Insulin Pump Vacation

Angie Type 1
By Angie Type 1 Latest Reply 2014-11-17 19:11:04 -0600
Started 2014-11-11 20:59:37 -0600

Hi,

I am a thin diabetic with little body fat and recently went off the Medtronic Pump because I needed a break #1 I am building up a lot of scar tissue and running out of places to put the silloutte infusion set. I have been on it almost 20 years. I had one of the original Medtronic pumps 506 I believe. Anyway. My doctor put me on Lantis 13 units at night and Humalog during the day for meals and corrections. This is not going well and my sugars are running super high. I am currently injecting in my belly and haven't ventured to legs , arms and backside. I am so afraid of going hypo that I'm nervous to inject large amounts of Humalog because I am very sensitive and have memories of calling 911 often when my children were babies. Can anyone give me any encouragement that this will get better and not give up? I just feel in prison on the pump anymore and LOVE the freedom of not have that dang tubing and something hanging from my waist band… BUT is it worth the crappy blood sugars. Thank you for any help. Angie


22 replies

funky-diabetic
funky-diabetic 2014-11-16 02:55:32 -0600 Report

I have been on Lantus and what I call the "freestyle system" for 12 years. My sugars are not perfect but it works great for me and my personal life (most of the time).
1. Lantus is a slow absorbing insulin. I take 16, also skinny. The key factor to Lantus is the morning sugars. If you wake up with high sugars (considering you slept with nomalish sugars) it means you are not taking enough (this would apply for the rest of the day too). The opposite is true also, wake up with low sugars (#danger) means too much Lantus… I have personally been advised by my doctor to take my Lantus once a day before sleeping (9-12).(some people do twice a day) To determine right amount you should consider 3-4 days of continuous results. (Exception Two days of low sugars for no reason: consider lowering Lantus.)

That was the easy part.

2. Humalog (or novorapid in my case, similar) is a fast acting insulin. Novorapid might be a bit faster. Ask your doctor. Anyway, point being if I eat fruit, soft drink, chocolate (aka fast sugars), I would take my shot before eating. Heavy pizza perhaps after eating as it takes forever to start digesting. Pizza really messes with my groove.

The key to this system is staying on top. You can't forget to take insulin and measure sugars etc. I hear pump lifestyle is more laid back.

If you are stressing, it's because it takes some time to learn ones system in terms of insulin amounts and food minus exercise. It's alright though. After 12 years I occasionally stress, when I do I make sure to check after shooting. Maybe 15, 30 or an hour later. See what's up. Sometimes I check twice to see if it's going up or down. After 15 or 20 minutes.

In terms of over shooting and under shooting. It is very psychological. Meaning different for everyone. For me personally if I am not sure of how much insulin, I will over shoot during the day (nothing crazy unless my sugars are high) because I can also check and be near a fridge with nice juices in case I feel low. On the contrary i under shoot before sleeping so I don't go all koma on the roommates or i undershoot before sport, or some adventure or if I know there won't be any sugar around.

In your own house you can experiment (within reason) it might take a couple weeks of more frequent measurements than usual but you will find patterns. I generally have been shooting th same. I hear it's more difficult across the board.

Stress also counter acts the absorption of insulin! Chemically speaking, so if you are stressing hardcore shoot a bit more, a couple units. Or one if you are super sensitive. When I stress my sugars are all over the place mostly high and becomes a vicious circle. The more I stress the more I shoot, the more I shoot the more I stress.

I find the best thing when ones numbers are all over the place, is too eat light (quality wise, eat as much as whatever you need) no heavy carbs. And to exercise. Even a jog or walk. Calm the stress get body to work get mind to chill. Things fall in to place.

It sounds like you shoot the same amounts as me more or less. If you have been waking up with higher sugars than going to bed with increase your Lantus by 1-2 points and see if anything happens? My best advice… Discuss it with your doctor.

I am not a doctor.
This is all information (badly quoted for the most part) given to me by my doctor who specializes in diabetes type 1 management.
Don't follow my quantities, trust your own.

Be strong! One day at a time.

Angie Type 1
Angie Type 1 2014-11-17 19:11:04 -0600 Report

I tried and crashed and burned! I couldn't deal with the high sugars and MDI… I went back on the pump. Maybe I'll try again at some point. But a few more days with those highs, I was risking DKA. Thank you for your advice and encouragement. :)

Type1Lou
Type1Lou 2014-11-16 11:46:04 -0600 Report

Prior to pumping, I was on MDI of Novolog and Lantus. My endo changed my daily 14u Lantus dose to morning rather than bedtime to help me avoid those early morning low BG's. It helped some but I ultimately opted to try using a pump and have never looked back! Pumping has given me tighter control and virtually eliminated those scary low BG's.

