Insullin pump

Morning all my sugar has been nice this morning 760. I hope to find everyone well. the weekend was too short. I am thinking of visiting a diabetic and endocronology specialist to enable maybe authorisation for a insullin pump. although I don't think it is often used in south africa. what is the down and up sides on this pump?

A normal blood sugar might be 70-120 mm/dl in the US or about 4-8 mmol/L in other parts of the world. So I'm not sure how to interpret your reading of 760. I do think that we all benefit from good blood sugar control. A pump can help us along that way, but in order for it to work, we have to devote ourselves. We have to accurately count the carbs in our food, test our blood sugar at least 8-10 times a day and we have to work those buttons. Sadly, a pump is not an automatic, rather it provides more extensive and accurate ways for us to adjust our blood sugar.

There are many who have found that use of the pump markedly improved their blood sugar control. But I have to ask you to look inwards and ask yourself the questions about whether you are counting the carbs and testing sufficiently so that you can be successful. If you can answer yes, then it is quite appropriate to ask your medical team about a pump.

Every one of us here has a right to pursue a normal blood sugar and a healthy life.

I have been sent from pillar to post with the counting of carbs after nine years this has only been brought to my attention recently. How do you calculate the carbs as referred to in your note above. Yes I test quite regularly.

You count carbs by reading labels and weighing foods that for which carb counts are not readily available (such as fruits). There are lots of books that give you the carb content for food. For example, I use an iPhone app that tells me how many carbs are in all sorts of foods. Are foods labeled there in South Africa with the grams of carbohydrates?

Pumps can be awesome tools. But, if you are living in a country that doesn't use them frequently, you may have trouble finding the right resources to help you learn how to use the pump properly. For example, endos may not familiar with the pump features and how to properly set basal rates. This is not to say that using a pump would be impossible for you; you would just need to be really committed to researching online as much as possible. A great place to start is YouTube. People have posted all sorts of informative videos there demonstrating how to use an insulin pump (including changing infusion sets, entering information into the pump before a meal, etc).

OUR PACKETS SHOW CARBOHYDRATES IN GRAMS. I HAVE A BLACKBERRY IS THERE A WAY OF A WEBSITE DOING THIS CALCULATION

I have found a GI CALCULATOR I just want to see it's hanging at the moment. What carbs are you allowed dayly?

Welcome to TuDiabetes, Belinda. If you are really talking about a blood glucose of 760 mg/dl then you do not need a pump in the first place. In my opinion you need much more knowledge about the management of diabetes. What is your current treatment? Which insulins do you use? We need the dosages, timing of injections and so forth. How do you calculate your dosage for food and for corrections?

The core concept in the basal/bolus insulin model is that you separate your insulin into two parts. Your basal insulin keeps your fasting blood sugar stable and at a good level during times when you are not eating. And then when you eat, you count the carbs in your meal and take a bolus of insulin that "covers" (matches) that amount of carbs with the ideal that in 3-4 hours your blood sugar will return to your fasting level. So the idea is that you change your bolus insulin to match the carbs you eat.

Many of us find that it becomes much easier if you eat fewer carbs, you will have to figure out how many carbs to eat as you work through it. A good book on the basal/bolus subject is "Using Insulin" by Walsh.

Good. If you have the ability to calculate the amount of carbohydrates (in grams) of what you eat, then it should be fairly easy to count your carbs. Keep in mind that you have to take servings into account. For example, if a package of something says that it contains 2 servings, and each serving has 15g of carbs, then eating the whole package means you're getting 30g of carbohydrates.

The amount of carbs you eat daily depends on a lot of factors. Many people on here eat "low carb," keeping their carb grams under 100g per day. Some type 1s eat a more "normal" diet, probably eating upwards of 200g per day. I think 200g/day is the daily recommended allowance here in the US, but I know I find that to be too much. If I eat 200g/day, my blood sugar levels are way more....wacky. I try to stick to around 120g/day. For me, that is more realistic. But I am also very active.

Keep in mind the source of your carbs too. Not all carbs are created equal. For example, I find it very easy to bolus for carbs that come from fruit. But I have a harder time controlling my blood sugar after eating things like bread, rice, and pasta....so I try to just avoid those foods as much as possible.

But everyone is different. What works for me may not work for you. To some degree, living with type 1 diabetes is just a lot of experimentation to find what works right for you.

