Treatment holiday?

I’ve had T1 for 16 years and I’ve grown increasingly annoyed with the treatment. I’ve been on a pump for many years and recently changed to the medtronic 670G, hoping it would make the treatment more bearable. It hasn’t. I have more and more trouble controlling my blood sugar the longer I have the disease. I have been toying with the idea of taking a “holiday” from treament, i.e., not taking insulin for as long as possible. For example, when it comes time to change my infusion set, I would go the following 8 hours before changing it out/taking insulin. Has anyone else tried a “holiday” from diabetes, even for a short period, like 1/3 of a day? Please tell me about your experience or thoughts on this idea.

My son has had pump problems where his canula loses it. Within 2 hours, he starts on an inexorable upwards trend, and reaches 350-400 in the next 3-4 hours. When he is there, it takes hours to bring him down, and we have to test for ketones every 30 minutes.

I don’t know how long it would take you to get there—but I wouldn’t risk it. DKA is right around the corner at these levels.

[EDIT] You could engineer a 3-hour respite by injecting a medium-size bolus right before disconnecting, then setting an alarm for three hours later. That would work. You would also have to inject another bolus right when you reconnect. We do that often for sports practices.

That is an awful idea.

Look, I have thought of it form time to time in my 20’s and Lord knows I am so glad I did not. Please you must not do this. Why? First it is very dangerous, yes you can die and of you don’t you will no doubt feel awful. Second you will use much more insulin bringing your blood sugar under control, than if you had just managed it correctly int eh first place

Hey I hate Diabetes. But we have so much to live for if nothing else live your life to beat this damn devil.

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The idea of a respite is good. I would like to do some competitive road cycling this year, and there isn’t a good place to attach the pump. I could see how I might do that in everyday life, too. Generally, time away from this crap is what I am looking for. Thank you.

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Hey, Rphil2, thanks for the response. Here’s the problem: my BG is all over the place. I frequently have lows in the 40s and 50s, and also highs in the 300s and 400s. I go to Joslin - supposedly the premier T1 clinic in the US. They aren’t helping. The treatment doesn’t work. And it’s ruining my life. Something has to give.

Be careful about IOB when doing a hard aerobic activity, though, you might plunge fast :slight_smile:

FYI, when swimming a hard swim practice, my son actually stops his basal 45 minutes before practice, then turns it back on 20 minutes before the end. He also boluses up to 1 hour’s worth of basal right as he restarts his basal, depending upon how long he was suspended.

For insulin and sports, you should ask @Eric2, he is the specialist.



I get. i really do. I had a long of period of a rocky relationship with diabetes. I abused myself in other ways but it was abuse none the less.

My best advice is that I had to come grips with one fact. No doctor or clinic can or could manage my diabetes. Only I could do that. I challenge you to educate yourself a bit more, being a member here is a great start, test more, consider the tools available (a CGM is the tool I have).

I wish you the very best. Drop me a note if I can help in any way. But around here I am not unique we all feel the same and want to help if we can.

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Unfortunately for you, me and everyone else here, there is no time away.

I’m on my diabetes every two to three hours whether is a shot, a bs check or eating something.

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Losing your pump for 8 hours will cause your bg to rise (roughly) by 600. This is a VERY rough rule of thumb based on “rule of 1700”. If you didn’t eat anything for several hours before those 8 hours, and didn’t eat during those 8 hours, the rise might be only 300. There’s a very real risk of DKA whether you eat or not.

I think what you really want is a “pump holiday” where you switch to basal/bolus insulin by MDI. Or at the very least basal. Lantus has a nominal 24 hour absorption curve so it doesn’t start and stop on a dime - not bad for a week-long pump holiday but hard to account for in a 8-hour pump holiday. Good old regular or NPH might be a better choice for 8 hours.

So seriously think about a week-long (or longer) “pump holiday” where you switch to MDI. You may or may not already have some MDI supplies? I go for 12-14 hours at a time between my evening shot and my next morning shot. I would usually check my bg 2 or 3 or 4 times in those 14 hours but I’m sure there are occasional situations where I felt pretty confident and didn’t check it at all. AKA "inertial navigation :slight_smile:

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All of the previous replies were right on the money. It is a really bad idea to stay off of insulin for as long as the original poster is contemplating. If they want a vacation from the pump than they should use insulin pens and use long-acting and short-acting Insulin. I did that for an entire year a few years back because I wanted to lose weight and I knew that a small component of the reason I wasn’t at my desired weight was because of how simple it is to bolus using a pump. My Method worked I lost the amount of weight that I wanted to and then I went back on a pump. Then I wondered why I even opted to stay off of my pump for a whole year because my overnight blood sugars were not in my desired range. I don’t think I will ever do such a thing again ever in my life.

Sometimes you just need to change up your treatment regimen to keep your sanity. I was on a pump non-stop for 11 years and decided to try MDI because I was having infusion set/site problems and wanted to try something different. I wouldn’t say it’s better or worse, but it’s nice at times not to be attached to something and not to worry about whether my site is working and maybe that’s what you need. The basal insulins today are much better than when pumps were first developed. Insulin pens can dose in half-units which makes things easier too.

How long have you been on the 670G? I have heard that many of those who were pump users before have a hard time transitioning because part of the process is allowing the CGM/pump to get to know you.

So, at first, your control will NOT be as good. If you’re used to micro-managing, the auto mode at first will drive you crazy. If it’s been two or three months, talk to your endo/CDE/Medtronic. If it’s been less time than that, I’d say allow the auto mode a chance to figure you out.

It took me more than a month or two to figure myself out on shots and pump!

