Fast switch from pump and CGM to long acting insulin

Well this is new… I’ve been diabetic for 53 years and on a pump for over 30. All has been well. My medtronic 780g with CGM has been marvelous. Life changing. I have been doing well. Today the pump went into such an error that it shut down and I need a replacement. I’m on vacation with no backup and feel like a fish out of water.
I got an injection of long acting Baslagar. I’m higher than I want to be at 255 but afraid to go too low with no CGM. My normal insulin is Fiasp which is fast acting.
Advice?
I feel very very vulnerable.

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Diabetes technology is incredible until it isn’t.

Are you in the US? Will Medtronic send a replacement overnight?

Does your endocrinologist (or someone else in their office) have any suggestions or useful contacts?

Is there a way to connect your CGM directly to your phone, the phone of someone you’re traveling with, or to a dedicated receiver?

Can you get a different CGM from a local pharmacy? Is there a local endocrinologist who might have a sample CGM that they would part with?

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You’re in a tough situation, especially being on vacation! You’re forced to switch from a pump to MDI and you’ve lost your CGM. You say that you got a shot of Basalgar (long-acting). Did you just get one shot or do you have a continuing supply? A vial or a pen?

I assume you have a supply of your short-acting Fiasp. You can simulate a long acting insulin with a short acting like Fiasp but that means taking small doses every few hours.

If it were me, I would cut back on almost all eating. I know when I had to fast for medical tests, my blood sugar was well-behaved. You’ll need to do a lot more finger stick tests to protect from low blood sugar levels and not let the high blood glucose persist for too long.

I would suggest writing everything down (insulin doses, times, and BGs) to help with your management.

You can do this. Think it through, keep good records, and moderate (or even eliminate) the next few meals. I hope Med-T comes through with a replacement pump soon. Good luck.

Please update when you can.

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Several years ago I was using Medtronic 523 that failed when on vacation. They overnighted me a backup, but it was a 723. So they don’t always get exact model. But once I was back home they swapped it back to 523.

I have Tandem now, a few days out of warranty, with a new one on the way once Medicare approves it.

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My Walgreens usually carries my Freestyle Libre 3, or can get them the next day.
Can you have your doctor send a prescription to the pharmacy for this CGM, and also for Fiasp or another fast-acting insulin or pen (might want to check with pharmacy first to see what they have in stock or can order fast).

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Terry I knew you’d be the calming voice. Thank you. Yes I have Fiasp to bolus. I am getting the replacement pump today but can’t connect until the long acting insulin is at the 24 hour end. My blood sugars went up to high 200s overnight so I bolused this am and will watch it.
I only had a salad with Turkey and cheese at night because I was afraid of a low with no alert. I kept my sensor on me but I don’t think it connects to my phone without a pump. This was scary after being so trustful and dependent on technology. I really even forgot how to carb count without the pump automatically calculating it! I think I learned from this. Always have backup wherever I am! No matter how long I will be there.

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+1 :wink:

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I offer this not knowing anything about the Guardian 4 CGM but you should be able to find out if you can use the Medtronic’s CGM app here:

I called Medtronic and I cannot connect my CGM to Carelink without the pump. On its own I can’t use. Still learning old school today. Medtronic can’t ship til Fri. So I’m bolusing with Fiasp and injecting the long acting every 24 hours. Sugars in high 200s. And I’m eating almost nothing. Had a low sugar 6 carb yogurt so far. And coffee with cream. And it’s 3:30 pm here. Waaaaaa😫

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sorry to hear about your issue, however, around 2015 or so, (i didn’t receive a dexcom g4 until 2016)i started testing on my forearm, with the Dr’s warning its fine for fasting, but will be a little delayed…so if im trying to mimic a cgm directional arrow, ill test on my arm and finger to see where my glucose is headed…hopefully you still have a glucometer…

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Yes I’m testing every 3 or 4 hrs

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I have to admit … I always bring MDI … and even a back up pump . Last year I did a 3 month sail … using the 780G and Guardian 3 … but also had some Libre2’s as back up … and had Omnipod Eros to use.

I am hoping that you might come in contact with another T1D while on holidays. That’s been handy over the years for me.

No this isn’t much help, but next holiday, hopefully you are prepared, e.g. bring 3x what you need (and on my 3 month sail … it was ALOT) … and you should be all.set for a less stressful time.

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I always have an app on my phone as well for MDI. The one I use is by the Ypsomed pump company… and it’s set up all the time with my current settings from pump. So can be used for calculating for food, corrections, logging your insulin, etc. I use vials for my fast acting too with a .5 unit refillable pen. Its as close to a pump for microdosing that you can get. Being American, I know there’s other similar apps that do this … but just thought I’d help you for next time (or pack me in your bags … I’d love a holiday) … https://play.google.com/store/apps/details?id=net.sinovo.mylife.app

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I wear 780 and I have imagined what you are going through. My goodness. What in the world happened to the 780? Man, makes me glad I have my prior 670 in a drawer as backup. I realize this can happen in the back of my mind, but……

It sounds like you are doing a great job. I know it’s difficult to relax, though. I bet you’ll be glad when pump arrives and all set up.

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Here’s how I did. Today is the third pumpless day. They couldn’t get the pump to me because of July 4 but it finally just arrived. Today I felt much more confident in the old injection method. The first morning pumpless,my blood sugar was approaching 300. This morning it was 115. It took me 24 hours to wrap my mind around what to do and testing and keeping track of timing and carbs and all but I feel more prepared for the next time something unexpected happens.

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And tomorrow I can finally catch a flight home because I had to miss the original. I upgraded to the best class to celebrate my survival😂

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Thank goodness! You deserve it!

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Best wishes. Libre and DexCom 7 work fine without a pump.

Good save, @Mbstarr.

I think that running an automated system does change your relationship with diabetes in significant ways. The mental shift back to the old fashioned way of doing biz can be hard.

You seem to have done well. I don’t think its unreasonable to think you might run some 300s and it might take a few days to figure out the dosages. You did great! We all should probably practice this more often.

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