670G Medtronic

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Faith_exx

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Relationship to Diabetes
Type 3c
Hi guys!
I’m looking for someone that can help me.
I’m 20 years old and I’ve been insulin dependant since I was 6 but my family and diabetic team have always altered my pump and I’m trying to learn how to use it to its full potential.
I’ve tried sensors that connect to it but I’ve only gotten along with the new libre 2. Thanks to this forum I’ve realised I’m type 3c diabetic and not type 1 as I’ve been lead to believe for the last 14 years. I know my questions may seem trivial but I need to understand what’s going on and how to make my diabetes more manageable.
My questions are:
What way do I change my carb ratio to reduce the amount of insulin I get and by how much do I alter it each time?
How much do I change my basal rate by each time and what way means what? Like if I go up do I get less or more?
I’ve only just started trying to look after myself and my health and I’m trying to learn the best I can.
I only currently how to put on a temp basal, give a bolus and I know how to get to things on my pump. However I don’t know how to change anything or what means what. If anyone can give me any help I’d really appreciate it. I’ll put another post on with my basal rates, insulin sensitivity etc…
Anything you think I should know that’s not listed please tell me! Thank you ☺️
 
My basal rates are
(00:00-04:00) 0.550
(04:00-08:00) 0.550
(08:00-11:00) 1.10
(11:00- 15:00) 0.650
(15:00-17:00) 1.10
(17:00-19:00) 0.925
(19:00-24:00) 0.600
Carb ratio is
(00:00-06:00) 12
(06:00-24:00) 10
Insulin sensitivity factor says 4
 
Hi Faith

It is great that you are now looking to take on your own management. Do you have access to a specialist team to help you with this locally? We can not advise on dosing and changes but can suggest general principles around this.

Basal rates
In general it is most important to get your basal rates right. Is there anything to suggest that these are incorrect Eg are you having hypos in the night? To check the basal rates you would need to do a fasting basal rate test.( I will drop a link in to a description on this here assuming my tech skills work). You check this in blocks of hours through the day, and check a different block on each day. This can take a little while as we end up having to stop the test if you hypo or go hyper, so need to be patient. If you need to change a rate for your basal insulin, you need a little more insulin if your levels are going high, and a little less if your levels are going low. Changes are made cuatiously.

Carb ratios
I can understand the confusion around changing ratios and have to stop and think before I make any changes. I will try with an example.
You say that your ratio is 10 during the day.
This probably means 1 unit of insulin for every 10 g of carbs
If I find, looking at patterns from my sensor, that I need a bit less insulin, I would change that to 11. So now I would get one unit for every 11g of carbs.
I notice that your ratios are the same throughout the day. A lot of people find that they need different ratios at different times of day. BUT check your basal rates first.

I would start to work on one thing at a time, and work with your team to help you if you are in any doubt.
I hope that that helps.
 
SB2015 said:
Hi Faith

It is great that you are now looking to take on your own management. Do you have access to a specialist team to help you with this locally? We can not advise on dosing and changes but can suggest general principles around this.

Basal rates
In general it is most important to get your basal rates right. Is there anything to suggest that these are incorrect Eg are you having hypos in the night? To check the basal rates you would need to do a fasting basal rate test.( I will drop a link in to a description on this here assuming my tech skills work). You check this in blocks of hours through the day, and check a different block on each day. This can take a little while as we end up having to stop the test if you hypo or go hyper, so need to be patient. If you need to change a rate for your basal insulin, you need a little more insulin if your levels are going high, and a little less if your levels are going low. Changes are made cuatiously.

Carb ratios
I can understand the confusion around changing ratios and have to stop and think before I make any changes. I will try with an example.
You say that your ratio is 10 during the day.
This probably means 1 unit of insulin for every 10 g of carbs
If I find, looking at patterns from my sensor, that I need a bit less insulin, I would change that to 11. So now I would get one unit for every 11g of carbs.
I notice that your ratios are the same throughout the day. A lot of people find that they need different ratios at different times of day. BUT check your basal rates first.

I would start to work on one thing at a time, and work with your team to help you if you are in any doubt.
I hope that that helps.
Click to expand...
My basal rate seems okay. I’ve done half the carbs I’m meant to and I seem to be stable I think it was the heat mainly but I’ve been having hypos some of the time when doing insulin. I don’t have a specialist yet I’m waiting to be referred. My gp didn’t acknowledge I was diabetic, even though I’ve gotten my prescription many of times, and I had to ask to be referred. I found out yesterday that I need to go get my bloods taken on Monday so they can send it to the hospital before I’m officially referred . When I’ve got an appointment there’s a few things I want to mention, including my bloods. But the libre 2 has helped loads with gathering data and I’m hoping they’re going to be able to help and be able to give me the libre on prescription as I’m on universal credit.
 
