Untethered Regimens? My try with Levemir and NPH

I know some people do variations of this. I think @Jen started this a while ago with Lantus. @Chris’s son does this. And I am trying to get Darling @Nickyghaleb to do this too…

For me the huge benefit of a pump is being able to turn off basal completely for exercise. But the downside of the pump is that there is a lot of variability with different sites. And different days of the pod.

Because I want to still be able to turn off basal for exercise, if I want to do this, I need to do a basal insulin that has a short lifespan.

I had the idea of turning off pump basal during the nighttime, and using Levemir and NPH. The NPH covers the 4am-6am time, which would otherwise spike me.

So this is what I got last night. Zero from the pump, totally the magic combination of Levemir and NPH:

I think I am going to start doing this at night. I liked it.

@Jen, are you still doing this?

Anyone who is doing untethered combos, please share what you do.


I’m currently not. I was initially only taking five units of Lantus, and then hormones kicked in and I increased that to 20 units and didn’t feel it was doing anything, so I stopped. But I have more Lantus in the fridge, so I’ll probably start again sometime during the summer. Probably sticking to five units and doing any basal increases I need through the pump.

For me, the main purpose of this was to provide a whiff of background insulin, which seemed to really dramatically help my control. Any more than a whiff just seemed to get complicated. I wanted to still be able to disconnect the pump and get close to zero insulin, but maybe be protected from infusion site variability.


There are so many variations on how this can be done and used for people.

What I did last night was turn off basal for 12 hours (which is about how long Levemir usually lasts for me). I turned it off right after I took the Levemir and NPH.

But I know it takes a little while for Levemir to kick in, so I did an extended bolus to cover 1 1/2 hours of ramp-up time for the Levemir. And it worked pretty well, so I will definitely keep that same thing in the mix.

And if I forget to take the Levemir at night, it’s no big deal since the pump basal will still be on.

The only issue I foresee is if I take the Levemir and forget to turn off basal. But I will get into the habit of doing those at the exact same time, so hopefully it won’t be a problem.


Saw this today, too, but haven’t had time to respond. Definitely interested in exploring…

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So?? How is this going? Are you still doing it? I see my endo in a month and was going to ask for Tresiba… then to return here for further instructions. Is that still the plan, or have you abandoned it all?

I am doing it sometimes. I like the coverage it gives me, and I think reducing the total insulin delivered into a single spot in your body definitely improves the pod for the rest of the time I am using it.

If it is late and I just want to go to bed and not worry myself with taking the Levemir and NPH, I just skip it, and leave the pod running.

I think it can help you for sure if you still have the pump turning itself off without you being aware of it.

I think anything new or different is worth at least trying a little bit. No harm in trying it.

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At least twice a day a suspend is well underway before I catch it. Sometimes I need them, but more often than not, it just complicates things. My sensors have been really messed up lately, and twice a day my pump is suspending itself because it thinks I’m at a 50 when I’m at a 100+. It’s like keeping an eye on another child. Who’s playing with matches. :grin: anyway, I’ll plan on getting the Tresiba and messing with it…

Don’t you get an alarm when it shuts off? If not can you enable it?

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Are you not able to shut this unknown suspend feature off?!?!

3 things I would suggest:

  1. I would defintiely tryTresiba as a partial basal supplement, so you do not ever have zero basal.
  2. Try using some Tresiba to supplement your basal.
  3. See if you can get a sample of Tresiba, so you never have unknown zero basal.


All kidding aside, this would entail a bit of adjustment to your exercise BG management, but it is perfectly manageable.

I’ve also noticed this, since I started never delivering more than 3.5 to 4U at one time and injecting the rest, which has recently morphed into pumping the decimal amount of a bolus and injecting the rest, meaning even less is delivered to the same spot. I hardly ever see those third-day WTF highs now.


Went to the endo and got me some Tresiba…

Is this still the cool thing to do? Or did I miss it? :smiley:

I’m sorry… I just saw this. On the 670G, the alarms are just not great. They changed the sound, and they just don’t catch your attention the way they used to. Or, at least, in my opinion. I have learned how to double up on the alarm so as to stand a chance… I have it set so I receive notification I’m approaching my low limit, then notification it’s suspending itself. My brain, however, has trained my ears not to hear it. Once you clear that notification that it’s suspending, and that tone really just doesn’t demand attention in the first place, you silence your pump for the remainder of the suspend. So, say, if your 3 boys are having an all out wrestling match in front of you, and you’re trying to peel them off each other while avoiding having your tube caught up and ripped from your body, AND you clear that alarm without thinking… which has been known to happen here… you just might not look back down again until enough time has passed to have created a small mess.

I’m master of the blind clear. It has not been a skill that’s worked out well for me. :roll_eyes:

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