More than 5 units up front

[tracey w]

Can anyone tell me why i was told never to give more than 5 units up front? I was told this by pump nurse and rep from roche.

For instance just dual waved for fish and chips, needed 19 units. Wanted to do 50/50 as i usually go quite high on 30/70 etc. But was worried to give 9.5 units up front.

But i cant remember why i was told this. Normally dont need to give more than 5 or 6 initially but has been bugging me lately. Sometimes i do extended doses for large amounts, but for this type of meal i need to dual wave.

 

[bev]

Hi Tracey, that does seem odd! It would also depend on your ratios wouldnt it? We have never been given a limit of how much to do up front and Alex is a child so i would have thought they would have told us. Perhaps Adrienne could tell us if she sees this!🙂Bev

 

[tracey w]

Hi Tracey, that does seem odd! It would also depend on your ratios wouldnt it? We have never been given a limit of how much to do up front and Alex is a child so i would have thought they would have told us. Perhaps Adrienne could tell us if she sees this!🙂Bev

hmm, just something that stuck in my mind when i got my pump. obviously there was a lot of info to take in. I couldnt understand it as ive often given much larger amounts than that up front.

I know i havent dreamt it as the dsn watched me eat a sandwich whilst i did my first dose and she said it was ok to give 4 units (which is what i was giving), as if it was over 5 i would have to do extended.

So basically you are saying you dont do this? I think i will scrap this idea then. I know i should ask my dsn but ive had no contact with her since my first week pumping and am pretty sure she would say the same thing!

 

[randomange]

I wasn't told this either, and I quite regularly inject more that five units up front. The only thing I can think of is that it can sometimes sting a little if you inject a lot up front? I know that if I'm doing more that ten units I usually do a small extended bolus for that reason. 🙂

 

[bev]

To be honest, i dont think of how much insulin is going in - i just do the carbs and the dual waves etc and dont give it much thought about the total amount. Alex has had pizza and a pudding before that came to something like 150 carbs and we did a dual wave of 60/40. His ratio is 1/16 so that means he has had 5.62 up front and we havent noticed a problem with it. It might be worth asking though as i may be wrong - or perhaps its the different pumps?🙂Bev

 

[Adrienne]

Maybe this was just to begin with. What was she expecting you do to then. 5 units is not that much for an adult really. I have given Jessica 9 odd units before, which is a lot for her but if she eats that much I give it.

🙂

 

[Red Pumper]

I went onto my pump about five weeks ago and the DSN advised me not to bolus more than 8 units in one go as having more than this going in at any one time can affect absorption.
If my required bolus was more than 8 units ,she advised to either deliver 8 units initially followed by the remainder 30 mins later. If the required bolus was more than 16 units she advised to deliver 8 units, wait 30 mins then deliver another 8 units, wait a further 30 mins then deliver the remainder.
The alternative is to use the dual wave to do the same thing or use multiwave to deliver the first 8 units immediately followed by the remainder ober the next hour or two depending on the size of the dose.

 

[tracey w]

I went onto my pump about five weeks ago and the DSN advised me not to bolus more than 8 units in one go as having more than this going in at any one time can affect absorption.
If my required bolus was more than 8 units ,she advised to either deliver 8 units initially followed by the remainder 30 mins later. If the required bolus was more than 16 units she advised to deliver 8 units, wait 30 mins then deliver another 8 units, wait a further 30 mins then deliver the remainder.
The alternative is to use the dual wave to do the same thing or use multiwave to deliver the first 8 units immediately followed by the remainder ober the next hour or two depending on the size of the dose.

Thats the only thing i can think of , that it might affect the absorbtion for some reason. But like Adrienne says 5 units is not much initially for an adult, I regularly need more than this. Am going to give whatever is required up front from now on and see how that goes.

thanks for replies guys!