New AccuChek Combo User

Hello fellow pumpers.. I recently started using my new AccuChek Combo, Thursday to be exact. So far so good. I really like the features this pump has which happens to be quite a few. I used to have/use an older Medtronics pump but it didn't have near as many functions or options to suite my needs. Along with my Type I Diabetes I also have Gastroparesis and trying to manage my BS and Diabetes along with the everyday struggles of GP can really be a pita. I knew going into this new pump thing that I would have a lot of roadblocks to overcome but I am hoping I can manage this pump idea.

I was wondering is there anyone else on here using the AccuCheck Combo or on a pump struggling with GP??

I have a lot of looking around and reading to do but I am glad this forum is here..

Thanks for the help and I hope you all are doing and feeling well.


Hi Chris.
Please join this group, where many experienced akku check pumpers exchange their knowledge:

Thanks I’ll check it out

Thanks swisschocolate, I was just going to recommend our little group to Chris.

Chris, while I don't have gastroparesis, I hope the pump features that allow you to spread out your bolus (Extended and Mulitwave), along with temporary basal rates will help you.

Hi Chris, welcome to pumping - I'm a long time Accu-chek user. Did your trainer mention any tips on dosing to deal with the gastro? I know mine asked me if I had it (I don't)because they had some info on it.

also, please join this group

Hi Marie
Actually I didn't get that far with my trainer, he didn't want to listen to me. When he gave me my initial settings I honestly wasn't sure what to think but I quickly found out that these Basal & Bolus rates as well as insulin sensitivity amounts he had set up were NO GOOD for me. I actually went back to my Dr who wanted me on the pump and the trainer made a call out to him which ended with my dr hanging up on him and not wanting to deal with him period. Not much longer after that I decided I would work with my dr and trust my better judgment to get my rates down. I had 2-3 really low blood sugars which he said were my fault.. NOT THE CASE I have since dropped my basal rate almost .8 from what he wanted me to use and I have not had a single low since my adjustments..

I am going to have to learn this all over again which is fine I am not to bad with making sure I am good. I have not been using a Bolus to be honest I have been focusing on using Extended & multiwave. So far it seems to be working using those over a fast acting bolus.. :)

wow Chris, I must say that has not been my experience with Accu-chek trainers all the years I have been using their pumps. The last one I had was a RN, CDE, and d-mom. she called me several times after having taken a long drive twice to get to my house, just to make sure everything was working out. she spent hours with me, even though I had trialled the combo a year ago and remembered most of it. I'm sure their customer service would want to know about your experience.

btw, I know some people who only use multiwave boluses.

That sounds great, not quite sure who was at fault whether it was him or me but I just know I do not want him to come back nor do I really want to deal with him. I never claimed to be an expert when it came to the pump but I do know when my body is telling me something isn't right. And after 3 low blood sugars and the last one being a 29 and almost a free ride to the ER thanks to my local EMT's I decided I was better off on my own.
Not quite sure if I will call or email their CS but I have been tossing it around in my head..

Chris -- I'm a long-time pump user and currently use the Animas Ping. In the past I've used Medtronic (Mini-Med) and Omnipod pumps. The biggest lesson that I draw from pump use is that the most important element of this whole equation is the knowledge and attitude of the person with diabetes.

It's important that the pump be dependable and accurate. It's also important that the pump company customer service provide good support and responds well to the pump user.

If you are not conversant and fluent with terms like insulin duration of action, insulin sensitivity factor, insulin to carbohydrate ratio, basal rate testing, temp basal rates, and combination boluses to name a few, then you should seek to learn the meaning of these terms. There are several books written on these topics. Check on books written by John Walsh and Gary Scheiner.

I was dagnosed with gastroparesis (GP) two years ago. That motivated me to use a low carb diet along with daily exercise to gain the best control in my 30 years of living with T1D. I've mostly minimized, but did not eliminate, my GP symptoms. I find when I experience multi-hour highs that the GP symptoms return. I politely withhold description of these symptoms but it's not hard to guess.

My biggest pump tactic that I use to control my blood glucose is dosing insulin based on not only the carb content of a meal but also protein and fat. I use a combination bolus, an immediate bolus for carbs followed by a multi-hour extended bolus to cover the protein and fat.

For example, this morning for breakfast I ate two scrambled eggs made with whole cream, four half slices of bacon, and one medium tomato sliced and fried in the bacon grease. I dosed for 6.4 gram of carbs, an immediate 1.6 units of insulin. I followed that with an extended bolus of 6.7 units over the next 5 hours. I dependably get very even post breakfast BG numbers that rarely rise to more than 140 mg/dl and often go flat for 4-6 hours. Please be aware that this example uses numbers that are personal and unique to me. You need to learn your own customized insulin program.

Learn as much as you can about your pump as well as general pump therapy. Don't be afraid to experiment. Just make sure to document your experiments so that you draw the right conclusion. Logging is a highly effective tool that I always fall back on when things get rough and I need to reset my control. It's a pain at times but you don't have to do it every day.

Good luck with your new pump. Did you get any software that enables you to upload pump and meter data for your analysis? If you did, I encourage you to make a habit of looking at that data to improve your personal insulin program. Your goal should be to become an expert on your unique glucose metabolism.

Hi Terry you made some very good points, I have orderd Pumping Insulin by John Walsh from Amazon my local Barnes & Noble did not have any in stock so I ordered on line. I am getting the hang of things still learning all the terminology and "figuring things out for me" but for the most part I am doing ok. I got my Basal rate set to where I think it needs to be for me.. I am running glucose readings of 100-128 all day long, I run a little high when I eat though larger meals I still have not gotten this carb counting down but I am getting there too :)
I sent in a free form for the Accu-Chek 360 software for the PC it allows me to download all of my data from both the blood sugar monitor & pump to the pc and then allows me to print, email, save as a pdf so its really coming in handy. I can share all the info with all of my drs. My Dialysis drs really think its cool. What I have been doing is saving the logbook and readings to a Google Drive file so that while at Dialysis or in a Drs office I can pull it up on Google Drive where I save the file so they can view the results.. I am far from knowing everything but I am getting there..

I am going to give the way you are treating your GP a shot to see if it helps me. I have actually been doing really well with the GP since getting on the pump. I noticed today though I had some stress & anxiety due to the flooding and all the rain we had and getting to Dialysis for my treatment this morning and I had a flare up.. Otherwise the GP has been a lot better since getting on the pump.. :)