After being on this site I have found myself even more conscious then I was before about everything with my D’s…which is a good thing really! :)Having it for over 25 yrs it becomes a true annoyance to say the least. But I have realized that after being on an insulin pump now for about 3 yrs, I don’t have a back up plan if my insulin pump malfunctioned for any reason!!
I would like to have one now so I’m not panicking and prepared if something ever happens unexpectedly!! I feel a sense of urgency about it now for some reason! But I only use Novolog with my pump and it is the only insulin I have now. I tried Lantus before going on the pump and didn’t really like how it worked with me personally. I was on Humalin and Humalog when I was on MDI before that. But any Lantus I had left or longer acting insulin has since expired obviously. So I’m left wondering what would I do? I don’t have a long acting insulin now as a backup and don’t even know which one would work for me now! Even though it’s only been 3 yrs since being on a pump I don’t even remember what dose I would start on. I feel spoiled already being on the pump! I’ve heard about Levimar and wonder if that would be a good back up for me. Can anyone suggest a good long term insulin besides Lantus that I could ask my DR about to try out as a back up plan? I realize we are all different in how our body works with different types of insulin but I’d like a starting point at least. I’d like to hear some feedback from others before I talk to my DR about it. I may even try a day off the pump after I get a back up long term insulin to see how I do on it before there is an emergency to worry about! Any suggestions would be greatly appreciated!
I wouldn’t know what to do either, because I have a back-up pump. It gives me complete peace of mind. a couple of weeks ago, one of the buttons on my pump wasn’t working well, and I contacted the company, and they sent me a new one the next day. In the meantime, I switched over to my second pump. Here's an older discussion on the same topic. Hope it helps!
Thanks…how do you have a back up pump? I had to return my MM due to the front being worn down which made it hard to read. But it still worked fine so it wasn’t a problem switching to the new one. But I was told if I did not return the old one in time I would owe a huge amount for the old one. I couldn’t afford that! I wish I had a back up pump! You’re lucky! I did read the older discussion you listed Marie before I posted my discussion looking for an answer before I posted this…but thank you! I guess I mainly want to know if there is a particular long acting insulin I could use/ try as a backup along with the Novalog (other than Lantus) if something ever happened that others here have had good results with or anyone has used when they are not using or could not use their pump for any reason at all.
Let’s get some more people on-board this important discussion! I know Dave and Kristin have back-ups that they bought. When you go with my pump (Accu-chek Spirit), it comes with the back-up. Things do happen, so it is important to have a plan.
I’ve got a bottle of Lantus, my rapid, and some syringes for back up. May I ask what didn’t work for you with the Lantus, Stacy? I’ve had a pump failures long ago, and had to take a ton of needle shots every few hours to keep my bg in control, this was before Lantus/Levimer were even around. I’ve never used either of those insulins but would replace my basal with them rather than do the all day needle shot gig. Dave’s worst case idea is probably true unless you live where I live and UPS can’t get up the icy hills in the middle of a winter storm! Even with a back up pump on hand, I’d have some syringes in store so you can get a shot if you should ever need to.
Many insurers will let you get a new pump after 4 years (it’s when the MM warranty expires). When it is time for your new pump, do not send the old one back, keep it as your back up (but take the battery out). The requirement for you to return the old pump is only for warranty replacements. When you (or your insurance company) buy a new one, the old one typically stays yours.
In the meantime, if you have a total pump failure, Dave’s suggestion may be the best. I had a total pump failure a couple of years ago and had to go 36 hours without one. Checked BG every 2 hours (even over night) and took small injections as needed, and did pretty well. Just make sure you have a package of clean syringes around.
Wow Marie…how great that they give you a back up pump! As to your question Karen regarding why I didn’t like Lantus-it just didn’t seem to work well with me for some reason.Maybe we had the wrong dosage for me but my Endo and I carefully worked on the correct dosing once I got on Lantus…maybe I didn’t try it long enough though. I had a really scary low that came on suddenly and I remember feeling like I was dying and barely made it into the kitchen to get something to bring it up and I was home alone at the time! It was horrible. It just felt very different for some reason then any other lows I had in the past yrs. It scared me so bad I just told me Endo at the time I wanted to switch back to my Humalin/Humalog regimen until I finally decided to get the pump which I am thankful I did! It seems like there are more choices in insulins now and I just don’t know what to try now besides the Novolog I use with my pump if I had any issues with the pump. I would just prefer not to have to rely on giving myself continual shots of Novolog if something happened if at all possible even if it was for just a day.
I have this info sheet with my pump supplies , received from my pump nurse a few years ago : ( I have to type every word, since I have no idea how else to get this here ) …it is called " Temporary Removal guidelines "
There maybe times when you need to off the pump : Lack of supplies while away from home, Pump malfunction and a replacement not available , Pump lost or stolen , You want a break from your pump for awhile or even just for a day ,Going for tests or to the hospital where you will not be able to operate the pump.
When you are off the pump , stick as close to your basal/bolus routine as possible. Check blood sugar more often , including during the night , to assess how this is working.
Day time :
if you will be off the pump for less than 24 hours during the day , you need to take rapid-acting insulin every 3 hours . Combine : 3 hours of basal insulin ; your meal bolus, if you eat and your correction bolus , if needed .
Example : stay tuned …rest to follow later …
It is now later !!
At 8.00 am , blood sugar is 14.8, you eat 45 grams of carbs. Your insulin/carb ratio is 1 unit /15 grams , insulin sensitivity factor is 3 , and the basal rate from 8. am to 11.00 am is 0.5 unit/hour
…3 hours of basal insulin is 0.5 x3 = 1.5 u
…Food bolus is 45 grams divided by 15 = 3 u
…Correction bolus is 15-6 divided by 3 = 3 u
This totals 4.5 ( 1.5+3+3) so the insulin dose at 8.00 am to 11.00 am is 4.5 u of rapid -acting insulin by pen or syringe. Another dose is needed in about 3 hours.
