Does not matter what I do

I am type 1 and I have been on the pump for about a year. I have had no training with it, i am all over the place. I have not had a meal bolus in forever. IT dose not matter how much insulin i take i am always adjusting my basle rate all day long. I cannot seem to find a good endo. I was diagnosed with type 1 when i was 19 it was cause by complications to a surgery i had. I have had problems all the way through. I am always in the low 200 no matter what i do. i can not tell when i am low. everything is a mess most of the time i just would like to totally give up. any ideas on what to do. I know the first thing is to find a good endo but i am not having any luck with that. I am testing all the time i can go through 600 stips in a month easy sometimes. I hardly eat and have no carbs. the only time i have ever been in control was when i was pregnant with my daughter which is almost 5 years ago. alot of that i think had to do was i was just diagnosed a year before i had her, I had the worst time with my son he just turned a year in aug. i was in the hospital a couple of times for a week each time and then they finally deiced to put me on the pump but did no training with me at all. When i was first on it it worked great then he was born at 32 weeks almost a month after i got on the pump. Since i had him i can not get my sugars under control and i can not figure anything out. i have not had any luck with my diabetes . I just don’t know what to do. they have classified me as a brittle diabetic and not much can help me and they were not sure the pump would either

i am open to anything

the biggest thing of all is to contact whoever made your pump and ask for a pump representative to meet with you. They will do this. Also get the book “Pumping Insulin” it is the bible of pumpers. What kind of pump are you on?

I am on the medtronic minimed pump paradigm 722 . I will call them on monday I never thought to call them. Thank you very much.

Medtronic will send a trainer to meet you. My doctor wrote my script for the pump and he has had no one but me on it and when I told Medtronic that, they contacted a local rep and she met with me to work with me on the pump.

Thank you i will decently be contacting medtronic monday. I appreciate everything.

I think that Landi and Cody have given you great advice about the book and a rep/trainer, but I have to ask, do you see a diabetes educator? An endo is a great resource, but they often aren’t comfortable going over the ins and outs of diet and basal rates and dosages and ratios - that’s the arena (generally) of a CDE (certified diabetes eductor). If your insurance doesn’t cover education (I go every three months) at your endocrinologist’s office, then see if a local hospital does an annual education clinic (some do) as most insurances should cover at least an annual hospital-based program for type 1 diabetics. I don’t know what I’d do without my educator! They are nurse specialists, nutritionists, technology buffs, and diabetes experts rolled into one.

A basal rate should be set and not messed with all the time. If you’re making adjustments to your basal throughout the day, it might be that you need some training in how insulin works, too. The book Landi suggested can help with that. But insulin has an active time (could be anywhere from 3-6 hours usually) that it takes to bring your sugar down - and that’s with a bolus. Basal rate is too slow and conservative to account for your meals. If you’re adjusting your basals to change your sugar, you’re spreading that insulin out way too slowly, I would think. In general, a basal rate’s effects are felt approximately 1 hour after you’ve received that insulin. If my 6pm blood sugars are high with no food on board, then my 4-5pm basal rate is probably at fault. Anyway, I strongly suggest that book (Iook on Amazon for it), a meeting with a Minimed rep, AND most importantly, with an educator.

i use to have an educator and she told me that their was nothing she could do for me i was to complicated. my mom and i could not believe it. i can not count how many different educators and endos i have seen in the past 6 years. it is crazy. i am always lookout for a new one that can meet my needs. thank you for your advice

Hi Rachel
I am on my second Medtronic Minimed Pump (522), and I have nothing but praise for the training and follow-up care that I got from Minimed, back in 2003… My initial Minimed pump trainer was a type 1 diabetic herself, a cross-country runner, a resident in Pediatrics, as well as a young wife, so she knew how hectic everyday life could be when paired with diabetes management. I also received follow up calls from the Medtronic Minmed CDE/RN . Please talk to Minimed about getting a trainer and see a CDE and as soon as possible, if you can. So much of diabetes self-care does have to be done ON YOUR OWN; BUT ONLYALONG WITH ADEQUATE EDUCATION AND TRAINING. Do not give up hope.


Though a good endo is best, some internists can also be helpful. They have so many diabetic patients, sadly. I couldn’t stand the only two endos in my area, but I’m lucky to have a fabulous internist who keeps current & is very supportive. Just a thought, but if you can’t find a good local endo you might want to interview some internists. Also worth driving out of your area to find a good endo. That’s what I ended up doing.

My endo has changed both my basal & bolus insulin types several times to find what works best for me. Hoping you can locate a good doctor who will do the same for you.

Depending on your health insurance company, some insurance carriers offer free phone diabetes counseling. My BC/BS just started this. They have 800 number with CDEs & nurses available 24/7. Not any replacement for training on your pump, but they’re great on answering specific questions that arise.

So sorry that you’ve had no support or guidance:( Telling you that you’re too complicated is ridiculous!

You seem so overwhelmed, Rachel. I’m sorry to hear you are having a rough time. I think you can get this under control, though, and quickly.

First of all, regarding the basal rates- At some point, you are going to find a rate that pushes your blood sugar into the normal range and keeps it there for a few hours. Most people need different basal rates at different times of the day. I have several different basal rates programmed into my pump for this purpose. The way that I did it was to break up the day into 4 hour segments and figure out what I needed for a typical day in that 4 hour window if I was not going to eat. It took about two weeks for me to get some good basals going. Maybe you need to work on smaller blocks of time, or maybe you can get by with 6 hour segments.

Truth be told, I am always making small adjustments to my basal rates every few months, sometimes more often. If you need assistance with your pump, contact Minimed. They will help you! When I got my 722, they sent someone to my house and she spent hours showing me how to use the different features.

Consider using Symlin. It will get your post-prandials under control and give you some room to figure out what different foods do to your blood glucose. Also, the continuous glucose monitor that interfaces with your 722 would be extraordinarily useful to someone in the “brittle diabetes” category.

Do you exercise? If not, consider getting into a routine 3-5 days a week as it will work to push your blood glucose levels downward even when you are not working out.

Good luck and don’t be so discouraged. You can do this.

I would check yourself into the Joslin. Not sure where you are but they will help you get on track.