Question about Bolus

Hi, I am new to this site. I have been having a question go unanswered by my Dr. and Medtronics. I am interested to know if other people have this problem or if it is just me.
My dr. set up my bolus or as I call it background insulin to 9 units when I go to Utilities, then to daily totals then check on totals for any given day I find that I some times don’t always get the 9 units that was set up. I can’t seem to get an answer as to why. I have the paradigm 515. I have been on the pump for 3 years and this is my third pump. I am starting to second guess it and I am thinking about changing to another brand. I don’t feel I am getting the support that I feel I should be getting from my Dr. or the people at medtronics. Any body else have this problem and I am wondering if this would be a reason for weird BG readings.

hi Grandma,
hmmm, I am confused too. do you mean bolus or basal? Bolus is usually not called background insulin. Bolus is the type of infusion if your bs is a little high (correction bolus) or if you are going to eat (meal bolus). The pump gives you a bolus immediately, so if you set it for 9 - you get 9 unless you suspend during the bolus.

basal is sometimes called background insulin. you set it up for units per hour, you set the start time and how many units per hour. I have 4 different basal settings that change during the day and night.

if my basal, or background insulin is 17.5 units per day, I may or may not get that whole amount. The biggest reason for not getting 17.5 is because I “suspend” when I shower or if I am really low. The amount of time I suspend will change my total basal (background) insulin I get over 24 hours. I also use temporary basal rates for strenuous activity, that also changes my total basal for the day.

wierd bg readings can be caused by almost anything.

I hope this helps a little!!!


Thanks Joe you are right I didn’t mean bolus. But anyway everything has been checked out and still no reason for the difference. I think that I said that this is my third pump in three years and I am thinking of changing to something else. I have changed Drs. and I now go to a Diabetic group in Rochester. I have called them and asked about a different pump, but I don’t think they are going to back me. They are a strong Medtronic user. I guess I will have to see. I have been looking up and getting information on other pumps. I have nailed one down yet. I guess that is another reason why I found this site. I need to hear what other people have and how they work and how the companies are to work with too.
I have a busy life and do try hard to keep myself in check. We have a garden and I can many things. I am always looking for a better way to eat and keep a close eye on my diabetes. Maybe I think about it to much.
Anyway Thanks for your reply It is nice to know that I am not alone.

I suggest that you meet with a diabetic educator. They are trained to deal with these intricate pump settings that a regular doctor or endocrinologist is not. Your total daily dosages that you’re looking at in the paradigm’s history are factoring in the different amounts you are taking for the food you eat and the high blood sugars you correct, too, so the different daily totals are going to differ. Your basal rate should be delivering just fine. I’ve never heard of a pump not delivering your basal insulin. That would be a major malfunction and your pump would be telling you during the day that it was unable to continue delivery. It’s essentially the pump’s most important job!

I suggest you talk to someone at Minimed about using their online software called “Carelink.” They allow you to “upload” all of your pump information and history with a data cable that plugs into your computer. There, you can see what percentage of your insulin each day was devoted to basal rates and what percentage went to bolusing. I think it’s your best bet.

From the way you describe what’s going on, my first guess would be that there are a lot of features you don’t yet understand about your current pump or even pumping in general. I’m not sure I would encourage you to jump ship with your Minimed just yet. I believe that a single meeting with a diabetes educator nurse would teach you what you need to know about your pump’s features and how to read its data. You should also check out the book “Pumping Insulin” by John Walsh. It’s amazing. I’ve pumped a long time and learn new things every time I pick it up.

Minimed is certainly not your only option (Accucheck, Omnipod, Cozmo, and Animas being your other pump options) and while some people love MM, others have complaints about their customer support (I’m one of 'em). But they do have the most widespread use and are generally great pumps for new pump users. I spent my first 8 years on a Minimed (4 of them on your pump!) and am now on a Cozmo 1800. The Minimed’s features are very simple and it sounds to me like you may need to better understand its components before you go to one of the newer, more advanced, feature-rich pumps offered by either Minimed or the other pump companies. I think that your doctor is leaving you in the dark about some of your pump’s basic functions and you deserve more support. The John Walsh book, an educator visit, and a phone call to Minimed’s 24 hour customer support regarding Carelink will probably help you.

Best of luck!

I think nobody explained it to you. Under Utilities, Daily Totals, the amount of basal show is the total delivered, not the total programmed. If I Suspend my pump, even for a minute, the total delivered will be different than the total programmed.

example (I program 17.5 units per day basal) here’s what’s in my pump memory

27 SEP 17.05
26 SEP 17.14
25 SEP 17.0

and it’s because I suspend my pump before my shower, when I should be getting 1.0 unit per hour! (OMG I guess you can figure out how long my showers are!) =)

anyway there is nothing wrong with your pump!

