# New to insulin pump



## Lorraine hunt (Jan 19, 2016)

ok I started on my insulin pump yesterday, and it's going ok, but can anyone tell me how long I would be staying on the settings currently have, as the carbs to insulin ratio they have me on seems very high 1u to 12carbs when on my pen I was 1u to 5carbs in morning and 1u to 7carbs rest of day, have done fair bit of adjustments today, don't see nurse again till Thursday pm, feeling little bit frustrated.


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## Sally71 (Jan 20, 2016)

They are probably being cautious as a lot of people find that they don't need as much insulin on a pump as they did with pens, due to differences in the way the insulin is absorbed.  Also, you don't want to change too much at once or you will get confused, if you have made changes today then you need to wait and see what effect they have before you change anything else.  It's very early days, so don't panic!  What are your blood sugars like?


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## Annette (Jan 20, 2016)

Also, it will take several days before the basal you used pre pump (lantus/levemir) is out of your system, so until that point, you cant really tell what is happening. Give it a few days, correct as needed, you will get there.


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## pottersusan (Jan 20, 2016)

Don't expect it all to get 'right' immediately. It does take time plus. our insulin needs change too - or at least mine does


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## everydayupsanddowns (Jan 20, 2016)

As others have said - your nurse is probably just being cautious. 

The way that insulin is absorbed from a pump cannula is quite different to how it works with injections for many (most?) people - and it is not uncommon for insulin requirements to fall quite dramatically at the start. Plus as others have said, you may have some old basal lingering for a day or two too. 

The last thing you want is to have crashing hypos every 5 minutes in your early days. Would put you right off!

Just keep an eye on things and don't be afraid to consider making small adjustments yourself (up or down by 10% or 20% is usually a reasonable tweak) if you think things are getting out of hand.


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## Lorraine hunt (Jan 21, 2016)

Ok, my first week completed on pump, readings higher that I normally run at 7 & 8's some above but been a positive week.  I changed the set today, and since then been hypo, I had an operation when was 18 for crohns which would have left a lot of scare tissue on left hand side of stomach, that's the only thing can think of to make such a difference, anyone else experienced this??


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## trophywench (Jan 22, 2016)

Yes everybody Lorraine - eg lot of ladies have stretch marks and you can't stick a cannula or jab into them either, cos it's the same thing - scar tissue.

You need to avoid that side of your tum.  It will probably never recover frankly.  can't use any of my tum - too damaged from all the years of MDI.

I hope you'd changed the cannula before a week! - mine are every two days because the absorption anywhere on me goes off rapidly after 48 hrs.  others can leave em in 3 days.  It's usually only the reservoir/tubing you are told to change - every SIX days! - although mine used to last me nearer 10 days and if I wasn't having any trouble or it wasn't eg stinking hot, I'd just leave it till then.


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## Lorraine hunt (Jan 23, 2016)

Well was going ok until today awful day, sugars 11+ most of the day go to bed and 17.7 had a panic as ketones 16 never had them over 1 feel totally out of control and now wondering if done the right thing, having a bit of a panic changed cannula and did pen correction, not sure do you then leave that running as normal or what


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## Sally71 (Jan 23, 2016)

If you've been doing corrections and your numbers still aren't coming down, and especially if you have ketones, change your cannula immediately! Sometimes they can go "off", or maybe you have inadvertently not sited it very well.  You could also do one correction with a pen so that you know it's gone in and you don't have to worry about whether the new cannula is working.  Then wait and see, hopefully your numbers will stay at better levels after that!


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## Lorraine hunt (Jan 23, 2016)

Omg again high this morning, so changed cannula again, pen correction, hour later still no change, am so frustrated, as was all going so well god know what is going on but am so stressed


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## everydayupsanddowns (Jan 23, 2016)

So sorry to read this Lorraine, but DON'T PANIC! You are doing great, and these sorts of things are completely normal. There is so much to re-learn when moving from injections, so many firsts to have. I had several levels in my first year that were WAY above anything I had experienced on MDI. It may be that the cannulas you are using do not suit your frame, but don't jump to conclusions.

Not uncommon for a correction to take an hour for BGs to begin to respond. And that time drags so slowly while you are waiting. You are doing all the right things. Stick at it!

In a few weeks/months you will wonder why you stayed on injections so long.


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## Pumper_Sue (Jan 23, 2016)

Lorraine, it just sounds to me as if your background insulin is now out of your system and you need to up your basal on the pump. This is normal procedure. This is where the hard work begins plenty of basal testing and basal adjustments. It can take a few weeks or even a few months to sort it out.


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## everydayupsanddowns (Jan 23, 2016)

Ah yes! Thanks for the reminder Sue - now you mention it I *do* remember that after 5-6 days I had to hike all my basals/meal ratios, and so did two other people who started on a pump at the same time as me.