(BTW, I am NOT on the 670G, but have heard very similar gripes from other 670G users).

I’ve been on the Medtronic pump for a few months, but will only start CGM on Wednesday, and then “auto-mode” in a couple of weeks. This pump is more annoying than my last pump (Animas), and I have heard similar gripes to what you outline about the system. However, I am so fed up with my treatment and want to try something else, and what is there? This is supposedly state-of-art and wonderful and awesome, but I expect more of the same. It’s still insulin, and the disease will still have a mind of its own. Perhaps I will have less hypos.

Hi Scott_Eric. MDI or pump, it’s still insulin, which I loathe. I went on the pump b/c I can’t stick to an eating schedule. That is the only problem the pump solves, but then it comes with new problems, like being attached to a machine 24/7, having everyone know you have diabetes, infusion site discomfort, etc. And the hypos/highs still happen. Basically, insulin therapy sucks, and it apparently just gets worse over time. My best days as a diabetic were in the first few months after diagnosis.

You know what else really pisses me off? My doctor at Joslin said that he and his colleagues view a super smart pump as a “cure.” They aren’t even aiming for a cure where we don’t have to test, wear a device or worry about BG. Anyone hoping for a cure is apparently deluding themselves b/c the experts don’t anticipate it happening.

I agree, diabetes blows and the treatment isn’t anywhere near as good as it should be by now. If you want to get off your pump though you should know there is no need to eat to a schedule on MDI anymore - if there was I wouldn’t dare try it. The modern basal insulins (Tresiba, Levemir or Lantus) last from 12 to 24 or more hours on a single dose and do not have sharp peaks that require you to eat a meal at certain times. I am not saying they are as good as a pump basal since they are not as adjustable throughout the day, but a lot has changed since the days of NPH and Regular.

I think what everyone has lost site of is that infusing insulin subcutaneously is part of the problem of why diabetes is so hard to treat. I was reading about the implantable insulin pump once and how great it was because it delivered insulin directly to the portal vein just how insulin is naturally delivered from the pancreas. It’s disappointing to me that Medtronic stalled and cancelled development soon after buying MiniMed, and that no company seems to be researching this.


Ah, it’s nice to see that I’m not the only one aware of how problematic subQ infusion of insulin is. I never see anyone discuss this most obvious issue when discussions appear regarding so-called “smart pumps”, or “closed-loop (BS) pumps”, or the worst, “artificial pancreas”. All of those terms make me want to yell at the screen, as there is no way subQ infusion is going to allow for true closed-loop operation; at least none that is safe and effective. Marketing types would have diabetics believe that a closed-loop pump is just around the corner, and to top it off, MM keeps applying the hype to each successive model number, despite the fact that there’s very little difference in infusion between the latest model and the 551. Sure, they tout how the pump can suspend when it gets a low-glucose reading from the sensor, but IMO those MM sensors aren’t even accurate enough to trust, and simply suspending isn’t going to get you out of a low anyway. What you need is to eat some carbs! Suspending is great for periods of activity, but once you are in the throes of a low, suspending is essentially worthless. I’ve read so many complaints from users of the 670 that the AUTO MODE is more of a PITA than just using the pump in manual mode. Doesn’t surprise me one bit! (And MM calls that model a “Hybrid Closed Loop” pump. I call BS).

You want to do TRUE closed loop, you better think about delivering insulin directly into the bloodstream. And you better think about having such a system be hooked to a totally accurate, failsafe (redundancy built in) glucose sensor. No margin for error.


Ahh, trust me you will get no where on a road course with a blood sugar of 300. You might get down the road a few miles, but sustained road work? It will not happen. If you want to do road work on a bicycle get your blood sugar in good shape. The most competitive type 1 I know who rides a bike in AZ, does 100 miles on most Sundays and 50 miles every other day all winter and summer. She has RA and is a nurse as well.

I cannot do that not even close. She keeps her blood sugar at 100 and it rarely moves ±10 points all day. She wears a pump and calibrates insulin based on several dozen factors. How does she do it besides the pump? She does it by knowing her diabetes inside and out. Trust me when I say no doctor taught her that.

Best idea? Know the carbs you eat, and what your ratio should be, test more than you think you should, and keep track of it all then share facts not generalities with your your doctor. You cannot accomplish in 20 minutes in front of even the best doctor what you need to know to be successful.

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Diabetes doesn’t work that way for me, Rphil2. I frequently eat a standard lunch so I know the carbs, and the theoretical amount of insulin to take. Except the amount of insulin that works one day will be too much the next; and too little the day after that. It drives me crazy. If it were simply a case of finding the right I:C ratio, I would have found it years ago and wouldn’t be here complaining about it. For me, controlling diabetes is a myth. I can only react to it. And even then, when I have a high, sometimes my correction factor will work just right; sometimes it won’t be enough; and sometimes it will be too much. There is no rhyme or reason. This is why I frequently feel like quitting.

Try it. You don’t make insulin and you can’t live without it. So if you stop taking insulin, you won’t live. But that is absolutely your choice. If you make that choice please call 1-800-273-8255.

There’s no control. But learning how much insulin you need when you need to manage better is possible. You sound like you just don’t want to. And that’s a pretty normal reaction when we do everything we think we need to and it doesn’t work.

A happy medium might be to take your basal insulin as a one time a day shot and use the pump for your basal insulin for a while. It works for some.

Talk to someone - either a professional or a spiritual leader. A mindset change will likely help more than any of us can. I wish there was a way to take a break but as above, without insulin, a break could be permanent. Before you make the choice to take a break, please call 1-800-273-8255. Someone will pick up the phone.