What's a Really Low Basal Rate?

So, as I sit here waiting to find out if insurance approved me for a pump, I was wondering - what is a really low basal rate on an insulin pump? At this time, I’m on 6-8 shots per day of humalog to control my BSL. My primary endo agreed that I was a perfect candidate to start learning how to use the pump, even though I’m not yet on a basal insulin (although I probably would benefit from one). Anyway, she referred me to the pump endo who was a little more skeptical about me starting on the pump right away, mainly because I’m on such a low dose of humalog (about 15 units per day or less). But we talked and she agreed to go ahead and complete the certificate of medical necessity, even though I might get denied initially. She said that, for now, we can program the pump to just do a “low” basal rate throughout the day, and this might help me avoid the spikes I currently experience (I still can go upwards of 160-200 even with insulin and careful carb counting).

Anyway, what’s the lowest basal rate a pump can do? Is there anyone out there just doing a basal rate and no bolusing at meals? We talked about a basal insulin, but decided against it for a variety of reasons. I am also going to try and get pregnant and both endos I saw agreed that it would be better to learn how to uset he pump now, before my insulin requirements increased during pregnancy.

Any insight is appreciated.

Humalog has a duration of 6-8 hours. You say you are not on a basal, but taking 6-8 shots a day, your basal is Humalog. As a first estimate of your basal needs, if you really are on 15 units/day, figure you will have a 50/50 basal/bolus split. That means that you would set your basal at 7.5 U/day and then bolus another 7.5 units for meals. I can’t really answer the specific question about an unknown pump. For example the Animas 2020 can deliver 0.025 U/hr or 0.6 U/day, far finer control than you appear to need.

You may find the book “Pumping Insulin” by Walsh to be quite helpful.

I think my MM 722 will pump down to .05U/ hour. I’m not sure if the Revel can go in finer increments or not. I would think that if you aren’t doing basal insulin, you would probably benefit from some? Do you ever do tests like 15-20 minutes apart, to see if your BG is changing or stable?

The lowest possible basal rate with the Animas PING is 0.025 units per hour (that is, outside temporary basals/suspending it if you for some reason need to turn it off completely, which I sometimes do if I’m really low)

The revel can go as low as .025 units. I average around 20 units per day and the basal is 11.5 of that amount. I think looking at whether you could benefit from a pump based on the amount of insulin you take is wrong. It should be based on how the pump can change your health and your control.

Try another endo.

interesting…she wasn’t totally against it, but definitely laid out more cons than pros given my situation. For example, one concern she expressed was that my low insulin requirements would result in the pump clogging. But if the pump is designed to deliver doses as small as 0.025 units, I’m not necessarily sure that would be an issue. I don’t think she was being negative per se, but more just laying out all the pros/cons given my situation.

The pump is the way to go. I only give baby doses of insulin (.02 - .04) and only take 15 units a day. The pump will give mico mini doses that you can’t get on shots. I can’t imagine having the control that I do on shots. My A1C was 7 – 9 consistently on shots and now I am 5.0

Argh, that’s EXACTLY what I need!!! I am receiving the pump later this week, but there is still no guarantee that my insurance will cover it. I have been letting myself “run high” because I’m so scared of going hypo. I’ve often found myself in the situation where I keep my BSLs a bit high (i.e., 170-200) because I know just one additional unit of insulin will cause me to bottom out (this has been learned the hard way, through trial and error). I am hoping, hoping, hoping that my insurance company approves my pump. While I realize there are disadvantages, being able to properly dose insulin according to what I actually need would go a long way to keeping me healthy. Let’s just hope the insurance company agrees. If they don’t this time, I am definitely going to appeal…I want to get pregnant this hear and I’m trying to do whatever I can to make sure that diabetes doesn’t get in the way of that!