# Going from a pump back onto MDI's



## Babysaurus (Apr 23, 2012)

I have been on a pump since 1st February as pregnancy hormones and insulin resistance made things increasingly tricky to tweak quickly and easily, however I am pretty sure I want to hand it back once I have the baby (June) and things settle down. Never having any previous issues re injections (been Type 1 for 32 years) until getting pregnant this is no hardship! 

Does the transfer involve lowering the basal rate (previously on Lantus) so you still have some insulin working until the Lantus (or equivalent) kicks in? Obviously I will discuss this nearer the time with my DSN but I am curious to what it will involve. Anyone have any idea...?


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## HOBIE (Apr 23, 2012)

Good luck with this. I have been T1 for 45yrs & wouldnt give pump back. I will be very interested to see how you get on.  Keep us posted


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## Babysaurus (Apr 23, 2012)

Will do! Am pretty sure I want to give it back, but am trying to keep an open mind just in case. 
While control is great on it and easy to alter when you need to, I hate every other aspect of it, and as my control was also great before with MDI's it feels right for me to give it back, but will wait until things have settled a bit after the baby so its not too much at once.


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## trophywench (Apr 23, 2012)

If you are b'f your baby beware, your insulin needs will remain low all the while you are doing it.  The hypo-city phase of early preg isn't in it, so I hear LOL

Anyway - don't give it back.  If you still hate it once you are over the birth then take a pump holiday.  That will tell you which you really prefer! - and who's to say MDI will ever be 'the same' again?

Diabetes changes of it's own accord so when you throw in the huge hormonal challenges you are going through right now, MDI might not be as easy as it once was.

Or of course it might be LOL

Just take a holiday.  Then you'll know!


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## HappyHelen (May 8, 2012)

Hello

Just wanted to add my tuppence worth!!

I have no experience of using a pump so can't comment on that aspect but wanted to say that it may be worth considering staying on it for a few weeks (at least) post birth as based on my experience I found it very difficult to control sugars etc as hormones are just crazy!!  Just a thought, anyway.


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## Twitchy (May 8, 2012)

HHiya...just a couple of thoughts from me too... My experience was that after the birth of my first child blood sugar wise it was chaos - erratic highs / lows from attempting to breast feed & function on zip-all sleep plus the erratic hormones. An 'interesting' time! Also the dawn phenomenon got even worse - unfortunately not something MDI can address & a time when a pump would havd been very handy indeed! I don't know if there was a link with pregnancy & dp getting worse but it might be worth hanging on to the pump a bit longer, just til you're sure things have settled hormone wise? After all, although things were fine for you on mdi before, that was your pre-pregnancy body & you weren't kiddy wrangling lol. Call me cynical but i suspect it might be quite hard to get the pump back if you changed your mind. What did your team say? 

Re the doses, i suspect if you do step down the basal it will only for a few hours, given the short acting pattern of the insulin? Dunno for certain though, they'll have to knock me out to get mine back off me lol!


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## Babysaurus (May 8, 2012)

I spoke to my DSN re this today and she said she can understand completely why I want to give it back considering I had no problems at all before. However, she said that she thinks it would be a good idea for me to hang onto it for a month while I go back onto MDI's just to make doubly sure and then I can change my mind quickly and easily if needs be. 
It has been good to hear about other people's experiences post baby with blood sugar etc too, as currently I don't know what will happen (good or bad.) 
Have last (eeek!) ante natal apt on the 23rd so need to speak to the DSN afterwards to come up with a plan (pump or no pump) post delivery then. Am semi tempted to stay on it post delivery, but also love the idea of not having it at all and going back to pre baby doses (I went on the pump at 4 months so can't simply switch back to pre baby pump doses as I don't have them.) Will keep you posted! 
Thanks for the input everyone!


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## everydayupsanddowns (May 9, 2012)

Good luck with your last appointment, and *everything* that follows Babysaurus  

Sounds like you are looking at this very sensibly. I can understand exactly why you are tempted to go back to MDI given your successful past record and your aversion to the pump. As others have said though, I guess it would be worth hanging on to it for a while (6 months maybe?) so that as and when you try the transition back again you can just 'try and see' - I think others are right in that you just don't know *what* your new 'normal' will be after all those raging hormonal changes. 

Do you have any recollection of how your TDD changed when you went on the pump percentage-wise? I guess you could take your current pump TDD, add the percentage that you lost (if you did) when you went onto a pump and start with that 50:50 as starting doses on MDI? You'd have to test basal and recalculate carb and correction factors anyway I suspect.

Look forward to seeing how you get on and what you decide to do.


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## Babysaurus (May 12, 2012)

Hi Mike, Sorry to say it but my pregnancy mushed brain is struggling to make out what you mean re dosages! All I do know, however, is that generally speaking, they advise to go back onto pre pregnancy doses immediately after you hatch. So that would be 20 Levemir and, vaguely, 10 units Humalog (depending, obviously) with main meals. A FRACTION of what I am on now (approx 160 units of Humalog a day!!)


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## HOBIE (May 13, 2012)

I agree with Twichy !  About getting "knocked out". It would have to be Couple of big blokes to get mine off me ! (AND I MEAN IT !)    On a more serious note having babies & what is going on has got to have a big effect on "The Big D"     Good luck.


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## Babysaurus (May 13, 2012)

Possibly, although not absolutely, and I am not going to have raging hormomes for the next 5 years (I hope!) so it shouldn't be too big a deal (well, the DSN didn't seem to think so, which is a good starting point for me at this stage anyway!)


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## everydayupsanddowns (May 13, 2012)

Babysaurus said:


> Hi Mike, Sorry to say it but my pregnancy mushed brain is struggling to make out what you mean re dosages! All I do know, however, is that generally speaking, they advise to go back onto pre pregnancy doses immediately after you hatch. So that would be 20 Levemir and, vaguely, 10 units Humalog (depending, obviously) with main meals. A FRACTION of what I am on now (approx 160 units of Humalog a day!!)



Wow! I knew expectant mothers had to change insulin requirements but GOOD GRIEF!! 

Sounds like you have it well and truly worked out - and a DSN to help you transition whenever you want to do that. 

Good luck with the switch when/if you decide to go for it.

M


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## Babysaurus (May 13, 2012)

Thanks Mike! Yes, my insulin requirements seem utterly bonkers and I am going through a vial every couple of days. Bet my GP loves me!


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## Babysaurus (May 13, 2012)

ps My DSN told me about one patient she had who had to go onto double concentrate insulin when pregnant that had to be imported from America. Makes my current requirements seem rather tame...


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## Ellie Jones (May 13, 2012)

It's more than double strength as it's a U500

It's only manufactured in America, and got to be imported into this country on a individual patient licence/prescription...

Personally I would hang onto your pump for a while after you've your baby..

As life is totally different and never the same again, babies don't do routines well not what we call a routine....  And the pump can be handy when trying to keep up with a dynamic bundle of joy..


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## Twitchy (May 14, 2012)

Ellie Jones said:


> .  And the pump can be handy when trying to keep up with a dynamic bundle of joy..



That's a Brilliant description!!  While I'm doing the maternal equivalent of herding cats tomorrow trying to get kids to school / nursery en route to work I will remember that phrase & smile - thank-you!


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