Insulins Or Pump

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mandamoo1983

mandamoo1983

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Relationship to Diabetes
Type 1
Hiya

Just a quick query really not sure if you will be able to answer it tho, ive been diabetic for nearly 18years and i have been on various insulins, for the past 6 years i have been takin novo rapid 3 times a day and levemir insulin on a night time, its a pain havin to inject 4 times a day but its help to maintain my weight been only 27 i dont want to increase chances of heart problems etc, and at the moment im tryin to get pregnant. i qualiifed as a pyschartic nurse last year but my insulin regime isnt workin with my shift patterns, its either hypos or hypers wher i miss breaks of insulins doses. ive spoken to my diabetes nurse and shes keen on me havin a pump, not sure if a pump would be suitable as im tryin to get pregnant, which i really dont like the sound of, do you know of any other insulins that would better suit a busy nurse, that i can look up or suggest ??? ive mentioned goin back on mixtard, but last time on this my weight piled on, or any links where i could gain futher information. Im avoiding going to see my diabetic nurse as she doesnt seem to listen how much i dont want a pump attached to me 24hr a day, not really sure how it all works she did explain but i wasnt really listening as it freaked me out, im so used of injection dont know how it would be without???

sorry for the long message any help anyone:confused: xx

thanks amanda
 
A pump would be great and I think fine even if you are trying to get pregnant, as your control would be considerably much better once you had settled in to using one...............

But you say your job means your busy and often miss insulin doses, are you refering to your Levemir Insulin and if so is it when your on a night shift......

I think you may just need to make time for these things and let any superiors know this.......
 
i always take my levemir insulin its the novorapid that i have missed, durin the day, i contiue my same regime when on mights i just take extra levemir as id be snackin thru the night, then miss my morning novo rapid, just read the NICE guidlines on the pump n my last HbA1c reading was 6.8:confused:
 
Hi Amanda

I've been on the pump for a year now, and I wouldn't give it back! I think it definitely offers more flexibility and and better ways to control your diabetes, which are ideal if you're trying for a baby and it should help you with your varying work patterns. It's a lot of work, but in my opinion the results are worth the effort. If you have a look though the pumping section there are a few other posts where people have written about their experiences with the pump that might help you decide. You could also try having a look at the websites of the pump companies:

Animas: http://www.animascorp.co.uk/

Medtronic: http://www.medtronic-diabetes.co.uk/

Roche: http://www.accu-chek.co.uk/gb/products/insulinpumps/index.html

I think mixtard would be a nightmare with shifts - I always found I had to be much stricter with my routine when I was on mixtard and eat an inject at fairly specific times to avoid lots of hypos/hypers.

Have you been on a carb-counting course or something like DAFNE? I'm a bit confused when you say you're missing novorapid doses - if you match your insulin dose to your carbs, and your basal is set right, you should be able to skip meals without too much problem - if you're having to eat to keep your blood glucose up, or take extra insulin to keep it down, then maybe your levemir dose isn't right? Have you been taught how to adjust your insulin doses?

With regards to the NICE guidelines, you can be given a pump if you're having problems with hypos even if your HbA1c is lower than 8.5. 🙂
 
So you might not get a pump, as you have good control according to your HbA1c, if its the novo your missing then I would try my best not to snack or eat carbs........I would insist that I got a few minutes to test and inject, then you can snack all night............

Why do you take extra levemir then miss your morning novo dose.....?
 
+1 to suggestions of going with the pump. It's actually better than injections, IMO, and it's not a drag to wear one.
 
@ randomange when i was on the mixtards my diabetes control was very poor, and i gained weight, i have only ever been taught about insluin doses and "exchanges" as they were called when i was first diagnosed with diabetes when i was 10 years, i just adjust my insulin doses to as what i think is best, i.e by what im eatin/ not eatin, how busy my day is etc, no day is the same amount with my novorapid, as most days i only take it 3 times instead of 4 cos i dont have breakfast or sometimes dont have lunch. I always have 40 units of levemir n 42/44 whenim working night shifts which seems to work for me. I know this is very poor control really and being a nurse i should take more care and no about carb intakes etc.... but after being a diabetic for so long i have just lost interest, and as i have had no problems untill i started working fulltime now i must have 2/3 hypos or hypers a wk. The last week has been a nitemare. My bloods have been in the high 20's as im on night shifts atm, tried adjusting my insulins and yesterday i have 3 hypos after having good meals throughout the day, hense the reason for comin onto the forum for some advice. I have appt with g.p thursday, but will have to wait for an appt with diabetic nurse, its been over a y since i last saw her tbh.