Type1Lou
Type1Lou 2014-11-12 15:47:20 -0600 Report

Although a Type 1 diabetic for 38 years, I've only been using a pump since 2011. Prior to pumping, I was on Lantus (14 u/day in the morning) for my basal and Novolog for bolus insulin. Are you bolusing using the same carb to insulin ratios you had in your pump? I can understand your high sensitivity to insulin. When I began pumping, my insulin sensitivity factor was set at 120. Within the past 6 months, my endo and I reduced it to 105 which means I'm not as sensitive now. As we age, our bodies change and that requires changes in how we treat our diabetes. I still love pumping and am using a Minimed Paradigm 523. There do appear to be some absorption issues in certain infusion sites. I rotate from my thighs to my buttocks, abdomen and arms. I find that pumping gives me better control overall and am sorry that you felt you needed a vacation. I hope I never have to go back to injections. I haven't had a serious hypoglycemic episode since I began pumping and they were very frequent prior to pumping.

Angie Type 1
Angie Type 1 2014-11-12 18:27:03 -0600 Report

Thank you so much Type1Lou. I appreciate your feedback. I guess because I've been on it for almost 18 years it has really taxed me physically(finding sites that absorbed) & mentally. I've traveled a lot with the pump and it has not been enjoyable because of security(of which I do understand) and getting in and out of water. The doctors told me to just do Lantis when I travel but reallY? It takes awhile to get the adjustments and your sugars down to normal. Ahhhh… :( sorry! I'm just tired of all of this sometimes. As well I'm sure you are having it longer than me. Why did you wait so long to go on the pump. I went on when Medtronic 506 or 504 was out…long time ago.

Type1Lou
Type1Lou 2014-11-13 10:37:23 -0600 Report

I could have opted to pump back in the 1990's but didn't want to deal with something connected to me 24/7. It wasn't until I started experiencing more frequent and scary hypoglycemic episodes in 2009/2010 that I opted to try pumping finally in 2011. Prior to that, my control had been quite good with MDI of Lantus and Novolog and HbA1c's ranging from 5.9 to 6.7. In 2009/2010, my doctor kept upping my Lantus because my A1c had crept into the 7's…but I kept having these scary lows and he never changed his approach. I opted to travel 90 minutes to see an endo and they actually reduced my Lantus daily dose from 20u to 14u and re-educated me about carb to insulin ratios and sliding scales. Although things improved, they suggested I consider a pump and, by then, I was ready for it. Pumping has been a blessing to me…no more scary hypos! I'm sorry I waited so long to start using a pump. I love the flexibility of being able to reduce my basal rate if I will be exercising. This morning, I took a 30 minute walk after breakfast (fasting BG was 115) and I reduced my basal to 25%. After the walk, I tested and my BG was 68 (a bit low but workable and no cause for panic). With Lantus, the basal insulin is in your system once injected and you have to make accommodations for that; you can't turn it down or turn it off as needed. Back in 2011, I was diagnosedwith a vitamin B12 deficiency that had led to a clinical depression. Once we corrected the deficiency, the depression went away. Have your B12 levels been checked? Just wondering if that might be related to your current state of mind? We never realize how well the body functions when in balance until something goes out of whack! Wishing you well!

Angie Type 1
Angie Type 1 2014-11-13 21:10:39 -0600 Report

Hi, yes I've had that checked and a lot of other things lately and they were all fine. I am going back to the doctor tomorrow and going back on because I'm taking 13 Lantis(now i'm 126 lbs) and i awoke with high sugars and they've been high all day and I can't reduce no matter what I do. I can't take 7 or 8 or I will drop and I'm alone in the house right now because my new husband of 7 months went hunting until next Tuesday. I don't have any family that can stay so I don't want to go to sleep and not awake. it's scary and I have a friend who's brother did pass away that way. He was 25 and lived alone. Anyway, thanks for your advice and encouragement but I don't understand the Lantis and why it doesn't seem to work in my body.

Type1Lou
Type1Lou 2014-11-14 13:16:01 -0600 Report

Angie, you and I have many similarities: I developed my Type 1 at age 27, I weigh between 120 and 124 lbs, and when I did take Lantus, I was on 14 u/day. My endo had not only reduced my Lantus dosage from 20 u to 14 u but changed it from an evening shot to a morning shot because I was getting some scary lows during the night and early morning. Although Lantus is a 24 hour insulin, they explained that it does peak slightly in the first hours after injecting. That helped me somewhat but I ultimately opted for pumping. Hoping you find the answers you need.

