Pump or no Pump?

i don't see a problem with Gary's post...he's sharing his experiences and story, which is what we all do on here.

me too, Alan. I'm starting on a pump and will be getting a new script for 400/month. I always seem to run out of my 300/month. no one likes to test, but...life happens and this disease is so ever changing. At least 8 times a day, every endo has told me that (for type 1's). not to mention getting sick, stress or the wind blowing in the wrong direction :). Testing our blood sugars is the only thing we have..as they say, "test, don't guess." I sometimes think I'm high when I'm low and vice versa.

3-4 testing times a day is a good start for someone who doesn't have the test strips to "test properly" with. For someone who isn't in the habit of testing, I think it's a good start to do it 3-4 times a day. Agreed, it IS better, and ideal, to test fasting, before meals, 2 hours after meals, and at snack time, and at bed time... some people just don't have the financial means to get all those test strips. And in MY OWN defense, once I started on the pump, I did test a minimum of 6 times a day, and twice through the night just to get the bolus on target. The more you test, the better you know your body. I totally agree with that.

I made this list:

1)wake up, test bg
2) before eating test BG
3) before driving to work test bg
4) 2 hours after eating test bg
5) lunch test BG
6) 2 hours post lunch test bg
7) drive home test BG
8) get home, run 3 miles...oh wait, don't forget to test your bg!
9) post-exercise maybe, maybe not, maybe eat dinner and, you guessed it, test BG
10) 2 hours post BG, test BG ****AGAIN****
12) stay up late? probably...

I made this list, which is by no means unreasonable however I suspect I probably do some more tests here and there, as needed. The point isn't to do what somebody says, it's to know what's going on with your body. I've pretty much brainwashed myself so I don't consider it an inconvenience. I consider it more of an inconvenience not to test.

WOT, but if I get back far enough from my computer your pic looks like "Cookie Monster", w/ the white glare from your hair as his eyes...Hmmm, time for bifocals maybe?

So far today has been everywhere it started at 6 with a sugar check of 466 took my 60 Lantus and 20 Humalog. Stomach was upset I didn't eat. At 720 I was finally hungry so I checked again it was 369, I took 12 more Humalog and ate. At 1030 I felt loopy so I checked and my sugar was 54, needless to say i'm eating something to bring it up. My sugars jump around a lot.....

60 units of lantus - that is a very high basal dose, especially since you haven't had type 1 all THAT long, are you a type 1? 20 units of humalog....and you didn't eat, was that 20 units for a correction...? if you've had this for 9 years you should know how to manage this by now, no? I suggest seeing an Endocrinologist. Sugars over 240 cause ketones, continued sugars over 140 start causing damage.

that's about what I do too, of course that's considering no highs - lows, corrections. i test at 1 hour ppl sometimes, cause sometimes I want to see if i'm spiking too high, i've dropped fast too.

I'd wonder too if maybe the Lantus "runs out" in the middle of the night, causing an AM high? A lot of people split it into 2 (I think some people may do 3?) to get a smoother, flatter curve? It's hard to guess without knowing more about what happened before the 466. When I was on MDI, I had a lot of AM highs too, I never really bothered fixing them until I got a pump but getting precise info to deal with the AM and the smoother delivery of dripped Novolog basal has been great.

I did exactly the same thing, big shot, wait to crash and then eat. It's a hard way to start the day but I did it for *years*!!

I have been told to take 60 Lantus in the morning and 60 at night. I do what the doctor says and the last time I saw him he also told me to take 20 untis of Humalog everytime I eat, which I dont always do because I dont always eat a lot so my sugar drops. Im looking for a new doctor. I dont have any problems with anything. The 20 units was because I wake up with my sugar high and the only way I can eat is to bring it down.

