Replies to This Discussion

Permalink Reply by Natalie ._c- on September 3, 2011 at 4:26pm

Actually, they weren't suggestions, only questions to possibly get you thinking. I would NEVER tell anyone what to do -- I'm not qualified! :-)

I have a CGM, and while it helps, it's NOT the answer, because it's not accurate enough, although even meters are not that accurate. That's why the manufacturers tell you to always test and never to correct on the basis of the CGM. For example, my CGM (I have a Medtronic) may say 189, when my meter says 278 (made up numbers, but pretty much what happens). So the CGM DOES let me know I'm high, but not how much. My biggest problem is that it doesn't always catch lows, and since I live alone, that's a problem. Although I've never had a low I couldn't handle myself (well, one) it's really a worry.

If I was able to have a dog, I would get one of those Diabetes Alert Dogs. They're more reliable than CGMs for lows, and highs are not nearly as much of an emergency!

Permalink Reply by Brooklyn on September 26, 2011 at 8:20pm

I am getting a CGM to go along with my Revel. what is a seven plus cgm? Can you tell me about some of the issues you had? Thanks!

Permalink Reply by Char Berss on September 3, 2011 at 5:59pm

You're quite welcome Ruth!

What i find difficult is knowing when to bolus AGAIN for a high BS. For example, i tested the other day and was 301.. so i bolused a correction. An hour later, i was still in the low 300s, but i didn't want to bolus again for the high, knowing that i just did an hour ago and that the insulin needs time to do it's work. It did eventually come down, and i think i bolused a correction later..

The trick is knowing when to wait. It can be very frustrating knowing that you are sitting with this high BS and can't fix it quick enough, but it's the only way to do it without crashing later, at least in my experience.

Maybe if you talked to your doctor? See if he/she can advise you on when to do a correction, and when to wait it out..

I was on the Medtronic CGM a number of years ago, and it did help give me an idea of my trends. I currently just started on the Dexcom today for the first time, and it's amazingly close to my readings when i finger-prick test! For example, meter said 73, Dexcom said 64. About 30 minutes later and after a couple glucose tabs, meter said 107, Dexcom said 113. CGMS are a great tool if you use it with "a grain of salt" and good diabetes habits. :)
Hope this helps!

Permalink Reply by Brunetta on September 3, 2011 at 7:19pm

My suggestions;

1)Read "Pumping Insulin" by John Walsh. Contains many ideas that teach you how to set the ratios, find the inslliun sensitiviies, and tells how use insulin for corrections without crashing... Talks about Insulin on board (IOB), and how to manage blood glucose with exercise. An excellent book with many charts and graphs. And Yes the learning curve for a pump is long.. I have been on a pump for almost 8 yearws and I am STILL learning. But this book, will help. Do not try to do everything all at one time..If you do, You will get overwhelmed and want to toss the pump. The pumo Is a lot of work, but along with my CGM, which tells me trends, I have had pretty good control as long as I count carbs, bolus accurately and my setyings are ok. I can understand you wanting to take a pumo vacation, but I personally would never go back to shots unless I had too.

2 )I use injections for very high blood glucose levels ( over 250), rather than correcting wih the pump. I space them out in little injections ( 3-4 units) over a 2 to 2 1/2 hours; Works quicker than waiting the 4-5 hours from bolussing throught the pump, FOR me. I let the pump determine the IOB by disconnecting and bolusing wih ther pump, letting the nlittle units just drop nout. Then I reconnect after having corrected with a syringe( I am not a pen user). There is probably a way to do that and not waste insulin, but I do not know how and I always wan tot know the IOB, do not wan to stack insulin and get hit in the face with a low, low 3 hours later. I try not to 'rage bolus" when I am high, because it just gets me in more trouble.
I find that i I don't tend to get that high at all if I test and watch carefully with the CGM. And yes, it takes a bit of time and pulls me away from things I would rather be doing, but ala,s that is how I have to manage type 1,, It does take a lot of time and diligence, but it CAN be done!!!

3) You can do it..It is great you came here to get help from others: " We have "been there" and know what you are going through. Tudiabetes is great.

