Two days on the pump and on a roller coaster

Well, a roller coaster that’s actually just going up. I’m staying high, have changed the basal rate, but because I am scared of getting too high, I haven’t eaten any carbs at all today. Took a walk which always takes me down and I’m still a hundred points higher than when I got up. Any ideas?

I kinda had the same issues my first few days. I just started last Wednesday. I changed my set on schedule and today my blood sugars seem better than before. Try changing you set. I’m not in love with the site my CDE choose. This new site seems to be working well. I am going to have to change my basal and maybe my bolus amounts, but I started on the Dexcom and my CDE wants to see my numbers to make adjustments. Good luck!

Hi Carolyne,

Often when starting on a pump for the first time, the endo/CDE/MD will program in a very conservative basal rate to begin with. This helps keep people from having major hypo experiences when first starting on the pump. I suspect that this might be the case for you right now.

How much different is your total basal for the day vs. the amount of basal insulin you were on on MDI? They will probably differ a little anyway, but if the basal rate that is programmed into your pump is less than about 85-90% of what your MDI basal was, I bet that’s your problem. I would record your BG’s often, and then call your endo to ask if some changes should be made.


There are many variables to consider with your new pump. Have you been working with an endocrinologist or anyone to get you set up at a reasonable starting point? What is your total daily insulin dose? What are your starting basal rates? What is you insulin to carbohydrate ratio? Are you counting the carbs that you eat? Are you keeping a log?

You should not have to compensate by not eating. There are so many moving parts to this equation. I would recommend that you consult with an endo, diabetes educator, or at least the pump trainer to answer these important questions that you have.

Your body will adjust to the pump discipline and your BG number will come down providing your settings are at least in the neighborhood. It’s important to write some of this stuff down so that you can make reasonable adjustments as the days go by.

If you return here with more specific questions you will certainly get better help.

Good luck.

I assumed that if I was eating no carbs that I would not continue to go up given I stayed stable overnight and my basal is constant. My basal dosage is 7 and it was 11 before with a total of about 20-23 a day. I think it might have been low to begin with. I was having lots of lows and was reluctant to up as much as I probably should have… loss of my own insulin production has been increasing since I was diagnosed in July. So… I have a low basal and I think my carb ratio is set too high too so I understand why I would be going high, but with not eating any carbs and continuing to bolus myself for a correction I was really concerned why I wasn’t coming down and still going up. I got out Walsh’s pumping insulin book and found my way to the section on fat and protein causing an increase and I think maybe that’s what’s been happening. I ateno carbs today, egg and bacon at breakfast, a very high fat lemon custard I made this afternoon and it went up about a hundred after a couple of hours, and a few hours later had chicken wings which made it go up again. My endo had told me on Friday that fat and protein do not at all cause an increase. I had noticed, with high fat meals, that my glucose readings would be under 140 at the two hour mark but would be higher after three or four hours, so I thought that was just because it delayed digestion. Now I’m thinking that eating just fat or protein, or fatty protein?, will increase my readings. I gave enough insulin to get down to 150 and was hungry so ate a 15 carb non fat vegetable and grain meal. I’m about the same after two hours. Who’s right? Walsh or my Endo?
Thanks so much for your support. It makes a big difference.

  1. Patience.

  2. If you haven’t bought John Walsh’s “Pumping Insulin”, run, don’t walk, to your nearest bookstore or and order it now. It’s will be your bible.

  3. Work on getting your bg down to an acceptable range, then start your basal testing.

  4. It takes time to get things steady with any new venture. Pumping is not a magic bullet, it still requires work and attention, but I think you’ll find it more convenient that MDI in the long run.

Keep up the good work,


Yep, fat & protein effect BG though at a slower rate than carbs. I eat low carb, which means higher protein & fat. Took a lot of tweaking to time bolus right, not that I’m there yet.

Frustrating that an endo wouldn’t know this! About 58% of pure protein turns to glucose. Fat turns to glucose as well, but not it’s as not significant an amount as protein. The issue with fat is that it slows down digestion.

Ditto on this suggestion - I’ve had this happen a couple of times.

Good information, thank you. It’s so confusing… just dealing with the whole carb ratio thing is like playing a game of chess before every meal but with the protein and fat component it becomes three dimensional chess with a much smarter opponent than myself! I’ve been working with your advice and it has been very, very helpful. Also, I am going it completely alone, without the “diabetes educator” that comes with the pump. I just have to put in the time… and more time… and more time…I just read in a scientific journal that protein requires insulin to metabolize, but it does not raise the blood glucose. Same for fat, so perhaps the insulin is just “busy”, and takes longer to bring the glucose down for that reason, while it is dissipating at the same time, hence more is required. So the TAG approach may work for that reason, or am I overcomplicating things now?

Change your site! Manually inject useing your slideing scale. The cath (the peice that goes into you) gets cripped sometimes and you wont get insulin or you wont get the amount you should. Also, check for air in the tube, you might be pumping air.