Angie Type 1
Angie Type 1 2014-11-14 17:56:22 -0600 Report

Hi :) I woke up every two hours last night and checked to see what the Lantis was doing. Went to bed and it was high 286 took 2 U Humalog and my 13 Lantis. Was still high at 2a.m. then at 4:30 went to 154, then 141, 131 and when I went through my "getting to work routine" I checked at work(hadn't eaten yet) and it jumped to 197. Clearly stress affects me. It's been the best today but not sure why??? I reprogramed my new replaced pump and going back on later tonight. By afternoon I noticed the Lantis wasn't doing anything once again. That is ironic we both got Type 1 at the same age and my brother too? I wish you lived in and around York/Harrisburg PA. I would love another Type 1 to go to dinner with or talk to. Have a great evening.

Type1Lou
Type1Lou 2014-11-15 10:18:02 -0600 Report

I, too, wish we lived closer so we could meet and share experiences. We permanently moved to Florida in 2005 from New England. I used MDI quite effectively until around 2009 when I started getting increasingly more frequent and serious lows. I traveled a lot for my work and was able to manage my diabetes well. I stopped working in 1994 to join my husband in retirement. I found that as I approached 60, my body began to change which seemed to coincide with the increased lows and slip in control. Unfortunately, aging creates the need to adapt, and for me, happily convinced me to try pumping insulin. I think you're 13 to 15 years younger than I am (I'm 65) and also seem to be better about exercising although I just began some weight-resistance training. Glad to hear that you're giving your pump another try. I always have Lantus pens on hand in case my pump malfunctions but dread ever having to go back to MDI. Keep me posted on how you are!

Angie Type 1
Angie Type 1 2014-11-15 17:05:10 -0600 Report

Today I awoke to a 103 whoa! Haven't seen that in a week. Thank you so much for your support and may I ask your name? It's been a tough week and my husband decided to go hunting. I need to re realize that with the menopause and for some reason and the doctors have done testing…when I am stressed(getting ready for work etc. … my sugars elevate and the Lantis can't "deal with" that so the pump is the best thing so I can put in temp basals. :) What pump do you use? I read about the Omni and idk if that would be better. For now, I'm sticking with my 523 Paradigm.

Angie Type 1
Angie Type 1 2014-11-14 17:54:58 -0600 Report

Hi :) I woke up every two hours last night and checked to see what the Lantis was doing. Went to bed and it was high 286 took 2 U Humalog and my 13 Lantis. Was still high at 2a.m. then at 4:30 went to 154, then 141, 131 and when I went through my "getting to work routine" I checked at work(hadn't eaten yet) and it jumped to 197. Clearly stress affects me. It's been the best today but not sure why??? I reprogramed my new replaced pump and going back on later tonight. By afternoon I noticed the Lantis wasn't doing anything once again. That is ironic we both got Type 1 at the same age and my brother too? I wish you lived in and around York/Harrisburg PA. I would love another Type 1 to go to dinner with or talk to. Have a great evening.

Angie Type 1
Angie Type 1 2014-11-14 17:54:03 -0600 Report

Hi :) I woke up every two hours last night and checked to see what the Lantis was doing. Went to bed and it was high 286 took 2 U Humalog and my 13 Lantis. Was still high at 2a.m. then at 4:30 went to 154, then 141, 131 and when I went through my "getting to work routine" I checked at work(hadn't eaten yet) and it jumped to 197. Clearly stress affects me. It's been the best today but not sure why??? I reprogramed my new replaced pump and going back on later tonight. By afternoon I noticed the Lantis wasn't doing anything once again. That is ironic we both got Type 1 at the same age and my brother too? I wish you lived in and around York/Harrisburg PA. I would love another Type 1 to go to dinner with or talk to. Have a great evening.

Angie Type 1
Angie Type 1 2014-11-14 17:53:51 -0600 Report

Hi :) I woke up every two hours last night and checked to see what the Lantis was doing. Went to bed and it was high 286 took 2 U Humalog and my 13 Lantis. Was still high at 2a.m. then at 4:30 went to 154, then 141, 131 and when I went through my "getting to work routine" I checked at work(hadn't eaten yet) and it jumped to 197. Clearly stress affects me. It's been the best today but not sure why??? I reprogramed my new replaced pump and going back on later tonight. By afternoon I noticed the Lantis wasn't doing anything once again. That is ironic we both got Type 1 at the same age and my brother too? I wish you lived in and around York/Harrisburg PA. I would love another Type 1 to go to dinner with or talk to. Have a great evening.

