Insulin Pumps

Hey Helen,

Sorry if I missed any post regarding your pump, but how did it work out over in Australia regarding the funding, insurance etc...........

The hardest part was getting the appointment with the Credentialled Diabetic Educator...literally took 5 months! The Endo was fine with it (a bit surprised I went with an Animas pump but OK with my choice). He wrote a letter to the Health Fund (Queensland Teachers), (mentioning varying HbA1c's and hypos) and apparently teachers do well on pumps! (control freaks/obsessive compulsives?) they paid for it all ($(AUD)7,500). The day in hospital was fraught! There is a lot to learn in the 2-3 hours the educator is there. And off course you cannot really practice on your pump as it is attached. The educator established the settings and basically left me to it. Lunch arrived and I got out the cheat sheet and could not get past the first two steps,,,hence no bolus for lunch so used my trusty pen! Spoke to the RN who rang the CDE who simply said do the usual (use the pen!). I was unimpressed...what am I doing sitting in a hospital bed supposed learning how to "pump" and using a pen for more than 24 of the 28 hours I am in hospital (the basal was functioning). I then decided I could fix it...out with the manual and after some thought and manual reading I "enabled" a function. Did not realize I could test the "theory" by simply disconnecting from the pump so told the RN that I thought I had fixed it. She had kittens on the spot! Rang the Endo who blasted the CDE and the situation was wait until tea and do it with the CDE on the phone...reading each screen. I had fixed it! To the CDE's credit I think she had the basal rate fairly right (although it is the same over 24 hours and that does not seem logical) but she is way down on the I:C ratio and I have been asked not to touch it (I had, so reversed it) but to keep taking corrections through the pump! So I am still counting carbs inputing that data letting the pump calculate how much insulin I need...documenting that and then adding in what I think (and documenting that). The BGs are OK (not good) on this but it seems a bit pointless not to increase the I:C ratio based on what I needed for carbs pre pump. I will give her two weeks then I will decide what to change. My Endo is OK with that but has warned me not to be too adventurous! I leave to go to Korea (the land of rice and honey) in 11 days. Saw my GP for a flu vac yesterday...I think he is impressed!

I have decided not to insure it as it is attached to me, It seems that if I do insure it I have to insure it under house/contents insurance, like jewellery, and whilst I like the look of the pump it is hardly bling! This type of insurance is expensive. Will discuss travel insurance with the travel agent later today but probably will not insure it as it will never leave my side. The Animas "lady" has offered me a loan pump as a spare to take with me. Much more kit to take than when on MDI's

Helen

Hi,
I have been on a pump for 6 months now. I went on one, due to high BG in morning, due to dawn rises. And also i have a job which fluctuates the amount of physical activity i do from one hour to the next and i was constantly snacking.
I have found since i have been on the pump i have had less hypos but i also get a lot of high readings,especially after my bolus has run out.
The thing is how do i know if my QA CP RATIO is correct if if my sugars are going up 5 or 6 hours but ok say at 4 hours after a meal. The only way i imagine is by fasting at different meals over a few days or weeks EG: skip lunch see what happens to BG and then skip dinner on some other days.
I realise this probably doesnt make any sense. But how can you know if you basal is right if you keep topping up with boluses for meals

I've been using an insulin pump for about 4 years and my diabetes is the best it's ever been. Don't get me wrong it hasn't been easy and has taken a great deal of work but i would never think of going back to injections. I was having a lot of hypos at the time and had lost most of my awareness so my specialist decided to try me on a pump. I now have some awareness back but not fully and it allows me to fine tune my insulin to suit my day to day activities. I would recommend them to everyone if given the chance to try one.

Paul...................

The only true way to test your basal dose is to miss a meal, the QA dose being delivered at meal times would need to be removed to check, not all day though, just breakfast one day, lunch the next, as you described.

You say you get high readings when your bolus runs out, at this point, usually before a meal, your BG readings should be on or approaching target, if it is not, then something is wrong, basal or bolus, but at the 6 months stage I would assume you have established your basal rates throughout the whole day. But it seems you may not have it sussed totally. So in light of that you need to go on a mission to establish your daytime basal rate(s) before changing your bolus ratios ,basically back to basic, the DAFNE basics............

At the 5-6 hour mark your bolus has gone, so any rise in sugars should be down to the basal................have you played about the temporary basal rate function with regards to fluctuating physical activity............?