I w wondering how you calculate your basal rates on your pump. Im getting back on the pump soon and would like to know. Im on MDI right now but I still go by the setting from my old pump as far as my meals go. I took the classes for the pump 3yrs ago so I don’t know if they’ll make me take them again. Just wondering if anyone knew how to do it?
The way we did it was (I believe) as follows:
First, we took my typical TDD, reduced it by 20%, divided in half to come up with my basal amount, and then calculated my initial basal rate so that my basal insulin was divided evenly across 24 hours (I think this worked out to an initial basal rate of 0.225 u/H.
From there, I stalked my blood sugars and adjusted my basal rates accordingly to account for different highs and lows. For example, we pretty quickly noticed a huge spike around late morning. I was able to reduce much of this spike by programming my pump to increase my basal rate about an hour before I typically saw that spike. I later also had to program my pump to deliver a different I:C ratio for morning meals.
Some people do traditional basal testing where they fast for a period of time and check their blood sugar frequently to see if their basal setting for that time of day is working. I have had a really hard time doing this and have found it easier to just review my data and make adjustments accordingly.
Have you started yet? I would try 80% of your current Lantus/Levemir dose and tweak from there. Do you remember from when you pumped before if you had a higher rate to cover dawn phenomenon?
I agree with the above, although not all of us match up with the 50/50 basal and bolus. With a reduction of about 20% from your MDI basal, just divide it by 24 hours for an hourly rate, then start tracking your "in between numbers" - blood sugars on waking, before meals and at bedtime - and seeing where you have a pattern of highs or lows and then tweak it a small amount and see how that works for a few days. I always keep a good record of changes. I think very few of us have the same basal rates 24 hours but it's a place to start.
You say you "go by the settings from your old pump" for your meals. I don't know how long ago it was you were on the pump before, but especially if it's been awhile, you are better just sticking to the I:C ratios you currently use on MDI. Unlike basal, they don't necessarily change by much from MDI to pump and your old pump numbers might be dated.
I also want to suggest you get Pumping Insulin by John Walsh as it's great for helping you with everything pump related.
Thank youI did get the Pumping Insulin book by Walsh n did the example in the book and i think i got it but I w go over it with my Endo also and see what he thinks. I just dont want to take insulin management class thats 4 weeks(one class a week) before i start on my pump again. The Pumping Insulin makes it very easy to figure out though.
Yes, having used a pump before, you should be good to go with Pumping Insulin and your pump manual. Also if you haven't already, join the group for your pump (I think you were getting the minimed) because then you can ask questions that might come up specific to that pump.
for me, it was mostly trial and error. i started on the pump 11 yrs ago, and my I:C ratio
was 1 unit per 10 grms. now, yrs and yrs ltr, my ratio has changed. i now have 3 settings on my pump for my I:C ratio. i just kept meticulous track of everything i put in my mouth and every carb i stared at. i wrote down my daily well-being, what i had ate, and checked my BS every 2 - 4 hours after meals.
good luck and best wishes,