons they have their requirements because they want to be sure if they are going to pay out for this, that it REALLY IS going to benefit the patient. Otherwise if they aren't going to do the work, let them be non compliant on a cheaper treatment option. Also pumping as others have said is NOT an automatic magic fix, I love mine and have just recently started it, BUT I do think I am even more dilligent and on top of things than ever before and that probably even includes being pregnant. When you are on MDI insulin things can progress in a slower matter, when you are on a pump. and your NOT getting any insulin for an hour or two...or three or four, OR you only wanna test once or twice a day, you are really going to set yourself up for a lot of potential problems. I can certainly understand once you make up your mind the eagerness to want to get started, especially if your controll can really use a lot more fine tuning that you just can't get with MDI, but there really is a reason for the process to take some time and for things like logging to really be important for several reasons. It can be a rough few days. few weeks starting off on the pump, you really want to give yourself the best start possible by having accurate information to go on.
The A1C of 9 says you run around with 210 and the A1C of 12 says you run around 330?? That's a big difference in the A1c already. When you do test, what number do you get? You should not make up your bg's. Do you not test at least once a day? I think you are very fortunate to have a pump being considered for you. As others have already said, testing is necessary with a pump. And pumps today can log your bg for you.
Honestly, if you rarely check your blood sugars, there is NO way the pump is going to work for you. The pump is MORE work than shots, in my opinion. You have to be extremely on top of things; if something goes wrong with the pump and you don't test you may not know it. For example, you might have a kinked cannula....and your insulin isn't getting in. You will be extremely high very fast as this is your basal and bolus insulin......if you don't test you could be in DKA in hours. With shots you don't run quite that risk......if something goes wrong with the injection you usually know it right away.
I wouldn't advice 'cheating' to make up blood sugars. Rather, make checking a habit. In addition, how in the world are you going to create accurate basal patterns and know your ratios if you have no blood sugars to go off of? It just isn't going to work.
Um, I'm just trying to get my head around these statements:
the company providing the insulin pump is requiring 21 days of my blood glucose readings. Since I rarely check mine, should I make them up?
{snip}
My last A1C was 9 or 12,
I'm sorry, but to me, anyone with an A1c that high who rarely tests should be buying funeral insurance.
Accept the delay and do those 21 days of tests.
Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter.
No offense, but if you "rarely check your blood sugar", I hope you are not expecting a pump to make much difference in your A1C. It isn't a magic solution. It takes if anything more diligence than on shots, especially at first. If you don't yet know how to carb count and determine bolus dose, I strongly encourage you to read Using Insulin by John Walsh and wait a bit for your pump.
I agree with the other replies. My endo required that I learn carb counting and showed logs of MDI with BG, carb counts/bolus calculations for several weeks, before providing the Rx for the pump.
If you are really serious about improving your control and A1C, then you must get serious about testing at least 4 times a day, and better if 6-8 to include before/after each meal. Don't know any T1s that can get good A1C without multiple BGs per day.
You could reduce your A1C on shots simply by doing that, and based on the BG, adjusting your choices of food / amount of insulin / timing of injections, etc.
Once you are comfortable with balancing food with insulin, and understanding the relationship, then the pump would be a great addition to fine tune your doses of insulin, and lower your BGs / A1C even further .
As everyone else has said, you need to be testing in order to get your pump settings right. If you are not testing then how do you even know whether a pump will be of any benefit over shots to begin with.
Furthermore, once you are on a pump you NEED to be testing regularly throughout the day or you are putting yourself at serious risk of DKA. Insulin delivery with a pump can get interrupted for various reasons, and it only takes 6-8 hours of interrupted delivery to end up in full-blown DKA. The only way you will know whether the pump is working is to be checking your blood sugars.
I agree with the other replys here.
On a different slant, wondering why it is that you don't test more often ?
Long ago, I was on MDI with NPH and R. I also didn't test often, because I was not trained on what to change based on the results, other than to take more/less insulin for meals. (known as the 'sliding' scale bolus). So I would test before some meals, but always felt it was pretty useless, because my BGs still stayed high.