Amanda
 
Last edited:
mandamoo1983 said:
Hiya

Just a quick query really not sure if you will be able to answer it tho, ive been diabetic for nearly 18years and i have been on various insulins, for the past 6 years i have been takin novo rapid 3 times a day and levemir insulin on a night time, its a pain havin to inject 4 times a day but its help to maintain my weight been only 27 i dont want to increase chances of heart problems etc, and at the moment im tryin to get pregnant. i qualiifed as a pyschartic nurse last year but my insulin regime isnt workin with my shift patterns, its either hypos or hypers wher i miss breaks of insulins doses. ive spoken to my diabetes nurse and shes keen on me havin a pump, not sure if a pump would be suitable as im tryin to get pregnant, which i really dont like the sound of, do you know of any other insulins that would better suit a busy nurse, that i can look up or suggest ??? ive mentioned goin back on mixtard, but last time on this my weight piled on, or any links where i could gain futher information. Im avoiding going to see my diabetic nurse as she doesnt seem to listen how much i dont want a pump attached to me 24hr a day, not really sure how it all works she did explain but i wasnt really listening as it freaked me out, im so used of injection dont know how it would be without???

sorry for the long message any help anyone:confused: xx

thanks amanda
Click to expand...

Hi Amanda,
Ask your nurse to explain about pumping in more detail to you and show you a pump.
I can assure you that having it attached 24/7 is not a problem. I never noticed the pump after 24 hours.
The idea of the pump is that you can match your basal pattern to your own body needs. Thus you can skip meals or eat when you like without any ups or downs.
It takes a few weeks to sort out your right dose and pattern, but well worth the effort.
If you are either hyper or hypo durring your shifts then something is wrong. I would suspect your basal from what you are saying. Has it ever been sugested to you to split your Levemir?
Have you done any basal testing to see what is happening? Do you count carbs and adjust your insulin for what you eat?

I saw on another site the idea of wearing a yoyo as a pretend pump. Tape the string to your tummy and have the yoyo in your pocket 🙂 Another option so you don't have the temptation of playing with the yoyo 😛 is to ask your nurse if you can trial a pump with saline in it for a week.
Mixatard isn't made any more so you can't have that anyway.
 
A carb course is a must and soon............coz your busy and on night shifts once your educated you can function normally, because your doses are all over the place you will be having lows and then highs so you wont be much use at work.........I was the same on the night shift before learning carbs....

DAFNE is the most common carb counting course, last 5 days though, so might nor be pratical..........
 
Pumper_Sue said:
Hi Amanda,
Ask your nurse to explain about pumping in more detail to you and show you a pump.
I can assure you that having it attached 24/7 is not a problem. I never noticed the pump after 24 hours.
The idea of the pump is that you can match your basal pattern to your own body needs. Thus you can skip meals or eat when you like without any ups or downs.
It takes a few weeks to sort out your right dose and pattern, but well worth the effort.
If you are either hyper or hypo durring your shifts then something is wrong. I would suspect your basal from what you are saying. Has it ever been sugested to you to split your Levemir?
Have you done any basal testing to see what is happening? Do you count carbs and adjust your insulin for what you eat?

I saw on another site the idea of wearing a yoyo as a pretend pump. Tape the string to your tummy and have the yoyo in your pocket 🙂 Another option so you don't have the temptation of playing with the yoyo 😛 is to ask your nurse if you can trial a pump with saline in it for a week.
Mixatard isn't made any more so you can't have that anyway.
Click to expand...

what are basal testing, tbh i havent taken much notice of my insulin just inject n eat..... how often do u have the canula changed in these pumps??? and how oftern does the pump last??
 
what are basal testing, tbh i havent taken much notice of my insulin just inject n eat..... how often do u have the canula changed in these pumps??? and how oftern does the pump last??


i will ask about these courses when i see my gp thursday, really need to take more control not only cos i want to try for a baby but future health and wellbeing,

what happens to the pump during, sex, baths/showers/ exercise, will visit the website when im back on my pc as only replying from my phone atm xx
 
novorapidboi26 said:
A carb course is a must and soon............coz your busy and on night shifts once your educated you can function normally, because your doses are all over the place you will be having lows and then highs so you wont be much use at work.........I was the same on the night shift before learning carbs....

DAFNE is the most common carb counting course, last 5 days though, so might nor be pratical..........
Click to expand...

As Amanda knows what carbs are and has been used to the exchanges then the only dif is finding out her carb ratio and correction ratio. Then once basal sorted she well away. Her health care team should be able to help her sort this out. As you say it is life changing for the people who suddenly learn this skill. It isn't rocket science. 🙂
 
mandamoo1983 said:
what are basal testing, tbh i havent taken much notice of my insulin just inject n eat..... how often do u have the canula changed in these pumps??? and how oftern does the pump last??
Basal testing http://www.diatribe.us/issues/13/learning-curve.php this can be aplied to injections as well as pumping.
Cannula's are changed every 2 or 3 days most change every 3 days. Pumps are replaced every 4 years as this is how long the warranty is.i will ask about these courses when i see my gp thursday, really need to take more control not only cos i want to try for a baby but future health and wellbeing,

what happens to the pump during, sex, baths/showers/ exercise, will visit the website when im back on my pc as only replying from my phone atm xx
You can just disconnect at the cannula for showers etc. Depending on exercise if non combat then leave it on. The pump allows you to use a temp basal so you can lower it when needed.
Click to expand...