Faith_exx said:
My basal rate seems okay. I’ve done half the carbs I’m meant to and I seem to be stable I think it was the heat mainly but I’ve been having hypos some of the time when doing insulin. I don’t have a specialist yet I’m waiting to be referred. My gp didn’t acknowledge I was diabetic, even though I’ve gotten my prescription many of times, and I had to ask to be referred. I found out yesterday that I need to go get my bloods taken on Monday so they can send it to the hospital before I’m officially referred . When I’ve got an appointment there’s a few things I want to mention, including my bloods. But the libre 2 has helped loads with gathering data and I’m hoping they’re going to be able to help and be able to give me the libre on prescription as I’m on universal credit.
Click to expand...
As a matter of interest how are you getting your pump supplies if no hospital referral so far?
 
Faith_exx said:
My basal rate seems okay. I’ve done half the carbs I’m meant to and I seem to be stable
Click to expand...
What do you mean you have done half the carbs you are meant to?

When basal testing you skip a meal completely and the next day do a different time slot again missing that meal in the time slot.
 
Pumper_Sue said:
As a matter of interest how are you getting your pump supplies if no hospital referral so far?
Click to expand...
I’m just getting it from Medtronic, I was with a hospital up north and have recently moved. The hospital couldn’t transfer me because I didn’t do a face to face meeting before leaving. Medtronic haven’t mentioned about not being in a hospital
 
Pumper_Sue said:
What do you mean you have done half the carbs you are meant to?

When basal testing you skip a meal completely and the next day do a different time slot again missing that meal in the time slot.
Click to expand...
I mean that I ate 80 carbs worth of food and did 4 units instead of the 8 I was meant to and I actually still ended up going hypo. I don’t know how much that means I have to edit my carb ratio by- just something I don’t understand yet but want to. Problem is if I don’t eat on a morning I go hypo so I always try to eat something carby on a morning eg weetabix & milk. I’ll have to try to do that sometime though. Its all new to me (something my family or diabetic team have dealt with) and im really wanting to learn for myself so all of this is really helpful.
 
Faith_exx said:
I mean that I ate 80 carbs worth of food and did 4 units instead of the 8 I was meant to and I actually still ended up going hypo. I don’t know how much that means I have to edit my carb ratio by- just something I don’t understand yet but want to. Problem is if I don’t eat on a morning I go hypo so I always try to eat something carby on a morning eg weetabix & milk. I’ll have to try to do that sometime though. Its all new to me (something my family or diabetic team have dealt with) and im really wanting to learn for myself so all of this is really helpful.
Click to expand...
So your basal is wrong.
If you eat no food then you should not go hypo if your basal is correct.
As you are going hypo like you say then you are having to much basal insulin.

The idea of basal insulin is that you can skip meals and snacks all day long without going hypo.

Faith_exx said:
’m just getting it from Medtronic, I was with a hospital up north and have recently moved. The hospital couldn’t transfer me because I didn’t do a face to face meeting before leaving. Medtronic haven’t mentioned about not being in a hospital
Click to expand...
I think you will find the hospital is funding your supplies so once they realise you are not there any more, Medtronic will not supply your cannulas and cartridges.
 
Welcome to the forum @Faith_exx

Great to hear you want to start managing your diabetes yourself. Sorry that your house move seems to be complicating things - hopefully a referral to your new hospital clinic will come through very soon so that you can get the support and advice you need.

You should have an instruction manual which came with your pump - they aren’t always the lightest read, but there will be a section on setting insulin:carbohydrate ratios and setting up the ‘bolus wizard’ which should help you understand how to alter ratios to get less insulin.

It does sound like your basal is currently set too high though, if you are needing to eat something carby regularly to avoid hypos.

I wonder if a ’guidebook’ to insulin treatment like Ragnar Hanas’s Type 1 Diabetes in Children Adolescents and Young People might help you and give a few pointers about modern diabetes management?
 
Last edited:
Pumper_Sue said:
So your basal is wrong.
If you eat no food then you should not go hypo if your basal is correct.
As you are going hypo like you say then you are having to much basal insulin.

The idea of basal insulin is that you can skip meals and snacks all day long without going hypo.


