After my fourth attempt to put in an infusion set that didn’t either hurt when it was so much as brushed and/or bleed upon removal (which happens fairly regularly), I got so fed up that I injected 35 units of Lantus (my TDD for basal rates) so that I wouldn’t have to deal with infusion sets right now.
So I guess I’m on a pump vacation for the next couple of days, at least. (I mean, I may as well!)
My Lantus injection site stung for about half an hour after injecting. I forgot how much Lantus stings!
This is my first time using Lantus with a CGM. From past experiences, I have my doubts that Lantus will be able to meet my basal needs, but it’ll be interesting to watch!
I just had a bedtime snack (even though blood sugar is 13.3 mmol/L, probably because I disconnected my pump before Lantus has really fully kicked in), and when I went to inject Apidra I was like, “Oh, yeah… I have to actually calculate the dose… And log the results…” Definitely one downside to MDI, especially since I had different I:C ratios depending on time of day. I’ll have to remember it all for the next few days.
Ah, well, here’s one of the reasons Lantus didn’t work so well for me before and the Number One reason I went on the pump: I see my old friend Dawn Phenomenon hasn’t gone anywhere!
Curious how those of you who decided not to pump deal with such craziness. My only solution before was to get up every morning at 3:00 AM and give myself a few units of rapid insulin.
It is common that pump TDD and basal requirements are less than MDI TDD and basal requirements. You may find that you just need more than 35 units of Lantus.
I was thinking that, too. I think when I started the pump my basal dose was cut back a certain amount.
I purposefully under-bolused for my snack before bed because I had no idea what would happen, so that’s why I was running a bit high to begin with. But when I was on MDI before, even with my Lantus dose set properly and divided into two injections, I could not escape morning highs (unless I got up and corrected in the middle of the night) and noontime lows.
If I run high today I’ll up my Lantus by two units tonight (I’m not going to split the dose because I don’t think this no-pump thing will last more than a week or so…).
I use a CGM with MDI, after pumping for several years. I split the Levemir, 10 units around noon and 7 units before bed, which matches my changing needs better. As my needs vary, I raise or lower one of them. Dexcom shows what needs changing.
I did the same thing while on Lantus, which never covered 24hours for me.
Yeah, Lantus didn’t last 24 hours for me, either. I just didn’t split it right off the bat because the last time I took a pump vacation for a couple of weeks I initially only took a partial dose of Lantus and ended up spending a day with really high blood sugar and ketones… So this time I took the whole dose. If I add some on, I’ll probably do it tomorrow morning so that I’m taking two doses.
I’m not sure how long this break will last. I’m kind of liking it. But I’m also at home today, and I think at work I’ll really miss bolusing and being able to run temporary basal rates. If I were doing this long-term (as in not going back to the pump) I think I’d ask to switch to Levemir and NovoRapid. I’ve heard Levemir is shorter-acting than Lantus, which would make basal adjustments easier. And Novo products have pens that are so much nicer than any of the other insulin companies.
Have you thought about Tresiba? I’ve heard such good things about this long-acting insulin that I have a pen of it on hand for whenever my daughter wants a pump break or the Zombie Apocalypse occurs, whichever comes first.
Good luck with your temporary change to MDI. When things aren’t working sometimes you just need to change it up!
I experimented with Tresiba recently and found that I could not overcome dawn phenomena with one shot per day. I returned to my pump instead of trying the split dose. I was able to knock down the dawn BG rise with a 3 a.m. dose of Apidra. I really don’t mind the sleep interruption as I can usually fall back to sleep quickly. Delivering a pen dose of Apidra was quick.
@Terry4, did you find you needed more basal with MDI than with the pump? If I find I have to wake up every night to correct I’ll be heading back to the pump—I have to get up at 6:00 AM to get ready for work as I have an hour-long commute, so having to wake up every night would be really annoying and sleep-depriving to me.
Yes, I needed about 19 units of Tresiba per day compared to about 15 delivered via the pump. I just checked my current pump basal and it’s up to 18. Good luck with getting your basal dialed-in. With diabetes, it’s always something, isn’t it?
My control lately has been back to where it was last summer (I’m beginning to think there’s a huge seasonal variation, with control improving in the spring and getting harder in the fall). So I definitely think I need more basal, since I have yet to be in range since taking Lantus. I’m also probably experiencing the effects of hormones. This was another major advantage of the pump, as my basal rate would sometimes increase or decrease by five units in one day.
Yeah, I did something along those lines too. Actually what I did was to take a few units of novolog at bed time, depending on what my BG was, and I had kind of a sliding-scale intuition about how much I need to knock my BG down over the next few hours so that it would only come up to something in range by 6-7am. Sounds dangerous? You bet!
I switched to a pump a few months ago & had to reduce my basal 25% so it wouldn’t surprise me if you have to raise your basal a bit switching back to mdi
I know that I could have stuck it out and maybe worked things out to some extend, but my control with Lantus was terrible while I was expecting a somewhat straightforward transition. Only 22% of my readings were in range with the other 78% being high. I woke up high both mornings, went low the second lunch (but not the first) and spiked high both evenings—pretty much what I remember happening when I was on MDI. I was mostly fine the other times, but I spiked after eating, for some reason.
I missed not being able to take corrections easily at train stations and in meetings. I missed not being able to set a temporary basal rate as soon as I knew I’d go low or to help bring down a prolonged high. I missed not having to do the math, although that’s more of a lazy thing than an actual necessity. I did kind of like not being attached to anything, but overall it was so much more work for less results compared to what I’d get with the pump (it didn’t help that I was in a good spell of control with the pump).
One disadvanage of surfing (that I’ve noticed before now) is that when I’m heading off lows it makes looking back at records much more difficult because it’s not easy to see those times that I’m going low, because I’m not actually going low but instead eating to prevent lows.
So, last night I hooked back up. Interestingly, I looked back in my records and when I first started on the pump my doses increased rather than decreased, but it seems that now things are definitely the reverse.
This morning I woke up to this, which is more like it!
(I mean, I may as well!)
