That’s a good point, Jack. I started using the untethered technique for several months in 2016 before I started using Loop. I then used it for a few weeks with Loop but dropped it because I was changing too much at one time and I wanted to concentrate on learning Loop.
I remember taking a beach vacation during that time and disconnecting my pump for extended period for swimming and hot-tubbing was nice. I have some expired Tresiba on hand so I could give it a go. I’ll think about it. The biggest drawback (really a small thing) is remembering to take that long-acting dose every day. In fact, I now remember that Tresiba dose timing is forgiving.
I’d probably get a new vial, ring your doctor for a sample or script. Once you establish a stable program, then try the out of date insulin. Properly stored, it may be ok.
The other thing would be not to change cartridges at night, so you will see if there are problems.
That’s another thing that I always tried to avoid but relaxed my practice with so many successful cartridge changes. Your point is valid, however, since it only takes one bad one to threaten your well-being. And the daytime is a much safer time to detect and correct problems.
Trying to make full use of the cartridge insulin is a false economy.
Hi @Terry4, I don’t know if you have tried them and didn’t like them, but steel sets are another choice many people make for safety reasons. Steel sets can’t get kinked the same way plastic sets can. Their only downside is that they are supposed to be changed every 24-48 hours (instead of every 72 hours), and some people find them painful. I switched from plastic to steel sets back in 2011 when I started reacting to the plastic sets. I’ve tried plastic sets on occasion since then, and I don’t think I’ll ever go back to them permanently. I love the reliability of the steel sets, even though on rare occasions, I do still experience a site not working (I think due to immune reaction in my case, this isn’t something most people ever get).
@Jen – I’ve tried steel sets but have found them uncomfortable. Sometimes the pain was triggered by compressing the site as happens when rolling onto it in bed. Other times, the site starts out pain-free and then becomes tender after 24 hours or so. This scenario plays out a high percentage of the time for me.
I appreciate the fact that a steel set will never kink. I only mentioned kinking in the original post since I do see that but it is rare for me. If I have unexplained trending higher BGs I have found that a kinked cannula is sometimes the cause. But that only happens a few times per year and I’ve never suffered a complete loss of insulin delivery.
Thanks so much for sharing your experience. I don’t have a ketone kit in the house and this is a good reminder I should get one - haven’t tested for them in decades! Glad you’re ok and a good reminder of how quickly things can change…
Thank you for sharing your story. So scary! I’m glad you are okay. I am going to take it as a lesson to be more prepared. I’ve had T1 for almost 40 years and I rarely check for ketones. Right now I have a cold and I’m preparing to go on a three week vacation. I’m getting ketone sticks and testing before I go! Also, I am a pumper and wonder if MDI holds less chance of DKA than pumping as one doesn’t have to worry about kinks or delivery problems with MDI.
@Terry4, I was diagnosed in 1945, and I doubt there was any way of measuring DKA back then. No doctor ever mentioned DKA. I learned about DKA in 2006 when I first joined an online diabetes support group. I never bought a meter for measuring DKA, but maybe I should.
The only time I have a BG number over 200 is when I am experiencing scar tissue problems. I have a lot of scar tissue after 74 years of T1D. Do you think you may have experienced scar tissue?
I am 80 years old now, and I occasionally forget to bolus for a meal. When I get the CGM alarm, I am 170 or higher. Easy correction.
I am concerned that my forgetfulness may be much worse as I grow older.
I’m glad that you know exactly what to do with the kind of problem you were experiencing. I feel you have many many years of good health and good diabetes control ahead.
Thanks for your comments, Richard. I don’t think it was scar tissue that caused my high glucose. I had started that pump site about 24 hours before and it performed well until until about 8 hours before I pulled it. I do occasionally experience an infusion site that produces slowly drifting highs on the third day of that site – that is a site absorption problem. But that only happens a few times per year. I was lucky enough to have on hand some Fiasp to do an intramuscular injection and stop the progression to DKA!
You’re doing well that you only occasionally forget to bolus. I’m a few years younger than you and I left my apartment twice last week without my keys! Yesterday, I put a post-it note on my door, at eye level, with the reminder “Keys?” printed on it. Perhaps you could think of some kind of built-in reminder that could prompt your memory. Just a thought.
When I was on shots I used to have a large piece of paper on the door at eye level right where the door opened that said take Lantus! I would be in a rush to get out the door and forget sometimes, it saved me several times. After a few years though I got kind of good about ignoring the note but at least in my case by then it was more of a habit to take it than at the beginning.
In my dogs case she is on shots twice a day and while we give it mostly with her meals (sometimes a slight delay if she is lower) it was another thing we wanted to make sure we remembered especially since either one of us could be doing the routine and it needs to be at the relatively same time.
So we bought a cheap clock with 2 alarm settings, one is set for 9am and the other 9pm so we don’t forget her shot. If she actually hasn’t gotten it yet we put it on sleeper and don’t turn it off for the day/night until she has had her shot. We are in a routine with her now so it isn’t as important, but it still helps us to remember it’s also mealtime for her so we keep to her schedule…
Terry, my built-in reminder is my wife, but she is 75 and also forgetful. She used to be so good at reminding me to bolus. Maybe a note lying on my computer keyboard, and another on my car seat will help. Thanks!
Thank you for sharing your experience. You don’t know how much reading your comments and suggestions have helped me with during the last 6 years since I was diagnosed. Please keeping commenting.
I’m quite a bit younger than you, but have had some similar struggles. my issue is not age-related as much as absent-mindedness. The pens that tell me when I took my last shot were very helpful for that. I’ve also put reminders in my phone to remember my basal shot. Those usually seem to work. It’s been months since I woke up and realized I had forgotten to take my basal the night before.
Hi Bryan, I am glad you are not very forgetful like me. I am ok with my routine. Being retired and not much distraction helps me now. retirement is restful, but somewhat boring. lol
Hello Senator, I wanted to travel and talk to groups about T1D in the first decade of this century, but I began developing complications with my diabetes . I was still able to travel until 2015, but I did not know how to find speaking engagements. I was a speaker locally in Kingston, NY, to an audience of about 20 people, and I spoke to a larger audience at the Friends For Life T1 conference in Orlando in 2015. After that I have been having neuropathy in my feet and legs. I have poor balance that makes standing and walking difficult at times. It would be very uncomfortable for me to be a speaker now. Taking a flight to distant locations would also be difficult.
It’s been a week now since my brush with DKA. Your comment prompted me to start another experiment with the untethered regimen. I decided to take a chance on my expired Tresiba supply and it appears to be fully potent.
I’m aiming to replace about 50-75% of my basal needs with the Tresiba dose. I’m now four days into this new regimen and the results have been good. Mild hypoglycemia at times has led me to making adjustments to basal rates and insulin sensitivity factors in my Loop program. It’s important to allow Loop enough basal swing to permit it to counteract trends away from the target BG.
I think this will work well once I get it established. Yesterday, I enjoyed 100% time in range but this morning I woke up with some mild hypos. I’m taking the Tresiba once per day at 8:00 p.m. and have set a recurring daily alarm on my phone to remind me to dose. I’m entering the dose size and time on my calendar to help with later analysis.
