Switch from MDI to Pumping

Hi guys!

After many years with MDI, I’ve decided it was time to give a try to pumping. I’ll start pumping in a few days. I had a hard time convincing my diabetologist to make the jump since my last HB1AC with MDI (Humalog and Lantus) was 5.9. I have been told that with a well-balanced diabetes the switch to a pump is straightforward. Is that true? I currently have a TDD of 56 units (25 of Lantus and 31 of Humalog). I’ve also been told that I should start pumping with the same doses (25 units for the daily basal and 31 for boluses). Do u reckon these are the most appropriate dosages to begin with? How much time does it take to get BGs back in the normal range and have stable results?

Cheers!

Jerome

Jerome

my 9 year old daughter just went on the pump. She was diagnosed in February 08 so we are not experts. When Milly started they reduced her TDD by 20%. What a waste of time that was I wish someone had said just go straight onto your existing doses and make your basal the same as your lantus at about 50/50. It would have saved us the 3 days messing around with different rates.

We also had problems with the infusion sets for the first week. Nobody told us about that problem until we went to an advance pump class. Everyone there (children) were putting it on or above their rump. No problems since then and now that we are more relaxed have been able to do some back on the abdomen. We did 9 set changes in the first week. There are lots of people out there who have problems with sets to begin with.

Overall we settled down after about a week and good since then. Our average BGL is now about 7.1.

I am a 37 yr vet but still learning everyday I went on the pump feb 07 a1c in mid 7s to mid 8s. basal started at 80% of lantus and humalog droped by 10% I ended up going from about 125 u per day to between 30 and 45 depending on how much exerise and ccarbs I ate. I love my pump and the the freedom it gives me as well as best control in my life. last a1c 6.4
Good luck with your new adventure

I did MDI for 15 years before switching to the pump. I’ve been pumping for almost a month now and I love it. We started out with trying to use the same amount of insulin that I was on before but quickly realized that I needed a little bit more for my basal rate during the day. Since I took my lantus shot at night, if I took too much I would bottom out in the middle of the night, but then was going high in the afternoons, so we started with what I was taking before the pump and then went from there. I’m now taking about 2 more units a day for my basal rate than I was with the lantus and my body seems to like that. As for stabilizing back out…it took about a week. And some sites do worse than others. I found that my rear is the best place for me. I have a few spots on my abdomen that work alright, but I can’t always put them there because they get sore much more easily.

Hope this answers some of your questions!

I went from 12-14 units of Levemir a day to a total of about 13 units of basal a day - however, my Levemir did not deal with my dawn phenomenon and my pump does. I originally started off at 9.6u/day but had to change my morning basal so I didn’t have to eat right away. Ergo, my doc started me at about 80% of my MDI basal. I went from an IC ratio of 1:15 to 1:25 and a sensitivity factor of 1:50 to 1:75. Both of those have stayed the same ever since I started pumping.

I was on about 60 units of Lantus for basal and since I started pumping my basal is around 42 units a day. My pump trainer told me that I should be about 50/50 with basal and boluses. I am about 60/40 which she said is good. I have only been pumping since April but my A1c is down to 5.4 from 7 it used to be.