# TDD and basal bolus split



## bev (Nov 27, 2012)

Hi all,

I am interested to know what adults split of basal/bolus is and what your TDD is.

Alex (14) is growing and increasing insulin needs quite a bit. TDD has gone from 25 to 45 units in a matter of a couple of months. His split is 24/76% basal/bolus and just wondering whether this is typical of an adult split.Bev


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## Northerner (Nov 27, 2012)

I'm not typical at all bev - 0/100%  split!  I've always been weird though. Initially my split was about 30/70 then basal just kept falling. My TDD has dropped from 65 at diagnosis to around 20 now.


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## bev (Nov 27, 2012)

Northerner said:


> I'm not typical at all bev - 0/100%  split!  I've always been weird though. Initially my split was about 30/70 then basal just kept falling. My TDD has dropped from 65 at diagnosis to around 20 now.



Hi Northerner,

He he - are you sure your Type 1!!!!!!Thats amazing! I wonder whether you are on a sort of 'slow honeymoon' thing? What does your team think?Bev


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## Northerner (Nov 27, 2012)

bev said:


> Hi Northerner,
> 
> He he - are you sure your Type 1!!!!!!Thats amazing! I wonder whether you are on a sort of 'slow honeymoon' thing? What does your team think?Bev



Saw my consultant today and he is perplexed, although he says that nothing surprises him about diabetes!


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## AlisonF (Nov 27, 2012)

On the pump my total daily dose is around 50 units, with a split of 55% basal, 45% bolus.

I've always found on the pump that if I'm more than 60/40 or 40/60 things don't work well for me.


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## Pigeon (Nov 27, 2012)

I take about 25% basal and 75% bolus. Various health professionals have told me I should be on a 50:50 split but my answer is always that I'm slim (In my experience people with larger BMI seem to take more basal) and I'm quite active so need low basal, and I eat a lot, so need more bolus! I eat around 200g carbs a day, which I know is quite high compared to some people. I have a lot of night time hypos so really wouldn't want to increase my basal to twice as much!

So my basal is 10.5U (8U morning, 2U night) and bolus around 30U.


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## pgcity (Nov 27, 2012)

Basal is approx 13u. Bolus between 12 and 20 depending on the usual factors and how greedy I am


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## trophywench (Nov 27, 2012)

9.8u basal and 15.1u bolus yesterday.  

Not unusual for me.


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## Amanda102 (Nov 27, 2012)

I have always been told that Hannah should be aiming for around a 50:50 split. If it goes far off this we reset all her settings on her pump and with minor tweaking it is usually about right.


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## trophywench (Nov 28, 2012)

None of my basal rates match the 'typical' pattern suggested by Roche LOL

Have therefore agreed to basal test to prove they're right (my basals not Roche) and we'll see, won't we?  I volunteered to do that, I wasn't bullied into it - cos it's interesting.  Except it's just a PITA doing it and I haven't started yet.

Must try harder LOL


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## AJLang (Nov 28, 2012)

Yesterday was 22.8 units of basal and 14.9 units of bolus - but I needed slightly more bolus than normal because the gastroparesis was playing up


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## bennyg70 (Nov 28, 2012)

Basal = 12  , Bolus between 10 - 14 depending on food and at 10 to 1 carb to ins ratio. As Ive lost weight and my diet has improved this has decreased dramatically... this time last year maybe a little before - Basal - 28, bolus 22 - 30


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## Phil65 (Nov 28, 2012)

mmmmm, mine are wildly different, yesterday I had 115 units bolus and 40 basal units. Always knew I was weird!


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## Northerner (Nov 28, 2012)

Phil65 said:


> mmmmm, mine are wildly different, yesterday I had 115 units bolus and 40 basal units. Always knew I was weird!



Hehe! Well, you are a growing lad Phil!  How tall are you, exactly?


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## everydayupsanddowns (Nov 28, 2012)

AlisonF said:


> On the pump my total daily dose is around 50 units, with a split of 55% basal, 45% bolus.
> 
> I've always found on the pump that if I'm more than 60/40 or 40/60 things don't work well for me.



+1 to what Alison said. 