As often suggested on this site, reading books such as Using Insulin or Pumping Insulin (by John Walsh) and Think Like a Pancreas are great if you haven't yet had training in carb counting and understanding basal and bolus insulin usage.
The pump is a great tool, and I'm excited for you to get one if it enables you to get in better control and improve your BGs / A1C, which in the long term will reduce your risks of complications.
I'd continue to agree w/ the recommendation to start testing. I'd add that while in general the pump seems to be easier to control lows on, the occasions I've made errors and ODed a little bit or cranked up the basal and forgotten to turn it down, it will hit *really* hard, hard enough that I consider it somewhat dangerous if you are just guessing and going "well, that seems like about 5U", you would likely have some risk of more serious hypos.
AC - I agree.. but seems like we were beating up too much about the testing, and if someone told me that back when I didn't test, it would have turned me off.
I think getting educated, one will come to their own conclusion that testing more is the best thing to do. Knowing what your BG number is does nothing, if you don't know what to do with it, whether on MDI or pump. Knowledge is Power !!
So lets offer more encouragement on the motivation to test, and understand what's the barrier. Cost, access ?
I agree there are a lot of reasons why people do the things they do. And I think also a lot of misconception about the wonders of being on an insulin pump. It took me a REALLY long time to want to pump. And I admit for a long time I wanted an easy fix but wasn't commited to doing ALL the work.
I think especially since I've been on mine and having so fewer hypo's...they do still happen but it is not literally a EVERY day thing like it was, I really appreciate how much better control Im having and that really motivates me to make this work. BUT it really does require a commitment to a lot of frequent testing and understanding. I agree knowledge is power, and understanding why it is so important versus just do it, and also understanding the reasons why are essential.
I really think if one is commited going on the pump is a wonderful option and a great tool for maintaining much better control, but I think it does require even more work and understanding than MDI did.
Please know sarasugar that these comments are not meant to harp but out of concern and wanting you to have the best understanding to get the most out of pumping. Its a LOT of work, but the results are very worth it. I'd definatelly recommend reading Using Insuln or Pumping Insulin and Think Like a Pancreas too. Good luck, I know testing can be a drag but this is one thing if you really wish to go on a pump you want to be honest with and accurate with. It will make a huge difference in how successful you can make using a pump.
A discussion started by sarasugar some time back in February may have revealed depression ??? ...please read ...it may make more sense why the question this time ...I am not enough in the know to suggest ??? ...however I do wish you well sarasugar !!!!
. Well, I try to be encouraging much of the time but there's already plenty of encouragement and while I did all sorts of "SWAGGING" w/ shots and even occasionally rely on the CGM, I definitely think that the smoother delivery of pumps can hit you a *lot* harder if you bolus and forget to eat while surfing a correction bolus, etc. I don't see pump companies nor have I heard doctors stressing the "different buzz" of more severe hypos on a pump because, of course, they don't "plan" on hypos anyway? I try to stay as smooth as possible but running into more gnarly hypos seems to me to be a very real possibility of playing around with a pump without testing. I've had 2x different endos (we moved...) since I've been pumping and both recommended setting the BG reminder to test pretty much every two hours or two hours after bolusing.
I totally understand sarasugar's reading for blowing off testing her BG and agree it is bothersome or annoying or whatever else you might want to call it but it is what it is and I thinkt that pumps are more dangerous for swagging than shots, although I didn't shoot 'log or Lantus/ Levimir as I went straight from R/N to a pump? I think I briefly considered just making up some logs or perhaps fictionalizing them because I ***loathe*** logging (more than testing for some reason...) but realized that it would be easier to just use the #s off the meter as I'd overthink the fictional process
Eek!! You "rarely" check your BGs. Assuming you're a type 1, you've gotta be checking your blood sugar to know where you're at and how much insulin to take. No wonder your A1C is so high! Pumps are great, but they are way more work than shots. You have to test and log your numbers and use that data to make adjustments to your pump.
While sometimes the logs of BG readings are a requirement of the insurance company, they are really needed for the trainer and your doc to help establish your basal settings. Also, when you first go on the pump, you have to do even MORE testing than usual while getting your basal rates figured out. When I was tweaking my basal rates, there were times where I tested as much as 20 times per day!