Thanks Joe,
but I never suspend my pump. Sometimes my amount daily is 9 sometimes less. Sometimes it is different every 2 days and then maybe it will go for 5 or 9 then my total programed is less. Since I don’t suspend my pump to shower or whatever I am thinking that I should get the set amount. I was thinking that it had something to do with removing my pump to change which I do every 3 days. But for what I am seeing that isn’t always the case because sometimes I go 5 to 9 days without a problem. In case that you are wondering why I don’t suspend my pump well I guess that is because that is what my trainer said to do. I also believe that more training on my pump would help out too. I was trained on my pump for about 1-2 hours. I was told that I could work with that for a while then I could come back in for more. That has never happened. This was part of my reason for changing Drs. I am now going to a center in Rochester. I think that in time I will get caught up on what I should have gotten in the beginning. I wish I could have gotten into the Joslin center in Syracuse. That would have been closer. But there was a wait time of 4 mos. to see if they would take me and then I was told another 4 mos. wait time to be seen. 8 mos. is a long time. So I made the call to Rochester and within a 2 week time I got in. So maybe more training is the key. I need to learn to trust the pump more.

Thanks I will check out that book. As far as changing to something different well I guess I am just looking out there to see what is new. I am happy with the freedom that a pump has given me. But when I go back to the Drs. on the 1st. of Oct. I am going to ask about a different inserter. I use the quick set. I have a problem with my hand/ fingers so I am sure there must be something that can make that part easier. I am fine if I have a problem and my husband is here to help, but many times I am alone so that is top on my list of things to take care of. I am sure as time or years go by I will only have more troubles with this. I know what a cry baby. I am lucky that I have what I do. By the way I do use Carelink and download to take these things to my Dr. Its a great tool to help you see what you are doing. My insulin intake is at about 50% Basal 50% Bolus give or take.

how interesting… I am running out of ideas… okay so you absolutely never suspend or take your pump off.

do you ever use temporary basal rates, or basal patterns? just out of curiousity, what is your basal rate programmed for, you can go to (from the main menu) Basal, Basal Rieview and see what your standard pattern total is currently set for. I know you said 9, but is that what’s on your standard pattern right now?

hey don’t worry too much about learning the pump, you already seem to know more than most people who have them =)

Maybe you are looking at your daily total, which includes basal and bolus, or you are looking at your bolus history instead of your basal. I’m with the others, you need to get some more thorough training. Sounds like an endo. who knows the pump would be good too.

I have a MM 722 and under daily totals I do not have a daily total for just basal alone. I have an average daily total that tells my total insulin, averege bg readings, sensor average and my percent for basal/bolus but I do not have one for just basal alone.

Cody I have a MM 515. Go to Utilities, then Daily totals, then any day then next screen is BG low/high now arrow down this screen is Basal ? and Bolus ? and Carbs ?. In checking mine for yesterday my Basal says 8.90 I didn’t suspend so I am thinking that my number should be 9 as set by DR. Maybe your MM722 is different than mine.

I don’t use a temp basal rate, and I don’t suspend but I do remove my pump. When I go to the main menu it is set for standard 9.00 and that is what I am on. I am hoping that when I go to the Dr. on the 1st of Oct. somebody there can answer me. At least I can show them first hand. I am going to take my print outs I downloaded from carelink. Hopefully I can find out what is up. Just this week I ran into another pumper at the hospital shes a nurse so I asked her if she has noticed this. She checked in front of me and hers doesn’t do this. So I am stuck. My numbers sometimes are unexplainable and they seem to be around the day that my basal is less. I know that the difference isn’t much but I wonder if it would make that much of a change to affect my BG. Leave it to me.

I have a 522 and I am a data freak. I use CGM and watch all of my numbers. For me, most of the time my basal is consistent except for when I do a temp basal. There are a few occasions where I will notice that instead of getting 17 units I get 16.9 or 16.8 without doing a temp basal that day. This being said I am wondering why you are focusing on this so much? Are the numbers glaring like you are missing a full 2 units or maybe even just 1 unit? If that is the case then I would be doing exactly what you are doing, trying to find out what the heck is going on. Personally, with the variability of food intake, carb counting and bolus amount, missing .01 or .02 units of basal insulin over the course of a day is not likely to have a huge impact on your BG numbers.

To really see what is going on all of this data really needs to be uploaded to Carelink. Then call your Medtronic nurse and have her take a look at your Carelink info. I have done this several times and it is very helpful.