Currently averaging approx 43% basal 57% bolus. It does wander about a bit, but outside of 60:40 in either direction usually suggests something is not right and it's basal-test time for me.

Diabetes in teenage years sounds *horrible* 

EDIT - forgot to add TDD. approx 31u on average over the last 7 days


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## randomange (Nov 28, 2012)

I average around 70 units TDD, mostly split about 45% basal/55% bolus.


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## m1dnc (Nov 28, 2012)

Over the last 60 days my average TDD has been 53.5, with a basal/bolus ratio of 52.5:47.5. 

In that period I've had a couple of steroid injections which have pushed my insulin requirements way up for a week or so in each case, so for a 'normal' day my TDD is probably around 50.


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## Phil65 (Nov 28, 2012)

Northerner said:


> Hehe! Well, you are a growing lad Phil!  How tall are you, exactly?



I'm 6" 4 Alan.....height...not width!


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## Homedaze (Nov 28, 2012)

Started with TDD 36 units split 50:50.  

Now TDD 28 units split 50:50.


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## schmeezle (Nov 29, 2012)

30 day avg (same as 7 day).....TDD just over 15u with basal/bolus split of 64/36


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## Phil65 (Nov 29, 2012)

.....are all of your TDD units milli-units?


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## schmeezle (Nov 30, 2012)

Phil65 said:


> .....are all of your TDD units milli-units?



Yeah, tell me about it.  Looking fwd to pumps w/finer delivery - could help with basal changes.


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## Phil65 (Dec 3, 2012)

schmeezle said:


> Yeah, tell me about it.  Looking fwd to pumps w/finer delivery - could help with basal changes.



....I could do with a pump that has a bigger delivery.....25 units (my pump max) is often not enough for my bolus!


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## Pumper_Sue (Dec 3, 2012)

Phil65 said:


> ....I could do with a pump that has a bigger delivery.....25 units (my pump max) is often not enough for my bolus!



Hi Phil,
        can you not change that in the set up? But  at that bolus.

4.2 Programming a Standard Bolus
There are 2 ways to program a Standard Bolus:
Quick Bolus
Using a and s on your insulin pump, with bolus increments determined by the user
Using Standard Bolus menu
Using d and f to enter the menu and then a and s to program the amount
The bolus amount per delivery is limited to 50 units using U100 insulin.
After you program a Standard Bolus, there is a delay of 5 seconds before bolus delivery starts. This delay allows you to cancel the bolus by pressing the a or s key. The Warning W8: BOLUS CANCELLED is displayed. Press f twice to confirm and turn off the alert. See chapter 8 Warning W8: BOLUS CANCELLED.
Note You can not program a new Standard Bolus as long as one Standard Bolus, Quick Bolus or the immediate part of a Multiwave Bolus is running


Advanced user settings

Procedure for adjusting the prime amount
Press d to move to the THERAPY SETTINGS screen.
Press f to select.
Press d to move to the PRIME AMOUNT screen.
Press a or s to select a prime quantity between 0.0 and 50.0 units.
Press f to save and exit.


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## Phil65 (Dec 3, 2012)

Pumper_Sue said:


> Hi Phil,
> can you not change that in the set up? But  at that bolus.
> 
> 4.2 Programming a Standard Bolus
> ...




Hi Sue, no I don't think so, not a problem just mildly irritating bolusing 25 units when I need 32....just deliver 2 amounts. I need a lot of insulin my ratios can be as high as 3 units per 10g carb....so a carb fest meal is a lot of units!


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## Pumper_Sue (Dec 3, 2012)

Phil65 said:


> Hi Sue, no I don't think so, not a problem just mildly irritating bolusing 25 units when I need 32....just deliver 2 amounts. I need a lot of insulin my ratios can be as high as 3 units per 10g carb....so a carb fest meal is a lot of units!



Yes you can go into advanced settings. They have to have high numbers due to insulin resistant type 2's using pumps.

Perhaps your high needs are the cause of the insulin leakage at times. Have you tried delivering that lot over a 15 min period?
I have also heard of people using that amount due to a restance to the insulin being used. So have you thought of or tried a different insulin to see what happens?


