# Off pump back to injections....how?



## JoStan74 (Jun 10, 2017)

Hi all, new to Forum but after some advice.
I've been on my pump 4 months now after 25 yrs of injections. I'm going on holiday to Spain next week and after much reading up and deliberation, I've decided to go back on injections for my trip.

Does anyone have any advice on how to start my jabs back up, please?

Was thinking of reducing my pump tonight and taking my old normal lantus...unhooking pump tomorrow morning. What do you think?
Thanks....feeling anxious.


----------



## grovesy (Jun 10, 2017)

Welcome.


----------



## JoStan74 (Jun 10, 2017)

grovesy said:


> Welcome.


Thank you


----------



## Robin (Jun 10, 2017)

I remember when I first started on Lantus, my DSN told me it would take three days to 'bed in' and it did, so maybe you'll need more of a phased reduction in your pump basal over a couple of days ( or just be aware and correct with short acting)


----------



## JoStan74 (Jun 10, 2017)

Thanks Robin....good suggestion.
 I didn't realise it would take 3 days....but I'm not away until fri so plenty if time to settle in, hopefully. 
I usually test about 8/10 times a day so I'll make sure I keep on top of things and adjust accordingly. Thanks again.


----------



## HOBIE (Jun 10, 2017)

I like the pump when I am on the plane & waiting in the airport. Temp basal on cos sitting still (don't). Enjoy holl !


----------



## everydayupsanddowns (Jun 10, 2017)

You should be able to get an indication of your current basal requirement by looking at your pumps's history section. You can probably get an average for the last 7 or 14 days. 

Just be aware that you may have reduced your doses may have reduced on pump vs MDI because of more efficient absorption. 

And keep a good record of your current pump set-up for the switch back!

Hope the switch goes well, and enjoy your holiday


----------



## JoStan74 (Jun 10, 2017)

Brilliant....that was my thinking also. Thank you for the reassurance.


----------



## Simon Clifford (Jul 7, 2017)

I do much the same going on holiday, seawater, sand, and late-nights are a bit of a hassle for pumping.

If you've never done it before, do a practice run at home over a couple of days you're not working. It really is very easy to do.

 A day or so before the flight, I start up on the basal - for me that's Lantus. I like to have the extra control with 2 doses a day, but it might not be necessary. I find that  I need 10-15% more total Lantus in 24hrs than I'd have on my total basal regime. However, the switchover happens slowly and we're all expert at hour-to-hour managment.

So, for my total basal of 32u a day, I take 20u of Lantus (IN THE MORNING - NEED TO BE AWAKE TO WATCH). I then set a temporary basal decreasing by 10%. I gradually decrease the pump's basal over the next 12 hours, watch blood sugars every 2-3 hours as usual, and keep decreasing - I find I do 90% basal 1 hrs, 80% 3 hrs, 60% 4 hrs, 40%   (remember to have the evening dose of Lantus too!).

When I get to bed, it'll be running at ~10%. It's not that accurate, but remember the longer you go into the switch, the bigger the drops in basal and the longer they are. Pump alarms are FANTASTIC for keeping track - we don't want it going back to 100%!! 

I keep the pump on for as long as possible running with 0% basal because I'm lazy and still like to do long boluses when I'm eating on the plane. When I'm down and in the hotel at the other end, the pump comes off, and I'm on pens again.

On the way back, or when you've run out of Lantus, it's back on the pump in much the same way reversed. 10% total basal insulin for ~4 hours, 30% 3 hrs 70 % for a couple and back up to full basal after about 12 hours.

1) Remember what the slopes of the basal insulins look like. This is what will guide your choice of amounts and timings.
2) Timing and accuracy isn't terribly important if you're checking blood sugars and doing corrections. CHECKING - VITAL
3) Keep the pump running for LONGER - it's easy to do corrections and boluses with a pump - even when it's on no basal.
4) When you remove the pump, THINK AGAIN ... can you take the battery out? It'd be a shame for it to go mad thinking its run out of insulin when it's sat in your hotel room safe!

That's my approach to coming off a pump. Really handy experiment, I do it 2-3 times a year - IF I can persuade my GP to prescribe me some basal - It's not the easiest thing to keep them doing when you only get Lantus 2x a year, they so love to remove "unused items" from your prescriptions!!!!


----------

