Struggling with highs on the pump.. looking for help


New here, although I was a heavy reader of this forum for months when I was deciding whether to go on a pump or not. Anyways, I could use some insight/advice/suggestions.

I am a type 1 diabetic (for about 16 years now), 25 years old. I recently went on a pump in Feb of this year (tandem w/ control IQ). I was an insulin pen user for all of my diabetic years. So far, I’ve seen great success with the pump, couldn’t be happier with my choice to transition! However, I am currently struggling with highs (190s-250s) daily, a few times a day. I’m not sure if this is because I am currently working from home and my entire living/eating schedule has been thrown off. I saw much better control when I was physically going to work, where I rarely saw highs or lows.

I’m looking for suggestions, what I should be looking to change first? Basal? Carb ratio? Correction? How long do I go in between changes before I know it is not working and to try something else?

The pattern I’ve seen is that I tend to go high between early afternoon (11:30ish), return to range during mid-late afternoon until about dinner time (4:30ish) and remain in the high range until about 8 at night.

Thanks for any input. My doctor is currently not seeing any patients in-office and unfortunately my Mac does not seem to want to let me download the tandem software so that I could pull up my pumps data on my laptop to try to help me figure this out!

Welcome, @jrd!

I would look at your basal first. While at work you may be more active during the lunch hour, walking more than sitting at your desk and such. You want to increase your basal a few hours before you’re consistently going high. Although, it would be helpful to know if you’re eating differently while at home vs at work? I actually thought though, Control IQ would control all of that? Hmmm.

This site may be of some interest to you. The author is Gary Scheiner, Think Like a Pancreas

In terms of timing, basal rates are usually changed one or two hours prior to an observed rise or fall in the blood sugar, since the rapid acting insulin infused by the pump takes about an hour to peak. For example, if your blood sugar rises between 3 am and 7 am, you would increase the basal rate between 2 am and 6 am.

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I agree with this, assuming you are eating meals/carbs similar to pre-pump days and using same IC ratio in pump settings.

You can try skipping a meal, and see if you still get rise at same time.

I have seen others post that they keep pump on sleep mode all day, and it somehow gives more insulin to correct high numbers during day.

I plan on getting tslim soon.


You might have to increase your basal.
But, do this thoughtfully. Collect data hourly and see what the numbers do (at least 2 hours after you have eaten anything and 4 hours since you took any correction insulin). If they increase, basal up.

I am, personally, eating a lot of war food, which is making my numbers f’ed. I have pounds of dry pancake mix was just laying around. No matter how small the pancake and how large the insulin doses, I go extremely high and get sick.

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Thanks everyone for the suggestions! I appreciate it. I am definitely off of my typical eating schedule, which is for sure impacting my blood sugars. I will start with adjusting my basal! :slight_smile: