I’m third day in off pump. Had a major low around 2:30am(might have been some IOB since I had several highs, esp last night before bed). I had forgotten how hard I crash with long acting insulin, so treated it twice after waiting 30 min and it was even lower. Woke with 132 and like yesterday within an hr it was over 200 and kept climbing, even after treating it. I just got it down to normal now after 2 small injections. Appears, like yesterday that it takes about 4 Novolog to bring it down back to normal after 9a.m, which was my 2nd highest basal rate on my pump, just a bit lower than my highest at 8pm-10pm. Feeling pretty punk again today, sick to my stomach, headache and weak, but most likely from the highs/lows and trying to regulate. Added another 2units of T at 11:15am just now, will see how I do the rest of the day and night but will be careful not to over “treat” for highs before bed if I have a bunch like last night.
Thanks, Jd for your share as it helps me to kind of sift through the events of my past two days and answer some questions I had, esp why the morning rise was not budging with my normal amt.
By the way, I meant to mention that I have been using the following app: PredictBGL. I saw someone else post it in another thread, has been extremely useful to keep up with events, especially insulin on board since my pump use to take care of that information. Again has been very helpful.
I think we are doing better…she went to bed around 140s which for us is really great. She woke up around 325 per meter- Dexcom said slightly under 299. Looks like she started rising around 2am. Gave a modest correction dose of novolog and then bumped Tresiba up to 17. I really feel her basal rate is low and appears low in the pump because so much of her basal has been corrected throughout the day with pump boluses. She dropped all morning (has PE first period) until lunchtime at 11:15 to 106 then had a 10 carb lunch (only had black coffee with stevia liquid and a few almonds for breakfast) and is now 190 which is pretty good. Wearing pump at basal of .100 and her carb ratio is 1:5.5 all day except for dinner which is 1:6. Thinking of switching the tresiba to a night shot hoping it helps with dawn phenomenom a little better. We are still working on getting Afrezza with the doctor and waiting to schedule breathing test but if I can keep her out of 300s without substantial hypos I’m happy… one day at a time I guess! We both got some sleep so that really helped both of our moods!
Everyone - since I started this thread, I thought I might close it out So it has now been 5 weeks, and things are really becoming more steady, I have increased my basal by 5 units from where I started. To provide some insight that is 7 units less basal per day than I was using on the pump. I have been using my current dosage for 9 days at this point, which is plenty of time for the Tresiba to become “steady”. Bottom line I had to push through it, continue to increase my dosage to where it stands today. So to recap the transition from pump to MDI (Tesiba):
Start with a low dose, then work your way up, being high until I found my dose was hard, but as you work through it/transition I find that it was worth it. Ensure you do not modify that dose for at least 3 days per change!!
Food now has a tremendous impact on my blood sugars, if I do not cover with a bolus then I can skyrocket, I know that sounds like a no brainer, but a carb hits me differently now, not a big deal, but something to keep in mind.
Taking a pre-meal bolus at least 15-20 minutes ahead of eating really comes into play now as well. I see a huge difference when I do, very positive.
Make sure you go through multiple fasting periods during the day e.g. 6AM-12PM, 12PM-6PM, 6PM-12AM etc. This will really help you to dial into the correct basal dose.
I mentioned I am using PredictBGL, for me this app has been a great addition to my management, I realize there are many to choose from, bottom line it takes the place of my pump indicating insulin on board. I highly recommend using this or something similar.
Appreciate everyone’s support with this, MDI is looking like a very positive approach moving forward!!
Well after 3 weeks of some very chaotic sugars-mixed with so many emotions ranging from hopeful at times to on the floor defeated and one complete breakdown where my daughters hair fell out in clumps (supposedly from stress not Tresiba or high bs per Endo) we are back on the pump. We never did find the MDI balance with Tresiba but we have increased the pump basals quite a lot since returning (per Endo: teenage girls have large insulin needs even if we eat extremely low carb) which may have been the problem all along said the Endo (we will never know perhaps) Both my daughter and I have gained a new appreciation for her pump which I guess after 10 years we had taken for granted. Thank you Dexcom because we would have never made it through without you! We learned if it’s not truly broken we won’t try to fix it in the future…diabetes will never be perfect and there isn’t a miracle drug or device for her yet. But we learned a lot and with a new unavoidable summer cut (my poor girl!!) we are proceeding forward. One day at a time and if that doesn’t work then one moment at a time! On the bright side we both got 5 1/2 hours of uninterrupted sleep last night! First time in almost a month! We will take that as a WIN!!! Thanks for everyone’s support the last few weeks!!! ️
@Jd111 Did this end up resolving itself once the tresiba became steady? I’m currently taking my tresiba around 9pm. I notice I’m going high around 5/6 pm and it’s been difficult to bring it down via Novolog corrections.
Thanks for everyone’s support the last few weeks!!! 
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