Overnight .
There are 2 options for being off the pump overnight :
If long acting insulin is not available , continue to take Rapid-acting insulin every 3 hours overnight , as in the previous " daytime " example.
2 . Take Lantus insulin once a day ( Levimir not av.in Canada , when this protocol was prepared and I understand that originally Lantus was to be one shot daily ??)
use Lantus only if you will be off the pump more than 24 hours . Calculate the total daily basal amount of insulin and take one dose of lantus at bed time or in the morning and then every 24 hours . During the day , take rapid-acting insulin before your meals to cover the carb and correction.
When you are ready to go back on the pump , you should not have your pump deliver basal insulin until 24 hours after the last Lantus dose. If you want to wear your pump earlier , use the pump for your food and correction boluses , but a temporary basal rate of 0.0 u/hour until 24 hours after the last dose of Lantus .
OR
Take NPH insulin at bedtime .
Add up the basal amount of insulin during sleep and give 1.5 times this dose as NPH . During the day , follow the " daytime " example .
Example # 1 : hours of sleep are 10 pm - 6 am . Basal rate during this time 1.0 u/hr
1u/hr x 8 hours =8 u x 1.5 =12 u . The dose of NPH is 12 u at bedtime .
Example # 2 : Hours of sleep are 9 pm-7am .Basal rates during this time are : 0.6 u /hr from 9 pm to midnight , 0.5 u /hr from midnight to 3 am , and 0.7 u /hr from 3 am - 7 am .
Calculate : 0.6u/hr x 3 hours = 1.8 u
0.5 u/hr x 3 hours = 1.5 u
0.7 u /hr x 4 hours = 2.8 u
Total = 6.1 u x1.5 = 9.1 u . The dose is 9 u of NPH at bedtime .
That’s it folks …it reminds me travelling from West Coast Canada to the Netherlands , while on shots …all the math my Doctor and I had to do …and the time zones . Give me a pump and let’s travel is my motto now .
MM will get me a replacement pump pretty quickly and there is a pumper buddy in town , who will loan his spare pump to people at our pumpers support group .
Wow! That’s a lot of information! I think I will need to print that up to have on hand!! I will never remember all that especially how bad my memory is lately!! LOL. I appreciate you posting that! Much Thanks!! :0)
Or how 'bout if those old pump supplies crumble when you open them up. My old pumps wouldn’t use the new res and sets so I don’t keep them around. And I don’t wanna have to keep an eye on ‘obsolete’ supplies on hand. I’ve go enough stuff to keep track of. I donate them so that other folks can use a pump. I’d rather not have it just sitting in a closet if it can help someone. I agree a back up pump would be an awesome thing to have, but it is not always practicle. And Stacey, if NPH works for you then go for it. Also, thanks nel peach for that awesome back up plan - WOW!! The thing to remember is this is a back up plan, it’s to get you by for a short period of time and no matter what plan you choose, it’s gonna be a hassle and a challenge and if you end up with a long night of Novolog shots like Danny suggested you’ll still be okay
Great advice from the pump experts. I’m on MDIs & had a rough time with Lantus also. Changing to Levemir made a world of difference. Lantus had peaks for me. I take two doses of Levemir. One immediately before bed & another as soon as I wake up. Just wanted to add my two cents in case you needed a basal back-up plan.
I know this is somewhat old by now but you got me thinking about it (I’m new to pumping) and I thought about something I didn’t want to post until I verified it would work with my endo. Basically I went to him and after discussing this I had him write me a prescription for Lantus (the long acting I used prior to pumping, although any long acting you prefer should work) and the exact dosage I should take if needed. I filled the RX and put it in the fridge were it will stay in good condition for a year. The dosage is written on the box (Rite Aid does this, I don’t know about other pharmacies) so I don’t have to go from memory if the time comes.
If the pump fails I’ll take a shot of Lantus while I wait for the new pump to arrive. When it does and I get hooked up to it I will set a temp basal of 0 units until the Lantus expires (according to my endo the temp basal should expire one hour before the Lantus does). So if pump fails at 5 pm I call Medtronics, they tell me I’ll have the new one by 10:30 am next day, I take a shot of Lantus and I’m covered until next day at 5 pm. When pump arrives set temp basal to 0 until 4 pm and then I’m back to pumping again like normal.
The only downside I could see with this and my endo too (besides the money Lantus will cost possibly for no reason) is you don’t want to forget to fill that RX again and have the fresh Lantus in the fridge.
Just a thought that might be a bit easier than checking BG every hour and injecting every time.
When I was pumping, mine used to bung up all the time- it seemed- so I always carried syringes on me, including a fresh bottle of Humalog, and kept my bottle of Levemir on me. (I also was on Lantus and it peaked during my sleep cycles and caused some drastic problems) If my pump failed, I’d inject every hour and a half, to mimic the bolus the pump would’ve given me. It was a lot of work, and a lot of bruises, but it got me through some pretty tough nights when my pump just wouldn’t function with me. I had back up tubes, catheter, and carried my insertion spring thingy with me too. My purses are pretty big. haha
I like Pavlos’ idea with just injecting the Levemir/ Lantus once, then calculating the pump to a 0 temp basal 23 hours after the Levemir injection. Seems like I could sleep with that. haha.
I was thinking about it because I know I am not dedicated enough to keep waking up every hour (or staying awake) to check BG. Whatever the plan is I think all pumpers should have one and I find it odd that nobody (pump educator, endo, nurses) thought to tell me about it. You’d think they would cover something serious like that.
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