More Endo poor quality follow up related to TWIIST pump

Type 1 & LADA
1

Spoke to the TWIIST customer service again about my pump insulin cassette showing empty, when it had maybe 65 units insulin left in it. I found out that they have to report all customer concerns and problems to the FDA!!! I said, if I had known that I would not have called as much as I did. I was told that as a new medical device they are accountable for quality issues. Not all are quality issues, some are customer mistakes or lack of knowledge. I meant to talk a short call and ended up an hour or more as their reps are very patient and supportive (unlike my endo)..

My recent issue has been when I take the recommended Bolus the pump tells me to take, after putting in correct carb total, I have gotten low blood sugar on a few occasions.  Said i didn’t know if I could trust the TWIIST algorythm as several times insulin advised seemed to high for the current BS level I have.  Long and short, TWIIST advised me to review my number settings on pump with endo (the one that hardly talked to me and did no explaining of anything) telling him I have been having lows.  I have overridden the pump bolus numbers usually to a lower number but I am making my decisions contrary to pump figures.  Guess I have to have ANOTHER appt. with that guy and it probably won’t be for months. Most of the TWIIST reps are diabetics and I have asked some of them about their endo performance.
2

From your message it doesn’t sound like you’re going low overnight or when fasting. If that is correct, then the most direct ways to stop (minimize) post prandial lows would be to adjust either your target range or your insulin to carb ratio.

If your lower blood sugar target range is below 120, you might nudge it up a bit. However, the most direct approach is to make a small adjustment to the insulin to carb ratio. If you now use a 1 unit of insulin for every 10 carbs, you might just change to 1 unit for every 11 carbs. Small changes like that don’t carry big risks and if the experiment doesn’t work, you can always go back after a few days.

If you post more detailed information, you might get helpful suggestions

3

Not sure what you mean in terms of my TWIIST settings: glucose safety limit is 75; correction range is 128-150, carb ratio 8.5 (was 10). I called doctor and was told an M.A. would call me back and relay my issues to doctor…no appt. until end of August. It was in fact a Diabetes Educator who called me and proceeded to tell me that she could not authorize change in settings but could explain what they were for. Same old same old…have appt with primary in two weeks and will ask for another referral and look up on line myself…sick of changing doctors.