Angie Type 1
Angie Type 1 2014-11-14 17:53:39 -0600 Report

Hi :) I woke up every two hours last night and checked to see what the Lantis was doing. Went to bed and it was high 286 took 2 U Humalog and my 13 Lantis. Was still high at 2a.m. then at 4:30 went to 154, then 141, 131 and when I went through my "getting to work routine" I checked at work(hadn't eaten yet) and it jumped to 197. Clearly stress affects me. It's been the best today but not sure why??? I reprogramed my new replaced pump and going back on later tonight. By afternoon I noticed the Lantis wasn't doing anything once again. That is ironic we both got Type 1 at the same age and my brother too? I wish you lived in and around York/Harrisburg PA. I would love another Type 1 to go to dinner with or talk to. Have a great evening.

RebDee
RebDee 2014-11-12 11:05:10 -0600 Report

Since my bariatric surgery I am off the pump but I used to use one of a couple of details that helped. 1) Put the pump between your boobs so that your bra holds it in place. 2) Buy from Metronics one of their bands that have a place to put the pump and that fits around your waist. 3) Put the pump in your pocket so it is not on your waistband. 4) Suck it up and put the pump on your waistband and your blouse over it so that it does not show.

Cant wait to be thin and I am working on it very hard but oh so happy to not have to use any more insulin. Of course, I am eating under 1000 calories per day and that will change in another month or so. Each day is a challenge.

I eat mostly protein consisting of fish, chicken, turkey, beans. Not ready for nuts and meats as per instructions from the surgeon. I eat nothing white (sugar, salt, white rice, white noodles, white potatoes) but do eat gluten free noodles, sweet potatoes, and brown rice - maybe a half a cup or less at a meal. I don't eat lettuce as it has no nutritional value so therefore no salads (boo hoo).

Good luck with your Diabetes.

Poodle gal
Poodle gal 2014-11-12 07:58:48 -0600 Report

I read your message last night and thought about your problem—-I agree with Gabby's assessment that you ultimately need as much control as possible, but you still may be able to do this through using Lantis and Humalog. You would, however, need to weigh in with your doctor and record your testing blood sugars and what you are eating and when you are exercising. I am always working with my physician on how much Lantis is enough. If necessary, you could go back to the pump, but a good doctor could help you monitor your glucose levels. I'm so happy that you posted on Diabetic Connect because you have a whole bunch of people thinking about you. You will figure this out and help others along the way!

Angie Type 1
Angie Type 1 2014-11-13 21:17:35 -0600 Report

Hi, it's me again. This hasn't gotten better since last Friday and I'm giving up on this Lantis and Humalog. I am taking 13 u at night(i am 125 lbs) and it doesn't seem to do anything. I have talked with the diabetes educator everyday and they don't quite get it. I don't take huge amounts of Humalog like under 7 at a time because I am insulin sensitive and right now my husband of 7 months is hunting until Tuesday and I am alone without family to stay with me… so this is very hard without someone here but I can't stay this high until next week. :( I really wanted this to work and worked real hard with writing down everything… time, carbs, dosages … everything. How much Humalog do you "usually" take at meals? I realize its based on how many carbs but people tend to eat the same amounts unless they go to restaurants, Holidays, and special occasions. Thank you :)

Angie Type 1
Angie Type 1 2014-11-12 15:55:56 -0600 Report

Thank you Poodle gal. I wrote down everything I ate, times of testing, how much I took etc for my doctor appt yesterday Tuesday 11/11. She barely looked at them. I made a spreadsheet to note everything. I think she was upset I wanted a break. I've been a Type 1 Brittle Diabetic since 27, I'm 52, raised two boys with this disease and worked and still do(it's harder now) and went on the pump around 32 or 33. One person on here said "suck it up" really??? Hmmm? I don't know if you are a type 1 or type 2 and many people tell me it doesn't matter. But when your pancreas doesn't produce ANY insulin and you're brittle it does matter. Thank you so much again. You have great advice and encouragement.

Gabby
GabbyPA 2014-11-12 05:56:20 -0600 Report

Ultimately, I would opt for better control. Are there other places you can put your infusion set? 20 years is a long time to be on the pump and while I can see what you mean about the tubes, better control would win for me.

I have heard that members take a break from their pumps from time to time, but it's usually just a short time.

Angie Type 1
Angie Type 1 2014-11-12 15:44:01 -0600 Report

Hi Gabby,

Thanks for your input. I have used my waist, my butt, my legs and twist as far as I can go on my back around my stomach. I'm having a better day but it appears the Lantis 13 units doesn't last all day like they tell me it should??? Thank you and I know "better control" will ultimately win out I think.