God Bless,

Brunetta

Permalink Reply by rickyd7 on September 3, 2011 at 11:42pm

I dislike diabetes, A LOT! I have been a pumper for like three years? Was on an Animus pump, for like two years, now on a MM with a CGM, I also have been seeing a lot of positive comments about the Dexcom CGM.
I am so used to highs, had like a 350+ today Now it has gone from the 300+, and going down with one arrrow at 120. Just tested it came in at 111, that has been the closest in a while, usually it is wwwaaaayyyyy off!
I also can't feel highs or lows, AT ALL!
I just moved to FL from NJ, about a month ago, so I dont have ANY endo, or doctor YET. LOL, and MM could really care less, it seems!
The best doctor is yourself, I have found out, So I will continue to keep self medicating myself!
I had a CDE sit with me ONCE, then thats it! MM, I dislike the way that they handle the customers! I guess I will continue to gaze in my own pastures, and continue to figure things out for myself!

Permalink Reply by David Wheeler on September 4, 2011 at 5:09pm

"Pumping Insulin" by John Walsh

Thanks for reinforcing the use of this book. It is about time I added it to my library - and READ it.

Permalink Reply by Sandra Tamarin on September 4, 2011 at 5:24pm

I've been on the pump for a little over 2 years. Normally I love it, but the past 3 or 4 times I've changed my set, I've gotten a "no delivery" message, and I'm ready to give up. I use sure-T sets, so they can't possibly be kinking, and I'm pretty sure I don't have any scar tissue to block absorption. Plus when I try to call Medtronic, they say that there's a wait time of over half an hour to talk to someone.

I'm not sure how this is going to go. I've got pens, but the needles are 8mm, which are terrifying when compared to the 6mm ones that I'm used to. Basically, though, I think it'll be good to give the pump a break for awhile.

Permalink Reply by Ruthie on September 13, 2011 at 6:40pm

Hi Chrissy,
Thanks for your comments. I think I tend to micro manage my pump and when I go high and can't get it down, I am going way too low. My last bout with the ER really scared me, that's why I thought I should maybe go off, just because I get "trigger happy." I've not thought about depression as a side effect. That makes sense.

Having this support on Tudiabetes is going to help me because I am no longer feeling like no one understands what it is like. I don't have a lot of time to chat during the week because of work, but I plan to make staying connected a priority. Your comments encourage me to be smart about it!

Permalink Reply by Natalie ._c- on September 13, 2011 at 7:28pm

Not sure what kind of pump you have, but my Medtronic tells me whether there is insulin on board, and recommends NOT taking a bolus if I have enough insulin to eventually bring down a high. When I was on shots, I used to stack insulin all the time, and had a lot of lows, and with the pump, I have far fewer. I have learned to be more patient about waiting it out -- insulin does not act instantaneously!

With that said, there ARE times when I do need to take more insulin than the pump tells me to, but I am cautious about doing it. For me, a rage bolus (called that because you are SO frustrated with a BG that won't come down!) might be one unit. Or even two if I'm above 200. But just getting it headed in the right direction is my real goal. If I can get it down to 150, and it stays there, I can always take another bolus. I just don't want to take so much that it drives me low, because I HATE lows much more than I hate highs.

So what I'm trying to say is when you're trying to bring down a high, be cautious, and give it time -- what you say sounds you're stacking insulin, and you really DON'T want to do that!

Permalink Reply by Ruthie on September 29, 2011 at 8:02pm

Natalie, I realize that rage bolus -- I've never heard it called that, but it fits -- is part of my problem in yoyoing. When I test and get a high reading, I make a correction; then I test again in an hour or so, and if it's still high, I make another correction. The waiting is so uncomfortable because highs make me crave food. It's so frustrating when it's time to eat and I am high (lots of 300s) and should sit out and just watch everyone else eat. I often go ahead and eat and add lots of insulin. What a vicious cycle.

So learning about IOB is not only a new term, but just knowing it's a reality should help me stop the rage boluses.

Permalink Reply by Sam I am on November 2, 2011 at 6:01pm

I've been diabetic for over 30 years. Was on a pump from age 10ish to 20 or so. Then on shots until about 4 years ago. Benefit of shots--no attachments. But, I had no control what so ever on the shots...but with the pump, better control. My A1c is still off, but better. I got on the minimed and their CGM about a year ago. I am starting to loose "that" feeling, so now if I feel "off", I just look at my CGM to know if I should do a blood suger or not. I hate being tethered, but I like knowing what my bs is doing. It's a real catch 22.

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