AS I SAID BEFORE I SOUND LIKE A TOTAL IDDIOT AS NOTHING THAT EVERYONE TALKS ABOUT MAKES REMOTELY SENSE I WAS NEVER TOLD OF CALCULATIONS OF CARBS THEREFORE I CANNOT TELL YOU THIS MAKES ME EVEN MORE FRUSTRATED OF THE PEOPLE THAT WAS SUPPOSED TO TREAT ME. I USE LANTUS 40 UNITS IN THE MORNING AND IS NOW SUPPOSED TO INJECT APIDRA PRIOR TO LUNCH OR SUPPER AS PER THIS CALCULATION?????

Thanks I am not very active and not allowed any bread except low GI brown rice and wholewheat pasta

Just for clarification was your blood glucose level 760mg/dl or 42mmol/l this morning or was that just a typo?

If possible I would recommend that you purchase the following two books..

http://www.amazon.co.uk/Think-Like-Pancreas-Practical-Managing/dp/1...

http://www.amazon.co.uk/Using-Insulin-Everything-Need-Success/dp/1884804853

Both books cover carb to insulin ratios, insulin sensitivity and basal/bolus in great detail...

Well worth the money.

Good luck Buckley.

Belinda, please clarify for us as Holger asked, and we'll be much better able to give you information. There are online sites that give carb counts, such as CalorieKing. I eat very low carb, about 30 a day.

I'm sorry you feel so lost, but you've found the right place to learn all you want from a very supportive community, so you've taken a huge step in the right direction.

You're definitely not an idiot, you can't understand information you never knew about! The only idiocy here is not asking. What kind of calculation were you given for the Aprida?

Please be aware that typing in all caps is considered yelling.

You are not a total idiot! This is difficult stuff and if you're not getting the medical support/education you need, that just makes it harder.

Are you seeing an endocrinologist? Do you have access to diabetes classes where you are? I don't know anything about health care in South Africa, so I'm not sure what resources you have in terms of diabetes-specific care.

The good thing about diabetes is that so much information is available online (thank you, Internet!). Google phrases like "diabetes and counting carbohydrates" and you will get tons of good information. For example, the American Diabetes Association has some good info on carb counting (click here)

Your lantus is your long-acting insulin, so that is a (more or less) fixed daily dose based on what you need to keep your blood sugar stable. Your Apidra is your fast-acting (mealtime) insulin. How did your doctor tell you to calculate your Apidra dose? Typically, people dose their fast-acting insulin based on how many carbohydrates they are eating, but the ratio varies from person to person.

For example, my current insulin-to-carbohydrate (I:C) ratio is 1-to-15 (1:15). This means that for every 15 grams of carbs I eat, I take one unit of fast-acting insulin. So, if I eat a meal with 45 grams of carbs, I need 3 units of fast-acting insulin.

BUT, I also have to take into account what my blood sugar level is BEFORE I eat. If I am a little high, I need to add some additional insulin to "correct" that high blood sugar as well. If I'm a little low, I need to subtract some insulin. I use a pump, so my pump does this calculation for me. But if I'm taking shots, I have to do it myself.

There's a great book called "Think Like a Pancreas." You should read it. It is a really good step-by-step guide on how to use insulin when you have diabetes.

7.6 mmol/L then up to 24.3 mmol/L down to 13.9 6.6 mmol/l

So...

7.6 is about 136 mg/dl
24.3 is about 437 mg/dl
13.9 is 250 mg/dl.

Yikes!

Has your doctor given you ranges where he/she wants you to be when you wake up in the AM or after meals?

How much short-acting insulin are you taking before meals?

Please don't get frustrated. You aren't an idiot. We just don't know what you have learned about diabetes and what you are doing with your treatment.

Please realize, many of us are in the US, with expensive doctors all swirling around us, spewing the latest medical stuff. Sadly, that is not the way it is across the world.

We really want to help you. Wherever you are and with whatever medical support you have around you.

morning

thank you for your reply and support. This diabetes has driven me up the wall. Unfortunately I have ischomic heart disease, hypertension, hyperthyriodism, chronic depression only few of my problems. I am an "old" 41 year old.

thanks everyone for responding. Unfortunately no guidelines have been given now for injecting Apidra. The specialist seen a while ago uses a sliding scale but this new dr says it is .... but I think I should use it again as this carbs calculatation is above my head. no proper education is available regarding anything in S.A. we have access to specialist sometimes like an endocronologist but medical aid does not pay for the scessions and I have to fork this money out. our general practitioners is deffenitely not up to the standards you as accustomed to.

Yipee i found various listing of food calculating carbs in grams first step towards trying to stablise myself. Thanks all.