When I go to see my new Endocrinologist should I ask him to go on a Continuous Glucose Monitor to see if that helps?

kaytea, 120 units total of lantus is an EXTREMELY high dose of basal which, typically, a type 1 does not take. These sound more like insulin doses for a type 2. Frankly, i don't know any type 1 who takes that much nor do they take a 20 unit correction with NO food. How do you know you're type 1, just curious? Maybe you were wrongly diagnosed as type 1 and that's why insulin isn't working. Also, with such high numbers, for a type 1, we would probably go DKA.

By the way I have had this for 9 years uncontrolled because I didn't care now I do, I want to get better and feel better so if you could not scrutinize me for not knowing what i'm doing that'd be great. You don't know what I've been through, or anything about me, so keep your dirty comments to yourself. Theirs having an opinion and then theirs just being rude.

well, we all have stuff to go through, this disease is tough on all of us and no one likes it. you have to care, that's the point and i'm glad you care 'now'. also, it's my belief, just from what you've posted, you may be a type 2 with insulin resistance. type 1's do not take 120 units of lantus nor do a correction of 20 units. maybe you should look into that? good luck!

if a type 1 had continued blood sugars this high we'd go DKA. This, apparently, is not happening to you.

I did the pump in 2008 and the CGM in 2010, after I had the pump "figured out". The pump made things fall into place really quickly for me but, at the same time, I also got "organized" about carb counting and generally "cleaned up" what had been a rather messy "act" beforehand? I guess I did something like carb counting but really just guessed at it 100% of the time, which is not nearly as effective as more educated guessing.

The first and most important thing I would do is start testing a ton to get data. You would need to do that to get a pump anyway and it's not a bad idea to see where your "problem areas" are?

I started many days running high and knocking it down (I'd do IV R shots though, as I was in a hurry...) and then bouncing up and down and I know that it's 1) not fun and 2) hard to fix. A bad breakfast can spill over into lunch, dinner, etc. which sucks. Once I got breakfast "fixed", within a few days of pumping and generally behaving myself, things really fell into place. I don't know your whole scenario but it may be the case for you too?

The downside of a CGM is that I think that they sort of work better if your BG are stable? I find that when my BG gets crazy, the CGM doesn't work as well and is sort of fidgety and the data isn't as reliable. It's sort of a "loop" in that my inclination now is to make my BG "behave" so that the CGM will work, just the opposite of it being an amazing gizmo that helps you fix your BG but, in the end, it's sort of the same result?

I took some pretty whopping doses during my "guesstimating" era although 20U (of R...) was about the max? I didn't have a clue about carb counting or what ratios were, it was totally guesstimated. I think it sounds like the doctor is clueless and probably guilty of malpractice as the 20/60 plan seems like a "shot in the dark" guessing how to blindly fix higher levels in someone who's not reporting enough data to actually identify the problem?

well, no type 1 takes 120 units of lantus - basal, that's a type 2 dose.

I was just thinking that if I could give the doctor something and he could see how much I ate how much Insulin I took and what happened to my sugar it may help. Im not a pro at this at all lol but it just seems to me that sometimes when I dont take a lot of Insulin (say 20) that I dont feel it does anything but I also wasnt checking my sugars to know, but I rarely had a low sugar when taking that much. I know this is not going to be a quick fix its going to take a while and a lot of effort but I just want to be able to feel better. I wake up sick a lot and I lost my job because I had to go to the hospital twice in a month.

I've been in the hospital a few times for DKA but it doesn't happen that much. The only times I go is when I cant keep any foods or fluids down. I have bad days where I go to the bathroom consistently but other than that and being thirsty i'm fine. When I was diagnosed they told me I was type 1.5 but after all these years my body has completely stopped making Insulin. When they first found out my sugar was to high to read. That's all I know....

1) I think you need to see an Endo and discuss what type you are, sounds like, again, you're a type 2 and need oral meds. Were you told you were a type 1, did you test positive for the antibodies, low cpeptide? Type 2 and type 1 are two toally different diseases. Type 1 is an autoimmune disease and typically we are not insulin resistant, or not 120 units of basal worth.

2) An endo can run your meter or you can download it and bring in hardcopies or email to them.

3) Write down everything you eat, count carbs, write down your numbers.