I think you will find the hospital is funding your supplies so once they realise you are not there any more, Medtronic will not supply your cannulas and cartridges.
Click to expand...
They know I’m not in one as I’ve changed address. They didn’t seem to have a problem as I’m trying to get in there’s just not much more I can do. It’s down to the gp now my fingers are crossed it won’t take long.
I’ll have to ask about my basal rates being changed then as it’s only on a morning. Thank you for the info ☺️
 
everydayupsanddowns said:
Welcome to the forum @Faith_exx

Great to hear you want to start managing your diabetes yourself. Sorry that your house move seems to be complicating things - hopefully a referral to your new hospital clinic will come through very soon so that you can get the support and advice you need.

You should have an instruction manual which came with your pump - they aren’t always the lightest read, but there will be a section on setting insulin:carbohydrate ratios and setting up the ‘bolus wizard’ which should help you understand how to alter ratios to get less insulin.

It does sound like your basal is currently set too high though, if you are needing to eat something carby regularly to avoid hypos.

I wonder if a ’guidebook’ to insulin treatment like Ragnar Hanas’s Type 1 Diabetes in Children Adolescents and Young People might help you and give a few pointers about modern diabetes management?
Click to expand...
Thank you I’ll take a look at that- I think my manual may still be at my parents as when I got a replacement I didn’t receive one. I really hope I can get into the hospital soon so they can take a look at my ratios as like you said they’re clearly wrong. Thank you for the info ☺️
 
Faith_exx said:
Thank you I’ll take a look at that- I think my manual may still be at my parents as when I got a replacement I didn’t receive one. I really hope I can get into the hospital soon so they can take a look at my ratios as like you said they’re clearly wrong. Thank you for the info ☺️
Click to expand...
I put a link to the manual in your previous thread on the main forum
 
Faith_exx said:
I really hope I can get into the hospital soon so they can take a look at my ratios as like you said they’re clearly wrong. Thank you for the info ☺️
Click to expand...
May I also point out to you, it is your job to adjust your pump settings.

I hope you don't end up with a nasty shock and they take your pump away when you do get a clinic appointment due to not using it properly.
Basically you are a danger to yourself with your lack of knowledge regarding the use of your pump. You need to download that manual and learn how to use it before you end up in a coma.
Please note I am not being unkind to you just pointing out how serious your situation is regarding your safety and wellbeing.
 
Faith_exx said:
I mean that I ate 80 carbs worth of food and did 4 units instead of the 8 I was meant to and I actually still ended up going hypo. I don’t know how much that means I have to edit my carb ratio by- just something I don’t understand yet but want to. Problem is if I don’t eat on a morning I go hypo so I always try to eat something carby on a morning eg weetabix & milk. I’ll have to try to do that sometime though. Its all new to me (something my family or diabetic team have dealt with) and im really wanting to learn for myself so all of this is really helpful.
Click to expand...

I’d say your basal rates are definitely wrong if you’re going hypo without food in the morning. Until you get your basal rates right, then it’s pointless looking at your meal time ratios because if your basal is wrong it will throw everything else out.

I find getting the nighttime basal rate first easiest. Getting the basal test done is something that can take days or even a week or two depending on your situation. What time do you find you go hypo in the morning if you don’t eat? Do you wake up with ok blood sugar?

(And no question is trivial 🙂 )
 
Faith_exx said:
Thank you I’ll take a look at that- I think my manual may still be at my parents as when I got a replacement I didn’t receive one. I really hope I can get into the hospital soon so they can take a look at my ratios as like you said they’re clearly wrong. Thank you for the info ☺️
Click to expand...

You might be able to get one (or request one) from your local library first to get a feel for it before you splash out?
 
Inka said:
I’d say your basal rates are definitely wrong if you’re going hypo without food in the morning. Until you get your basal rates right, then it’s pointless looking at your meal time ratios because if your basal is wrong it will throw everything else out.

I find getting the nighttime basal rate first easiest. Getting the basal test done is something that can take days or even a week or two depending on your situation. What time do you find you go hypo in the morning if you don’t eat? Do you wake up with ok blood sugar?

(And no question is trivial 🙂 )
Click to expand...
I edited my basal rate this morning for night time as I woke up on 4.8 after a 75% temp basal last night. Hoping this will maybe fix the low on a morning.
Thank you for the help
 
Well done @Faith_exx
It can seem complicated at the start but once you have done a few changes it will get easier.
 
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