Untethering

There is no way to set an indefinite zero basal on the Animas pumps. Never tried setting one of the 4 Weekday settings all to zero. Does that work? Don’t want to mess around with my Ping to try it. I find that one of the most useful things about an insulin pump is the ability to customize the basal function. Wouldn’t do without it.

The idea of being UNTETHERED is that you can remove the pump for parts of the day or week. So you take a long acting basal by injection, and use pump for just bolus, or bolus and part basal.

It’s not used often, but for some it is a good option, sometimes for short term before returning to full time pumping.

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I am an adult, and use a modified untethered regime. I have 75% of my basal as Lantus, the rest via the pump, for flexibility , and obviously boluses via the pump.
I need to be off pump for up to 4 hours at a time for aikido training, which is why I use this.
Occasionally I forget my Lantus, particularly when I’m working nights, so leave my original settings in my pump as basal A, so it’s a really quick change back if I completely forget my Lantus.
Sometimes when I’m stubbornly high (hormones🙄), instead of endless ineffective boluses, I’ll simply bump my basal rate up to 2u/h for a couple of hours. That seems to work better for some reason. Or use a pen. That is quite effective too.

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I fully comprehend both the word and the concept of UNTETHERED. I untether for an hour for my daily shower. No problem. I also untether at my periodic visit to my CDE so she can download the information on my pump. So untethering for a defined period of time such as 4 hours is possible. What I doubt is that one can untether for a prolonged period such as a week or indefinitely and use the pump only for bolus. That would require one to remain tethered. Or do you tether and untether repeatedly for bolusing? Personally, I would not want the added confusion of different dosages and methods of insulin application. But that’s just me. In my view, simplicity and consistency of regimen is most desirable when managing diabetes in an adolescent, especially when hormonal activity is on the increase. But, again, that’s just me…

I would just call that disconnecting.

UNtethered is often used to describe an intentional plan of extended times on and off pump, and including injected insulin as part of the plan.

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The percentage of basal to be given by injection versus the pump would have to be your decision based on how much she will be disconnected from the pump. Like @Terry4 I believe that you need to keep some basal running in the pump.

Ultimately it is a science experiment. I have used untethered with 50% of my basal coming from injections and also done it with 80% coming from injections. But I have never done it with the aim of being completely disconnected from the pump except for a couple of hours at the beach.

I would argue that unless you understand exactly what you are doing and why you are doing it, you should consider working with your medical team to try the untethered regimen.

If your aim for the untethered regimen is for your daughter to be pumpless except when bolusing for meals and corrections, I would agree with your comment that you would like her to be completely on a pump vacation. A pump that is only connected when bolusing is just a fancy syringe/pen and you lose all of the benefits of a pump. Plus you run the risk of losing the pump. So I would think that going back to MDI for the summer might be a fine idea.

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