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## Phil65 (Dec 3, 2012)

Pumper_Sue said:


> Yes you can go into advanced settings. They have to have high numbers due to insulin resistant type 2's using pumps.
> 
> Perhaps your high needs are the cause of the insulin leakage at times. Have you tried delivering that lot over a 15 min period?
> I have also heard of people using that amount due to a restance to the insulin being used. So have you thought of or tried a different insulin to see what happens?



I have looked at my settings on my pump and can't see a way of changing the max delivery, I'll look at the handbook tonight but don't think I can change that setting. I don't suffer from insulin leakage, my sites are good also....I just need a lot of insulin (I have been put on metformin to try to help with my insulin resistance....hasn't seem to had any effect though) maybe a different type of insulin might help.


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## Pumper_Sue (Dec 3, 2012)

Hi Phil,
        what I put above is from the manual, so it can be done you just need to find the right buttons 
If you think of it logically a child on that pump would need a very low max delivery so for safety reasons it must be able to be adjusted.


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## Phil65 (Dec 3, 2012)

Pumper_Sue said:


> Hi Phil,
> what I put above is from the manual, so it can be done you just need to find the right buttons
> If you think of it logically a child on that pump would need a very low max delivery so for safety reasons it must be able to be adjusted.



ok thanks Sue....I will check the manual/book tonight....TBH I haven't really read it properly even after pumping for 19 months!


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## AlisonF (Dec 3, 2012)

Or if you're feeling lazy Phil, just call the Roche helpline and ask them how to increase your max bolus setting - they should be able to talk you through it.


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## Pumper_Sue (Dec 3, 2012)

AlisonF said:


> Or if you're feeling lazy Phil, just call the Roche helpline and ask them how to increase your max bolus setting - they should be able to talk you through it.



This is all he has to do................

Advanced user settings

Procedure for adjusting the prime amount
Press d to move to the THERAPY SETTINGS screen.
Press f to select.
Press d to move to the PRIME AMOUNT screen.
Press a or s to select a prime quantity between 0.0 and 50.0 units.
Press f to save and exit. 


Men should not be let loose with gadgets


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## Phil65 (Dec 3, 2012)

Pumper_Sue said:


> This is all he has to do................
> 
> Advanced user settings
> 
> ...


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## bev (Dec 3, 2012)

Phil65 said:


> Pumper_Sue said:
> 
> 
> > This is all he has to do................
> ...


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## Pumper_Sue (Dec 3, 2012)

Phil65 said:


> Actually........wrong Sue....take all your clothes off!  I have spoken to Roche and I cannot increase the max bolus delivery from 25 units unless I have the software (they are posting it to me), the only other option was to get a Roche rep to change it. Yes, you can change the priming amount and the increments but not the bonus delivery from the set limit. Happy that the little "problem" has been resolved, thanks for your advice.....I even managed to type this from my electrical gadget (IPad)



I find that shocking to need software to change the pump settings 
As far as I know all other pumps you just go to advanced setting and change to what you want.
In my defence the bit I read did not mention anything at all about needing software to change any settings.
What the heck do people do who don't have computers?


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## AlisonF (Dec 4, 2012)

Sue, I think those instructions are to change the amount you can prime with the pump, rather than bolus with it. 

I too find it ridiculous you need software or a rep to adjust max bolus. As a grown up, I manage my own diabetes 24/7/365 - I expect full access to all my tools to be able to do that. Glad you'll get it sorted eventually though Phil.


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## Phil65 (Dec 4, 2012)

AlisonF said:


> Sue, I think those instructions are to change the amount you can prime with the pump, rather than bolus with it.
> 
> I too find it ridiculous you need software or a rep to adjust max bolus. As a grown up, I manage my own diabetes 24/7/365 - I expect full access to all my tools to be able to do that. Glad you'll get it sorted eventually though Phil.



......Yes, totally ridiculous! The manual says nothing about raising the maximum delivery bolus ....or that additional software is required!


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## trophywench (Dec 4, 2012)

LOL - I didn't even know there was a max bolus limit!

I mean they can hardly justify it by saying it's to stop overdoses, otherwise they'd be having to put insulin in much smaller jars, wouldn't they?

