What prep did you do when preparing to switch from MDI to a pump? My CDE has me logging everything–pre & post meal BG, exercise (type, duration, intensity). I weigh/ measure & log the carbs in every bite of food, tally total insulin taken for the day, note stress level. Have others followed this same method to transition to a pump? I’m really curious as to what others did to switch from MDI to a pump.
Gosh no lol…but I did have an endo and her NP that were both type 1’s!!!
I did no prep, I got sent the pump in the mail and was set up with a training session by an Omnipod person on how to use it. But I had the directions that were sent with it and set it up before the training session. The trainer came with settings from my endo, but I liked mine better so I kept them instead. The trainer was helpful because while I read the manual and did the settings there were a couple of things I didn’t think of in some of the settings. Plus filling the pod, actually inserting the first pod, etc was nice to have someone to show me.
But lol, everything else it was assumed I already knew from being on MDI for a while. But like I said she was a type 1 herself so probably a lot more knowledgeable about our world and knew I was already independent in my own handling of my diabetes.
Having CGM before the transition makes it easier. We logged carbs and insulin in the Dexcom app for a few weeks before pump start, that way everything was available in Clarity reports, and you can see exactly the results of every bolus and bite of food. Patterns of highs and lows stand out, and every night’s readings is effectively a fasting basal test. Like @Marie20, our CDE provided the trainer with some suggested doses as a start point, to which we basically said “thanks…but no thanks”.
I had the CGM for 3 months prior to switching the pump so I was used to logging everything in the Dexcom app as well. I also had used MySugr for several years before getting the CGM.
The more you understand YOUR diabetes and how to best manage it the better prepared you will be for using the pump. Not sure if you are using basal and bolus insulins, but I use about 40% less insulin daily on the pump than I did on MDI.
Just have a clear understanding of the basal and bolus rates the CDE sets up for you and know how to change them.
I don’t think I had to do much beforehand. Luckily, I think my insurance just needed blood sugar logs.
My endo and CDE knew I could carb count and dose accordingly and didn’t make me “prove” it before allowing a pump, like some providers do. We just used my TDD as a jumping off point and adjusted accordingly - I did need to keep track of the things you listed after the fact to dial in my settings, though.
Hopefully all the work you’re putting in beforehand will make for a smooth transition!
I was diagnosed T1 almost 62 years ago and have been on a DexCom cgm for over 9 years (I have a G5 now). Current CDE looks at that data in Clarity–watches trends, but requires all the paper logging. For carbs, I’m logging amount & carbs of each food, so more detail than what can be entered in cgm. I’ve been counting carbs for many years–took a carb counting quiz with a dietitian recently—scored 85%—the question I missed was for a food I don’t eat! As for insulin logging, am using correction and dosing for carbs—CDE wants to see those 2 separate
numbers, so has to be on paper.
I was diagnosed Type 1 almost 62 years ago. I have a DexCom G5. I’m still unsure how all this logging (other than the carb counting and insulin dosing) will help with the transition to a pump. The CDE’s format is that after I receive my pump, there will be more classes on how to use the pump. From others’ responses to my post so far, my path to a pump is a little longer. Am hoping getting on a pump will enhance my life a lot.
Which pump are you getting?
There are online videos and user manuals for most pumps. You could review some of them before your CDE training.
The basics are getting familiar with the pump menus, and where to do what. Then entering certain settings that are specific to you.
I had to log my numbers to prove everything for the VA to authorize a pump. But it was easy to do.
My only initial concern was how to transition my basal correctly over to a pump from long acting. That was easy. And I adjusted my numbers myself pretty fast to make my numbers pretty stable.
I started my X2 pump the same time as my G5, so it was an easy switch.
I actually had the pump, G6, etc. all hooked up and running when I went to see my Endo for ‘training’. She just reiterated a few things, offered a few points of advice on how to fine tune it. Easy peasy.
I transitioned from MDI to a pump back when I was a Joslin patient, and they had a very structured process you had to go through. I was able to skip the carb-counting bit since I was already doing that, but there was other stuff about determining basal rates, just learning how to operate the pump and its accoutrements of reservoirs, infusion sets etc. Some of it was useful—they had a great program around choosing which pump you wanted to use, with all the various makers sending reps and pumps to demonstrate. But like any education program that serves a broad range of abilities, a lot of it was below my level and not particularly helpful. Had to go through it anyway.
Biggest pain for me: they were very hands-on, and very conservative about getting my settings adjusted. The medicos are always going to be way more hypo-shy than hyper-shy about this stuff, and after several weeks the incrementalism finally got too frustrating for me and I started tweaking everything myself. In the end I was happy I’d made the switch to pumping, but it took a lot longer than I’d been led to believe to get back to, let alone, surpass where I’d been on MDI. If I’d had a CGM this would have all been much speedier and easier, but I didn’t get one until I’d been pumping for three years or so.
On the most basic level, it allows you to more closely model what a real pancreas does by allowing you to make your basal rates and other parameters conform more closely to how your metabolism is changing throughout the day. It also gives you the ability to turn OFF your basal flow at need, something you can’t do with a daily injection. And I found it was the only thing that finally let me get control of Dawn Phenomenon, by setting a much more aggressive early a.m. basal rate in anticipation of it.
There is a tradeoff, in that it’s a more complicated system with more failure points than you face with just syringes/injectors and insulin. I know some people who just prefer that simplicity over whatever advantages pumping offers. But for me, I definitely prefer the flexibility of pumping over MDI and wouldn’t go back unless I were forced to for some reason.
Tandem t-slim—will add basal IQ when Medicare approves DexCom G6. I’ll check out the videos–thanks!
Nice to know your transition to pump went smoothly! I have talked with my CDE about the transition from MDI basal to a pump—her response was something about it not being as straightforward as you indicated (I like your answer!) Am looking forward to being on a pump, hoping it will simplify things somewhat. Am just currently tired of all the paper logging!
I did end up needing less insulin on a pump, pretty soon I started tweaking my basals and dropped it 25% pretty quickly to now I am using about half, or even less than when I was on MDI.
It just really allows you to get a handle on what you need when. And it’s a lot easier along with a CGM to give yourself small correction doses and split doses etc.
I have a DexCom G5. CDE looks at the data in Clarity for trends; hasn’t suggested using the cgm to track insulin and carbs (I know how to do that). I appreciate the detail of BG, carbs & insulin combined, just wanted to know if others had followed this same route to a pump.