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## Amberzak (Jan 23, 2016)

Hello. Yes, that's normal. I had the exact same thing. Been on the pump since June. 

Also, there will be other tkmes when things seem to go wrong. Don't panic then either. 

It's a hard learning Curve and hard work but so worth it. 

And all of us pumpers have been through it. You're not alone. 

Good luck with the basal testing.


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## HOBIE (Jan 23, 2016)

The first couple of weeks are a little strange but I can guarantee in a few weeks it will come together nice. Good luck & it sounds like you have been doing the right thing. Keep testing


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## Lorraine hunt (Jan 24, 2016)

Thank you all for your support, and yes pumper sue, sounds like your right, our nurses never warned us that this would happen infact, they had said that after fasting my night time one was correct. so have increased my basal and just keep going, but at least I'm back to under 10's again so far since late last night, still high for me as run normally 5.5-6.5, but better than 17-20.  ! could I also ask another question, do people adjust every time you have say a white coffee 2g?

you all did warn me lol


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## Pumper_Sue (Jan 24, 2016)

No to bolus for coffee unless drinking a gallon a day and a correction needed at a meal time.

Have you been told about basal testing if not look at the top of the forum as a link to basal testing.


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## everydayupsanddowns (Jan 24, 2016)

I've cut right back on my 'proper' coffee consumption and some days now where I have several strong/filter/coffee-shop coffees I do seem to get a bit of a BG kick from the caffeine (rather than the milk - doesn't happen with rooibos). However those days are also generally more unpredictable/variable food-wise so hard to see exactly what's going on. 

I don't tend to dose for anything under 5g CHO, but I know others are more precise.


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## trophywench (Jan 24, 2016)

No I don't either Mike.  Needs to be around 9g before I even consider it.

If we're talking about milk in drinks - have always drunk quite a few teas and coffees (instant normally) during the day so I should think my basal probably includes that after all this time!

Proper coffee, I normally only have when out at the shops.  Shops = walking.  Walking = hypos.  So all in all - definitely not!

In France, where we walk a lot sightseeing and stuff - when we stop for a coffee, not only do I just sit and enjoy it - but you normally get a small biscuit in the saucer even in the local Café de Sport (which is the nearest thing they have in France to a greasy spoon/workman's café) - I enjoy eating them too with NP whatever.  A visit to the Patisserie next door however, is rather different ...... and they do often have a café .......


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## Lorraine hunt (Feb 23, 2016)

Little update, have been on my pump for 4-5 weeks I think now, few rocky moments, but all in all going well, am pleased, just need to sort out after excercise to stop lows, especially after a run,  also was not impressed with the libre, however, spoke to them and they have been brilliant, just waiting on a replacement sensor, and some strips to see if meter faulty, and will try again 

Oh and has anyone using a pump use tannin stands? I know there bad for us, but have so few and makes me feel better, usually do 12-15 mins, guess would remove pump then adjust after??


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## SB2015 (Feb 24, 2016)

Hi Lorraine

I am glad that you are gradually getting things sorted with you pump.  Have they talked to you about using temporary basal rates during and/or after exercise.  It took me time to work out the reductions I needed for different types and lengths of exercise but it is this flexibility that is a big bonus of having the pump.


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## Lorraine hunt (Feb 24, 2016)

Hi SB2015 they have yes I use a temp basal, but haven't worked out what and how long after a run, i think I have it, but catches me out every time lol.


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## SB2015 (Feb 24, 2016)

Hi Lorraine
Like with so many things it is just try it, test it, review and adjust.
I found that keeping records for each of the different exercise things that I do helped me to spot patterns.
Sometimes these were not obvious, and I realised that I needed to keep other factors the same.

For example when trying to sort out my TBR for Pilates, this is what I did to sort it out ( eventually)
I kept to the same breakfast each time beforehand, 
I set a TBR ( for me 30%) half an hour before leaving ( the change in basal will not take effect for a while)
I walked there and and eat a small apple on the way no bolus
I kept to the same exercise programme for a while
I reset TBR to 50% when I left to walk home and kept that running for I hour to account for the restocking my muscles​This took me a lot of trial and error to get to but it seems to work now

Next I want to sort out  what to do for a Swim for Fitness class.  Lots more guessing, testing reviewing adjusting.  But once sorted I know it will be worth it ( and I will need to register for another 10 classes to use it once sorted - until my body decides to change again!)

Keep at it Lorraine it is definitely worth it.


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## trophywench (Feb 24, 2016)

Yes - when you need to change a BG at 7 o'clock, you'd have to change your basal rate from 5 o'clock - takes 2 hours to have any noticeable effect.


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