Uggh. All I can say is uggh. Starting dose of Lantus probably too small resulting in 500’s yesterday. Though the Accu Chek I was supposed to be using (long story, HMO wont cover strips) said 490, One Touch said “HI.” Lantus failing at dinner hour, took dose at 10:30 PM Monday and Tuesday night… Same issue today. Parked at 345 with Novolog not making a dent in things, again around 6 PM. Did I mention ate just about nothing for the last two days? Tried a two unit increase tonight and shouldn’t have read horror stories on here about Lantus lows because…wait for it…was 63 this morning. The what if’s are starting (what if I had just gone with a new Animas, which has always been best for me, instead of a new Revel. What if, what if…). I don’t mind MDI, but yesterday was the only time in about 30 years that my husband said we might have to go to the ER. I don’t like making changes that could result in that, since in 46 years with diabetes I have never been in the hospital or needed a paramedic.
My pump basal was about ten units, my TDD was about 15. I don’t know if I needed to use a 10 unit Lantus dose right off the bat??? Tired, grumpy, hungry…questioning this whole thing.
IIRC, the recommended conversion rate estimate for going the other way (MDI to pump) is that you need around 10-20% less basal with the pump compared to long acting. On that basis you might expect to need more Lantus (11-12 units) daily.
Personally I would rather cut off my own leg (without anaesthetic) that go back to MDI.
I would agree with jjm335 - it seems like your basal dose is too low. I’ve seen my fair share of debates of pump vs. MDI, and would say they both have their merits, and in my experience, I can get the same level of tight control with either.
I’ve settled on a split dose of Levemir for basal, Novolog or Humalog for meals, and Afrezza for corrections. I will wear an Omnipod when I travel for business - it’s just more convenient and discreet - but will still inject Levemir for basal. For me, nothing gives me steadier basal rates, and it’s a great failsafe in the event a pod fails - and they do every so often and at the most inconvenient times.
Overall, I prefer MDI because I like to have as little stuck to me as possible, but as they say, YDMV, so it’s really a matter of personal preference and what works best for you.
The most obvious reason you need more Lantus is that fast-acting insulin works…wait for it…faster. So switching back to a separate basal insulin would mean you’d most likely need to increase your basal insulin amount because Lantus is not as efficient as Novolog or Humilog or whatever.
OK, I give up. I miss my temp basal and my micro dosing and I hate using a phone app for my bolus ‘advisor.’ I’m hooking back up today. I read that you just turn the basal to 0 percent delivery until you know the Lantus is running out. I have some ideas on how to make the pump work better for me, and I just do not like these endless injections.
And it’s not that I hate the pens but I do get a 150 point drop from a unit of insulin and lows every morning so…not liking where this is going.
Hi @Laura_S! Was this carried over from another thread? I missed why you were “vacationing” to begin with. I had to go back to Lantus-Novolog MDI for several days last summer when my pump failed going into the weekend (of course!!!) and couldn’t get a replacement until the following Tuesday. It was a bit of a head scratcher at first but at least the basic principles are the same. If I had to go back to R/NPH I’d really be at a loss–20 years on it but I can’t even remember now how to dose with it and hope I never have to! Though it was a lot fewer shots per day.
Hey Laura.
Diabetes is so crazy. I’ve gone from “I will never give up my pump” to “I don’t want to go back on a pump” in the past couple months. I took a pump vacation and have been loving life. One thing I would say is that when making the change and dialing in the basal a lot of patience is needed. Patience is very difficult with diabetes when you are doing something (pumping) that works relatively well. Then, we try something different (pump vacation, MDI) and we freak out when those numbers are running so high, not to mention, we feel like crap.
Either way, I wish you the best as I believe in the merits of both pumping and MDI. YDMV rings no more true when making this decision!!!
Why don’t you try Toujeo or Tresiba? Lantus never worked for me but I consider Tresiba a miracle insulin. Any of the two mentioned should work better than old Lantus.
I know you are talking about hooking back up but I was just wondering why you didn’t go with one of the new long acting insulins, Tresiba or Toujeo? Not sure if it’s an insurance thing or didn’t know they were out there. I have no working knowledge of either as I have been pumping since 1990 but have talked with many who love them.
Well, I did hook back up and I called Medtronic again on the new BD silent occlusion sets, which were in trial and then pulled for some fine tuning. They said to keep watching the online store. I have some other ideas as well and a really sweet person sent me a new One Touch link meter for my Revel.
My new HMO does not cover Tresiba. They also wouldnt cover Accu Chek strips for the nice Connect meter I was going to use for bolus advice. Last night I woke up with a 350, that actually lasted all day yesterday and I would normally dose half a unit to bring that down. I drop overnight, so I hesitated taking more but I had to (they also wouldnt give me a half unit pen). Sure enough, low again today with a 100 point drop from 5 am to 9 am (350 at 3 am). I don’t have the patience. Yesterday I ate just about zero food, and still was 345 to 380 all day and I dont weigh anything to begin with.
So this nice new meter arrived just as I hooked back up (and am 345 right now). Thankful for internet people who are generous like that.
I’ve tried Tresiba, and I agree, it’s truly amazing and works as advertised. Unfortunately, I had to discontinue it precisely because it is so stable and consistent. My basal requirements go up by about 20% at night, and as such, I had to revert back to a split dose of Levemir. However, for those who’s basal requirements remain consistent over 24 hrs, it really is an amazing insulin.
Well, and my basal has to be majorly cut overnight or I go low, and even then I drop and drop between 9 and noon. I’m doing better on the pump. Even checking to see if I can obtain a new one at this time. And waiting for the return of those silent occlusion detecting sets from BD via Medtronic. I didnt mind the pen needles, but I missed my micro dosing too.
I’m sorry to hear it hasn’t worked out for you. I went off the pump about two weeks ago after thinking my Ping had died (it’s out of warranty), and I had much the same experience you describe: extreme highs and lows and missing the ability to micro dose. I went back on the pump after only five days and stability returned almost instantaneously. I’m interested in trying Tresiba when it comes to Canada ", but I think there are people who have very flat basal needs for whom MDI works really well and people with highly variable basal needs for whom the pump is better. I’ve been travelling for the past week and really cannot imagine doing so without the pump anymore (I’ve been using suspend, temp basals, touch bolus, and micro dosing every day, none of which is possible with MDI).
Oh I hear ya. All the features…I use them too. I would like to see if I can obtain a new Ping, as it has always been the best pump for me. I’m with a new HMO with good benefits, but I dont know how this will go. I’m hoping they will get me one. Mine thinks it is 2007 all the time, and my Revel is not the greatest for my needs. hopeful here…