Hope this helps. Ask all the question's you need. I have pumped for 3 years and can say it is completely life changing 🙂 and that was after 43 years on insulin. I like most would never go back to injections.
 
If you know nothing about insulin pumps and insulin pump therapy, yes it can seem very complex and scary having this little box attached to you 24/7..

Getting use to wearing the pump, is no different that when you got used to wearing a bra, a watch a wedding ring for the first time, it's a matter of days really..

Before I started pumping I was apprehensive about this little box dribbling insulin into more so over-night while I slept, that was until my husband pointed out that I injected levimer every night at 11pm then went to bed whats the difference! Wasn't a problem after that..

What advantages would a pump be for you, well as you said you do shift work, I used to work verious days shifts and even not working overnight it was difficult on MDI even though I could carb count very well indeed, the main problem was the diversity of my shift load being unperdictable both in workload and stress load, similar to you at the time I worked in dementia care, and theres no way of know what's going to happen on shift at the begining of the shift..

The pump is brill for this type of work, as you can increase or decrease your basal to compenstate the diversity of that particular shift load... Which once you've injected insulin under MDI nothing apart from eating carbs or injecting a correction jab to counteract not a lot one can do...

As for trying for a baby it's perfect to take you through the pregnancy, and when pregnant pumping is a lot easier to keep up with the ever changing insulin needs during the different tri-masters, a better out-come for mum and baby...

As for fitting the criteria for pump funding with what you say hear, you do meet it even though your HbA1c is below the ones the guidelines state, as you don't have to fit every aspects of the guidelines, at the moment due to your shift patterns mdi isn't working, so you qualify on this aspect, and the hope of being pregnant this gives you a better fit... You've tried different regimes (apart from fine tuning carb counting so you can adjust dose side of it) but that doesn't matter as such but you will need to learn this before or as you start pumping.. So don't worry do much about the HbA1c, if clinic says you fail the criteria due to this, then they are acting unlawfully as you do match some of the aspects of the guideline, clinic can't choose which aspects they want to use!

But have a good look around at pumping, ask questions etc, but from a pumper who did do several very demanding jobs both physically and mentally you can't beat it without a pump.... Best thing in my diabetic life I've fought for... It has made so much difference in all aspects
 
thanks everyone for yr comments just reading the info on all the links ur have posted.

how long did the process take from initally bein referred for the pump???
 
is on infomation overload here after reading n looking at info from the links

am i right in thinking boslus refers to the administer of the insulin from the pump and basal rates is the level of your blood sugar when no insulin or diet is bein taken?????? from this rate it provides a bassline on how much insulin is required for a set period???? but i dont get where the carbs come from??
 
Good luck Amanda! One thing you often find when you get a pump is that your basal rates are very different through the day and night - for instance I need a high on in the morning at breakfast, virtually nothing between 12am and 3am, and a very low does in the afternoon from 2pm till 4pm. This sort of range is not possble to replicate on any basal insulin, so the pump id fantastic for geting you right. If I had to stay up at night in the old days before my pump the same thing happened to me. When I was asleep, cos I wsn't doing anything, then I was not so bad.

I do hope you can sort this out, but another person here saying, the pump is not so bad!
 
mandamoo1983 said:
is on infomation overload here after reading n looking at info from the links

am i right in thinking boslus refers to the administer of the insulin from the pump and basal rates is the level of your blood sugar when no insulin or diet is bein taken?????? from this rate it provides a bassline on how much insulin is required for a set period???? but i dont get where the carbs come from??
Click to expand...

Hi Amanda,
bolus is what you have for food. Novorapid etc.,
Basal is background. MDI is Levemir or Lantus or whatever people use.

With a pump you just use one insulin novorapid (or your own choice.) The pump has setting which deliver the rapid insulin at the rate you set by the hour (basal)
You then can bolus for meals so just tell the pump how many carbs and the pump works out how much insulin to give once you have told it your blood sugar. You then agree or disagree with the figure. You can decrease the bolus for exercise for instance.

It sounds complicated but it isn't.
When you see your nurse do ask her if you can see and talk to a real pumper. This will help you no end.
 
I understand abit more now about these pumps...... Sounds a goo d method of controll I get the carbs part. Do u get a scale to how to programme the ratio dependin on carbs or bm or is it programmed in the pumps they are some pretty smart lookin ones. I from west mids @ shiv
 
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