So, we started my Revel pump this morning. Think I may be off to a rocky start because I'm at 174 right now. I don't typically see high fasting numbers like this, feels kinda crappy right now. I'm just trying to stay with it, of course, do what my pump nurse advises. she'll call me this evening to get blood sugars. She also stated not to do any corrections, initially, for the first few days unless 200+. But, I just used my bolus wizard and did what it told me to do, to do a small correction before lunch to try and get to a better number before I bolus-eat lunch.
What are typical target ranges: she set mine at 100 - 110. Also, anyone care to chime in on what infusion sets you use? I'm thin and decided to use the MIO's, very painless. Nurse also said the sure-t's work well for thin - lean women and typically don't bend and would also be good to use. Any feedback you could provide would be great.
they tend to be conservative with both basal and correction insulin, so it's pretty common to be high for a while until your pump nurse gets around to adjusting rates. I was so irritated I just set my own rates after about a week of being high.
The target ranges help account for slower absorption and for the error in your bs meter. when you put in a bs, the pump calculates how much insulin you "should" have in you, and then (if you are high) will give you insulin to get to your 110. I reset my ranges to 88-98 because I was a little tired of corrections that didn't get the job done.
i use the older "quick sets", they are a lot like mio. I think you could try the silhouette if the mios give you problems.
the pump is a fancy syringe with a computer. if the correction, the carb ratio, and the target is off then you will not get the right dose. I have almost the same breakfast everyday and I know exactly how much insulin I need, so when my silly pump suggested half the insulin I knew the settings were way off.
I bought "Pumping Insulin", and it helped me a lot figuring out how to fix the settings. good luck, in all it was a great choice for me, and the outcome of my first day pumping - 7 years of much better results, and a well tuned pump!
thank you so much, joe. so basically I've stayed at 236 since lunch and I over bolused and corrected for lunch and nothin', BG's not moving only eating a small piece of grilled chicken with 1/2 broccoli and bolused 22 UNITS for it, feels awful and I have ketones. i called my endo, he already readjusted my ISF, she set it at 1:90 when I do 1:40 on MDI's. I know my settings are wrong. Nurse told me it's probably the site. So, I've taken it off, gave myself manual correction and will see her tomorrow to maybe try a different set. I correct anything above 130 typically so to stay at 200+ for nearly 6 hours feels awful. agree, if everything is set incorrectly how does one know, initially, if its a site or settings. I know it's trial and error with this pump stuff but geez.
I agree it was probably the site. Try a new place. my absorption can really vary from place to place.
it's common to use a "little" less insulin but that's what I am talking about. it's okay to override the "suggested" bolus when you know it's wrong - but imo starting out with 50% less it not an experiment,,, it's silly. I started out with what I already knew - my total basal (which I just divided evenly over the day) my carb ratios and my corrections. then it was a matter of tuning. I really got a lot of help from the book. once it's set up it does work pretty good for me - but there are some people that have nothing but bad luck with infusion sets.
thanks again, joe. did your ISF (correction factor) and ICR stay the same when going from MDI's to pump? I don't know why, but she lowered those so much on the pump.
yes. those should be pretty much the same as before you were pumping. the only thing that went down for me was total basal, the idea being that with the pump I can program the right amount of basal and not take "a little too much" to cover me.
I guess your CDE/Nurse/trainer is conservative, just like mine was.