no basal at all from midnight till 4

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Liz!

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Type 1
I have always had terrible hypos at night, from when I was first diagnosed (40 years ago) till now. The pump made things a lot better - my Consultant just said try no insulin at all from midnight till 4 as i was on 0.05 which was too much and my pump went no lower. This morning my level was 5.0, the best it's ever been in the morning!

Went high after breakfast though so may have to put up basal or ratio for food.

wish I'd known this was possible before!
 
Liz! said:
I have always had terrible hypos at night, from when I was first diagnosed (40 years ago) till now. The pump made things a lot better - my Consultant just said try no insulin at all from midnight till 4 as i was on 0.05 which was too much and my pump went no lower. This morning my level was 5.0, the best it's ever been in the morning!

Went high after breakfast though so may have to put up basal or ratio for food.

wish I'd known this was possible before!
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Wow liz that is 5 hours without insulin in your body 😱
So working on the time scale the last 0 rate would still be active in your body at breakfast time.
My personal opinion is you need to go right back to basics and start testing from midnight and finding out exactly what is going on. Again my personal opinion but with that length of time with no insulin in you, you would be a prime suspect for DKA. It also sounds to me as if your insulin is active a lot longer than you thought.
 
+1 to Sue.
 
I feel so much better when I wake up though! They are lending me the latest Veo Minimed plus CGM soon and hopefully that will find out... but i have laways had aperiod in the afternoon too when I need no insulin.

What does that mean Ergates?
 
Just did test as dog alerted me and I'm 18.5... take away 12.5 % for the plasma readong...er that is 16.5. ish. It's nearly 11 am. I think my insulin lasts a lot longer!
 
Liz,
As a matter of interest when are you doing changing in your basal Pattern?
IE if you had a rise at 10 AM when would you change your basal?
 
An hour before.
 
Liz! said:
An hour before.
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Ah then that's where a lot of your problems are.
You need to make any changes 2 hours before they are needed when using Porcine or bovine insulin.
 
Im sorry Im not familiar with that kind of insulin, it lasts longer then and that is why you dont need any insulin between those hours? Have I understood it correctly? Or is there another reason?

Can I query with you as well Liz, I was always told to never stop insulin completely, even when I take the pump off. I was advised to let it run on 0.025u/hr just because the line can block as the insulin can stick to the inside of the tubing. Do you find this a problem stopping the insulin completely for 4 hours?

I have the Veo- good machine. What are you using at the mo? It has very small increments, so possably something that you will love 🙂
 
Sugarbum said:
Im sorry Im not familiar with that kind of insulin, it lasts longer then and that is why you dont need any insulin between those hours? Have I understood it correctly? Or is there another reason?

QUOTE]

The reason Liz has major problems is she hasn't been made aware of needing to change her basal at the 2 hour mark. Hence she has a stacking of insulin and a roller coaster going on. It's a bit like you if you changed your setting 2 mins before the change needed to take place instead of changing at the hour mark
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My team have not much knowledge of the machine or the insulin. But I do the animal an hour before, as that's how long it takes to start to work for me - if I do my insulin in fact and hour before a meal I'm hypo - so how can i be sure two hours is correct?

SB, I use a Deltec Cosmo, beleive me, if you had in the past, you'd have no desire for the Veo apart from its CGM capabilities!

I've never had a blockage with animal insulin either, I did have lots with Humalog though.

I'll have to try that Sue... but not sure I understand why exactly...
 
Liz! said:
My team have not much knowledge of the machine or the insulin. But I do the animal an hour before, as that's how long it takes to start to work for me - if I do my insulin in fact and hour before a meal I'm hypo - so how can i be sure two hours is correct?

SB, I use a Deltec Cosmo, beleive me, if you had in the past, you'd have no desire for the Veo apart from its CGM capabilities!

I've never had a blockage with animal insulin either, I did have lots with Humalog though.

I'll have to try that Sue... but not sure I understand why exactly...
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It's when the insulin peaks that you need to take into account Liz, A hypo an hour before lunch is due to the stacking you have going on because you have your basals and timing wrong.
Hence why you need to go right back to basics have a set low rate all through the night and start testing. Discuss with your DSN what the best rate is. I can't remember how it's worked out from total daily dose. I'm sure someone else knows the answer. I know I adjust my basal by 0.05 for every 3mmol rise or drop.
Do you have the book pumping insulin by John Walsh? It's a very good investment and you will learn a lot more from that book than any HCP in this country I suspect.
I set my pump up using the book had no help from any medical bods at all.
 
AFAIK Sue isn't talking about giving a bolus 2 hours before your meal, but starting the basal rate change 2 hours before.
 
I've only just seen the thread, so coming in a bit late here!

But from what I've read so far...

Personal opinion, I think that you really need to go back to basics, set a flat profile and start again, but look at changing your profile 2 hours before, it may be that over-night to avoid the lows, you will have to do somthing like a couple of hours zero delivery, an hour delivery, then zero so that you getting some insulin into the body, avoiding the increased risk of DKA or blockages..

I noticed you said that you've taken your I hour adjustment timing, basing this on what happen's when you bolus for a meal, not the greatest of guides as it could be misleading as doing this is assuming that your basal is set correctly, which it very much sounds as if it's not!

When you bolus you could actually been overloading the system, as you are having too much basal from the start..

Hence why at the moment you seem to be runing in circles of high's and low's, the more you adjust using incorrect profiling the worse it's likely to get, hence the need to return to basics as a newbie to pumping and start from scratch... Which if you explain to your HCP why you doing this, I suspect that they will find it a good idea, as well in truth when it comes to adjusting our pumps to our best advange well that's really down to us, as really we only use them for giving us probably good ideas or hints etc..
 
Ergates said:
AFAIK Sue isn't talking about giving a bolus 2 hours before your meal, but starting the basal rate change 2 hours before.
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Yep spot on
Bolus is 30 mins before you eat 🙂
 
ive just ordered the book for pumpers :D i cant wait till it comes lol
 
Funnily enough I orderd the book, plus another one someone on here was talking about, 2 days ago from Amazon.

I was told an hour before by someone, can't remember who... but I certainly didn't think you should bolus that early! I change that throogh the day, an hour before breakfast, amd half an hour the rest of the day.

Well I've never been given any instruction on the pump either. I was told how to use the functions, but not how to judge the doses.

I hav to admit I'm very scared to try this without help, especialy as my nurse is not full time.

But on the other hand, it would be good to get it right.

Whether it wil stop me ging all over the place is a moot point. I've always gone all over the pace from the year dot. I was thrown out of hospital as a child as they daid i wasn't taking my control seriously. Iwas, I was doing everything they said, but they couldn't account for my highs or hypos and presumed it was something I was doing. I ws in hospital for 6 weks before I started trying to get pregnant, that's how long it took to stop the hills and dips, but it only worled for as long as I lay down and did nothing else. So I stayed lying down mainly through my first pregnancy!

On animal insulin I am better than I was but still whatever i do I am never the same two days in a row.
 
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