MDI to pump, Lower ratios an stuff

#1

I started with my pump on Friday and was set up with a much lower basal rate, I to C ratio and sensitivity level than what I was using on MDI. When my endo was spelling out the rates to my trainer I thought to myself that they would never work and expected to soon raise them. Well guess what I'm two days in and things are going perfectly.

Here's where I'm at. My basal rate is about half of what it was with Levemir. My insulin to carb ration is set 60% less than when on MDI. My sensitivity level is set three times higher than what I have been using, haven't had to do a correction so I don't know how it will work.

I know that absorption is better with a pump but I didn't expect it to be that much better. Has anyone else had a similar experience. I am type 2 and considered myself to be insulin resistant but it appears that I'm not as resistant as I thought. I guess that all the diet and exercise has made more of a difference than I thought.

BTW the bolus wizard rocks.

Gary

#2

You give me hope! I received my pump and CGMS this past week, but won’t start training until after I see my Endo and PCP mid-January to get dosing orders and the doctor signs off on supply prescription. I have made HUGE diet, exercise and lifestyle changes for the better, now hoping I can fine-tune my diabetes management with a pump and rid myself of some bad complications from MDI. I’m going to spend the holidays reading Pumping Insulin by John Walsh and the manuals sent with my pump and CGMS. I am excited and a little scared all at once!!

#3

I never had Levemir, as I went from NPH to pumping, but I think that it might be like comparing (low carb...) apples to oranges. I was sort of in the middle of a huge transition period and wrote stuff down for a month and my doc came up with almost exactly what I needed to get things in order. I don't worry about any numbers other than my BG and, as long as those are where I want them to be, I don't worry about how much insulin I'm taking. Occasionally, I'll make adjustments and notice myself running higher or eating more jellybeans or whatever and that's usually a clue that I need to nudge the insulin one way or another but I wouldn't worry about how much insulin you are taking. Get the BG in line and enjoy it! That's one reason I am not a big fan of the term "insulin resistant." I will keep my BG in line by whatever means are necessary, even a quart of insulin!

#4

I might ad to Ac's comment ( I am not insulin resistant either ) I went from about 27 units down to 20 ish , my reason I think was I had too many lows and was correcting a lot , hence the higher amount ...ENJOY the pump , Tu friend ...Merry Christmas !!

#5

I found that I need considerably less basal insulin with the pump. But that may because Levemir appears to be less powerful than the equivalent dose of NPH. That was my experience even though theoretically that shouldn't happen. My boluses are about the same size as with MDI. My TDD is only 0.15 units/kilogram which is very low even for a T1. I don't think too many people can achieve that. My basal/bolus ratio is about 50/50.

#6

I agree with what you said especially the last statement. I will also keep my BG in line by whatever means necessary. When I was still 40 lbs overweight I was using massive amounts, it seemed that I was almost injecting by the quart.

I guess this is part of my transition from Bad T2 to Good T2. My insulin to carb was almost 1 to 1 in the beginning and was 1 to 4 before pump. They have my pump I to C set at 1 to 15 and I'm going to run with that a while. I will make corrections if I need to because Christmas holidays are not a good time to be fiddling with ratios.

#7

I know what you mean. Changing over is exciting yet frightening. I did my homework and it looks like you have also, that took a lot of the fear factor out of it.