I should imagine they leave it up to whoever teaches you to set your pump up in the first place and if they know you use a lot of insulin, which they ought to do, to change it to a more suitable amount at the outset?


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## Phil65 (Dec 4, 2012)

trophywench said:


> LOL - I didn't even know there was a max bolus limit!
> 
> I mean they can hardly justify it by saying it's to stop overdoses, otherwise they'd be having to put insulin in much smaller jars, wouldn't they?
> 
> I should imagine they leave it up to whoever teaches you to set your pump up in the first place and if they know you use a lot of insulin, which they ought to do, to change it to a more suitable amount at the outset?



Totally agree.....Roche's answer was '25 units' is maximum set amount! and the process of changing this is a safety measure!! particularly for children where 5 units might be the 'set' maximum


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## AlisonF (Dec 4, 2012)

Medtronic must have more faith in the common sense of their pumpers - I've just checked and I can raise my max bolus setting to 75u without so much as a note from my mum.


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## bev (Dec 4, 2012)

trophywench said:


> LOL - I didn't even know there was a max bolus limit!
> 
> I mean they can hardly justify it by saying it's to stop overdoses, otherwise they'd be having to put insulin in much smaller jars, wouldn't they?
> 
> I should imagine they leave it up to whoever teaches you to set your pump up in the first place and if they know you use a lot of insulin, which they ought to do, to change it to a more suitable amount at the outset?



Hi Trophywench,

I know a couple of children who havent locked thier pumps and actually bolused in their sleep! Luckily they didnt bolus many units - all random button pushing - but if the maximum bolus had been higher than their TDD then who knows what could have happened. It happened twice to one boy! I dont know how they did it as it seems hard to press the buttons in the right sequence and then press 'ACT' - but they did! Perhaps the maximum is set to try to protect youngsters from this sort of thing.ev


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## Hanmillmum (Dec 4, 2012)

Agree it is Bev,

My little one managed to unlock her pump last year and give self a bolus with some night-time fiddling (by pure fluke I should think in synchronizing buttons) , so glad there is a max setting for such cases. Use the "block" now - live and learn lol!


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## bev (Dec 4, 2012)

Hi Hanmillmum,

That must have been scary for you!What do you mean 'block'?Bev


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## Hanmillmum (Dec 5, 2012)

The block feature on the medtronic is in utilities menu, it stops all functions apart from suspend and self test but allows the parent/carer to use the remote to bolus etc or take the block back off to do so. As it requires a bit more programing/button pressing to set up and take off it feels safer.


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## bev (Dec 5, 2012)

Hanmillmum said:


> The block feature on the medtronic is in utilities menu, it stops all functions apart from suspend and self test but allows the parent/carer to use the remote to bolus etc or take the block back off to do so. As it requires a bit more programing/button pressing to set up and take off it feels safer.



Hi Hanmillmum,

Thankyou. We also use the VEO but as Alex is 14 I wasnt aware of this function but it sounds great for little ones who might get a bit inquisitive at the wrong time! We havent ever used the remote as Alex felt it was too big but I know they are great for little ones - not having to move them around when they are asleep is a bonus. Mostly Alex's pump is easy to find during the night - but there have been times when it has wrapped itself around his stomach and then he lies on it and trying to move a sleepy 14 year old can be a bit tricky at 3 in the morning! Are you on the CWD list?Bev


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## Hanmillmum (Dec 5, 2012)

bev said:


> Hi Hanmillmum,
> 
> Thankyou. We also use the VEO but as Alex is 14 I wasnt aware of this function but it sounds great for little ones who might get a bit inquisitive at the wrong time! We havent ever used the remote as Alex felt it was too big but I know they are great for little ones - not having to move them around when they are asleep is a bonus. Mostly Alex's pump is easy to find during the night - but there have been times when it has wrapped itself around his stomach and then he lies on it and trying to move a sleepy 14 year old can be a bit tricky at 3 in the morning! Are you on the CWD list?Bev



Yes, can imagine 14 yo lad is a little more bulky to shift, lol!

On CWD list but not posted as yet


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