Pumping: Week One

This was originally posted to my blog site, Diabetes Odyssey.

I started pumping on August ninth. The first week has proven to me that pumping is the way to go for me. It hasn’t been free of issues; there have been a couple, but this is to be expected when starting something new.

Day one I went through a two hour training right here in the comfort of my own home. By noon I was all hooked up and pumping away. The first evening and a few hours into the next day my blood sugar was low. We (my BG Manager and I) adjusted my basal rate to a lower setting and, boom, my BG evened out and stayed normal for the next couple of days.

The time came for me to do my first set change. This is when you change out your cannula, tubing, and insulin vial. Everything seemed to go fine (it’s not rocket science), but a couple hours later I noticed my BG was going up steadily. I did a correction bolus but it didn’t help at all. When I reached 300 I decided to try one last bolus. Huh, when I told the pump to give it I suddenly felt wet around my site and smelled the unmistakable scent of insulin. OK, I decided to change my set again because maybe I did something wrong. When I removed the current one I saw that the cannula had never gone into my skin, it was all smashed up and just crumpled on the surface. Well, there you go, obviously I wasn’t getting any insulin. I put in the new set and bolused one last time. It worked.

I have been working via phone and e-mail with a BG Manager. I am supposed to work with her for the first month or so of using my pump. She helps me to learn and get very well trained and comfortable with my pump as well as guiding me on how to use my pump to best manage my blood sugar. I am really grateful for her help, she really keeps me in line and accountable, and she knows a lot of details about using the pump that may not be in the handbook, etc… It is so easy to fall into habits that are not healthy, such as neglecting to check your blood sugar, not counting your carbs and blousing properly, using your CGM to determine a bolus instead of checking your blood sugar, etc… Just having to report to my BG Manager makes sure I don’t do these things. Hopefully the good habits will stick and the bad ones won’t return.

Apart from the issues I spoke about earlier, the pump has been a life saver. I really do feel more freedom. I feel as if I’m getting a small taste of what it must be like for non-diabetics. I know I’m nowhere near what it’s really like, but I’m closer than I was without a pump. I can dream, right?

On Friday I went on a day trip down to LA and back with my mom. I was stoked that I didn’t have to worry about taking my shot while on the road. I didn’t have to wait until the car was stopped (have you ever tried to shoot up in a moving car? Not fun), Nope, I just hit a button and all was done in a second.

I have my insulin right here on my body at all times, and my CGM. I don’t have to worry about refrigeration, toting around ice packs and syringes. All I need to worry about packing is my glucose meter and maybe some glucose tabs.

The pump itself is awesome. I have three options for how I want to bolus. If I already am confident about the amount of insulin I need then I just tell it to give me X amount and it does. If I’m going to eat so many carbs but need a recommendation on a bolus amount I can tell the meter my current BG and how many carbs I am about to indulge in and it will calculate a bolus amount and I can either go ahead with that or adjust it first. If my BG is high and I need a correction bolus then I enter my BG and the pump suggests a correction amount. The math it uses is all based on the settings I put in when I first set up all my information in the pump (this can be changed as needed) for my Insulin Sensitivity Factor, carb to insulin ratio, and BG range I want to stay within.

The pump, in my humble opinion, is an excellent tool for blood sugar control, and it really does make life a bit more convenient for a diabetic. I would recommend it for anyone who has the ability or opportunity to get one. At least give it a try and if it doesn’t work for you then you can go back to shots.


As we used back in the day,“right on!” :slight_smile:

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Glad it’s working out for you? Which pump did you get?

I’m glad it’s working out for you and you like it so much! Please make sure however that you also carry an insulin pen of fasting acting with pen needles, a syringe and at least one extra inset as well- you can very quickly get into an emergency with a pump if it fails or your insulin/inset fails and then you always have a way to inject. I still inject sometimes when a bolus with the pump isn’t working for whatever reason even when it hasn’t reached the emergency stage. I had two situations where my inset failed and my bg went up very rapidly like a dexcom arrow straight up. I was at home both times but it was still scary, if I had been away it could have been a disaster if I didn’t have my pens etc.

I’m having another situation now where the top button on my pump isn’t working, fortunately I’m having a new one shipped overnight but it won’t get here till Wednesday am. The pump is still functioning in terms of pumping insulin and I have it connected to a phone charger because when I connect the charging cable I can get into the menu to bolus and change my basal settings.

I think I mentioned this in another post here that I’ve also switched to steel needle insets now because I had lots of problems with the plastic cannulas.

I agree, at least at this point, the pump is the best thing going and I have no plans to go back to mdi, even for a day, I would rather be hooked up to the charger as well and manage things this way.

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I carry around emergency insulin and an insulin pen at all times. You already had one bad site—you don’t want that to happen while on the road and not having any backup. I also always correct with a syringe if I have a bad site (and change the infusion set, of course), just to make absolutely sure I’m getting the insulin, because if I’m already super high and spilling ketones, I don’t want to risk having a mishap with the new site (which happens!) and flirting with DKA.

Glad you like the pump! I knew that I had made the right decision within the first 24 hours, when I woke up with a somewhat normal blood sugar as opposed to waking up high (which I did every morning before the pump due to the dawn phenomenon).

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SO glad to hear it’s going this well for you! It’s funny how different we all are. I had such a hard time getting my bg back to where it had been on MDI after switching to a pump. Both my basal and bolus calculations seemed to be way off and it took weeks to get it adjusted right. I think part of why I was ready to throw mine at the wall was because of everything I’d heard about how great it was, and it wasn’t being that great for me! I also found out about 5 weeks in that the reservoirs Medtronic had sent me were under recall for faulty sealing leading to voids in the insulin flow, which explained some of why I was having so many mystery spikes and crazy results.

But it seems like yours is a more typical experience and it’s terrific that it’s going so well for you–it really does give you a lot more control and freedom when you get it all dialed in, and it sounds like you’re well on your way to doing that.

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I snuck up on the right settings by following my doctor’s advice: start low and gradually increase the basals until they are correct, rather than having too-high of a basal, getting low and dealing with that while adjusting everything. It worked well to do it that way. Bottom line is be very conservative in estimating insulin needs via a pump, which are less than on MDI. General advice is start at least 20% lower basals (20% less than total long acting insulin dose per day). If needed, ramp up, a bit at a time.

Once the basals are good, THEN it’s time to fiddle with I:C ratios and ISF.

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I guess I’m lucky to have hit the right basal on the second try (of course I’ll have to make adjustments as my body changes, etc.). I do notice now that my I:C and ISF seem to be set low…but I’m not as concerned with that as I am with my basal rate because I don’t need the pump to do my math for me, I just go right in to normal bolus option and tell it what to give me. I’ll change those settings one day when I get bored and want something to do, LOL.