Last week saw my Endo. I’ve been struggling with everything, normal day is as follows.
5 am wake - 350
5:15 Resting 300
6:50 Bacon Gouda sandwich + 6units humalog - 330
8:35 69 (Crashing!!!)
8:40 Rice Krispies treat , fruit snacks, 80carbs, 50 sugar - 64
1130 4U Huma + Small sandwich - 330
1220 - 128
100 - 84
115 - 72 (Crash)
130 - 69 - Orange Juice, Triscuits
140 - 79
215 - 200
245 - 301
He prescribed me a pump and a frestyle wirless reader. Got both Friday. Not knowing any better and being sorta of a figure it out type of guy. I started setting everything up…
I got to a point where I had a question, and called the support number.
They freaked out cause I didnt have a trainer, nor any numbers from my doctor. They instructed me to deactivate and remove the pod, which I did. So yesterday I played rollercoaster with me numbers… Again.
So… And pardon my rant, but Im hoping there is a way I can set this up, or calculate the numbers as the trainer wont have time to meet with me next week. that puts me into probably Jan to set it up.
While I know this seems a little odd, Im really really trying to get this under control because when my numbers get really high, I go into these crazy depression Falls (Name pending. LOL), and my day to day is horrible.
I saw you posted this awhile ago and wanted to say hello. I know all about rollercoasters, and I’d love to try to find someone who can actually help. You aren’t the first one to throw on a pump and get it going without doing the training first. I recently tried out an OmniPod and did the same. It’s a reasonable thing to do and a reasonable device with which to do it. Either way, you’re off of it now.
I’m not sure what would sound dumb about that. I’ve been diabetic 15 years and have only had any idea what I’m doing for about a year and a half. When I was done with all those crazy numbers though, I was done. It’s not a bad place to be… frustrated. It’s better than comfortable and accepting. But I might be projecting. Anyway, I’m glad you’re here. It took me 6 months in here to learn what I never could in 14 years out there. Don’t worry about sounding dumb. I’ve already cleared the way.
What is your pre pump routine?
Levemir or Lantus, or other long acting? What dose?
Do you bolus fast acting for meals and carb count? (Humalog?) What is your carb ratio?
Are you early stage LADA with unpredictable insulin by your own pancreas ?
This would help determine the initial pump settings. Then using trends from Libre you can adjust.
Books like Pumping Insulin by John Walsh and Think like a pancreas by Gary Scheiner, and Sugar surfing by Stephen Ponder may be helpful.
Hey! You must be my friend’s friend I referred here. Welcome!
Seconding the advice about meeting with a CDE—they can sometimes be more helpful than the endos re: the super practical stuff. I’d guess that your endo’s practice would have one, especially if they have a high volume practice.
Also, while I don’t have advice re: the pump, in the meantime, I think you are likely overcorrecting for both your insulin doses and low treatments. Both take a while to kick in, so one thing all of us have to learn is patience, which is super hard when you feel crappy and just want it to get better right now! But if you dose that frustration in either insulin or in carbs, it can often send you into the kind of rollercoaster you’re experiencing. There are some advanced moves to address that, like overtreating a low and taking insulin when you do (even though you’re still low or low-ish) but those take some experience and/or a CGM to get right. For the moment, I’d try reducing both your insulin and carb corrections—take less insulin to bring down when you’re high and give it a couple of hours at least to see what it does, and then take way fewer carbs (like 15 grams max) when you’re low. If you’re coming back up much at all in 15 min (even if still low), that’s probably enough, because you’re probably still rising. So I think even if you wait on the pump, there are things you can do in the meantime to mitigate the rollercoaster.
What questions do you have regarding the Omnipod? From your descriptions, this sounds to me more like a timing issue for the highs and perhaps a need to tweek I:C but I’d love to hear more about what you think the issue areas are and what you need as far as help?
There are quite a few PODders here so if it’s just technical in nature as far as configurations go, I know collectively we can help you out.
I agree with this, at least from the day you’ve posted so far.
If you don’t know how to count carbs and use a carb ratio (and correction ratio), these things would really help you both in calculating exactly how much insulin you need for meals and exactly how many carbohydrates you need for lows.
The numbers you’ve posted for lows seem to be borderline to me, not super low. Some people run in the 65-75 mg/dl range for hours and are fine as long as they are not dropping lower. Though if you are running high a lot of the time, that level can feel super low. Lots of us use around 8-12 g or so of carbohydrates to treat lows. So treating with 80 g may be way too much, though it depends on how low you are and other factors.
Learning about basal testing will also be useful and is probably one of the things that will be covered in pump training. Transitioning to a pump does bring a lot of extra terminology and things to learn to find and maintain the right pump settings (which will then change over time).
Meeting with a CDE or reading books such as Think Like A Pancreas by Gary Scheiner can really help you learn about this type of stuff.
What everyone has said is correct, but I’d also add dosing insulin is not just about the amount of insulin you take for food but the timing. Humalog has a very specific peak and curve that is great for matching some meals but is awful for others. A very simplistic example is if you were to eat 2 pieces of bread with nothing else vs. a bacon and cheese sandwich. The bread by itself will digest quickly, meaning dosing a certain amount of humalog and then eating might work out okay most of the time. If you add cheese and bacon you are adding protein and fat, which will not only slow the digestion of the bread, but some of the protein will convert to carbs hours later. If you took the same amount of Humalog right before eating you might go low, since the Humalog will peak before the bread carbs have digested, and then high later as you will have treated the low and carbs/protein converting to carbs will digest after the dose of Humalog has worn off.