Pumping and Higher Insulin Requirements

[Urbansoulpie]

Hi All

Just wondered if anyone could share their experiences with me?

I'm on a medtronic pump and coming up to 24 weeks pregnant. My insulin requirements and resistant has started to kick in and I'm having to change my pump every 2 or 2 and a half days, already!
I know this is only going to get worse as time passes, so was wondering how others have coped with this?

Did you just grin and bear it and change it as frequently as needed (even if this is everyday towards the end)? Or suppliment your pump with injections? Or go back on MDI completely?

Also did you start to try to eat less carbs in order to make your pump last longer?

Thanks all!

 

[trophywench]

TBRs is the answer in view of having to change so frequently. According to pregnant pumpers on my other forum anyway!

You may find you need to bolus mega early for meals, by which I mean half or three quarters of an hour, instead of the 10 or 15 minutes early you are probably used to.

Dunno whether you use the 200 or 300 reservoirs but anyway, that does seem a LOT of insulin to be using in a couple of days, even preg? How long did a reservoir usually last you when you weren't preg? You only change them when they are empty, not with every cannula?

(not being critical - if you need 100u a day that's what you need, just seems a bit 😱 to me as I only use about 20u a day I spose)

 

[randomange]

Hey,

I've had a similar experience while on a higher dose of steroids, and at one point I was going through a cartridge of insulin a day (about 180 units). I just changes as needed and didn't find it too much of a problem, but I wonder are you changing everything (infusion set and cartridge) or just the cartridge? Probably a simple question, but you should be able to just change the cartridge and leave the set in as long as you normally would. 🙂

Also, I use way more than 20 units a day 😉 (TDD usually about 60-70 units depending on food) Insulin requirements seem to be very much one of those things in which your diabetes may vary! 🙂

 

[mmackay20040]

Hello,

Congratulations on your pregnancy!

I'm a Type 1 diabetic and have been on a Medtronic Paradigm pump for 7 years. Currently pregnant with my second child. First child is 17 months. Due in 6-7 weeks.....!
I'm at 31 weeks just now and insulin requirements and resistance seem to have bounced up too. I don't remember this happening quite so dramatically last time! But every pregnancy is different! I'm changing my sets every 2-3 days but I'm thinking of making a point of every 2 days max. Taking boluses even 30-45 mins early is helping but still rising a bit post-meal. Needing to look at rates again.
As for the amount of insulin you're taking, don't worry about it. I thought I was taking too much too but it's all dependant on whatever it takes to keep your BMs stable. As long as they are kept within range, it doesn't matter how much it takes to get that result. With my first pregnancy, my pre-pregnancy daily totals were about 75 u/day. By the time my son was born at 35 weeks, I was taking 120 a day! At the moment, I'm at about 85 a day so it's fair to say things need to be altered now.
Any questions, just ask. We're all here to try and help each other!

Mxx

 

[trophywench]

Heehee, M - I meant the opposite - ie if you change your set, you don't have to change your cartridge - and my sets have to be changed every 2 days anyway as I'm prone to sites failing if I leave em 3. But a cartridge? about every 10 days (because you use such a lot priming tubing, although it's only one completely new tube every week)

 

[Urbansoulpie]

Thanks for all your replies.

When I started on my pump, I was told to always change my set every 3 days (mine tends to get a bit tender if I leave it longer anyway) and to always start a fresh with my insulin cartridge when I changed my set.
So that's what I've always done.
I guess different PCT's must give out different advice.

Congratulations also Mmackay on your pregnancy, not long left for you now 🙂 Good luck with everything!

I'm not worrying about the amount of insulin I take, although it takes a bit of getting used to seeing higher amounts being pumped in! My consultants and nurses are very happy with me, so I knew it wasn't a problem. I think at this stage, I'm on about 55- 70 units per day depending on what I'm eating/doing.

I'm just aware the resistance could get worse in the up and coming months and wondered how everyone else dealt with it.

 

[trophywench]

Well on the basis insulin's perfectly fine out of the fridge for 30 days, I guess it wouldn't matter if you didn't need to refill it for a month.

 

[Monkey]

Not a pumper, but just ahead of you pregnancy wise and am nodding along.

My insulin reqs have climbed fairly steeply in the last few weeks, and going on last time I expect that to carry on for the remainder of the pregnancy now. TBH, I just got on with it and didn't worry too much - I figured that keeping BGs in check was more important than worrying about using insulin too quickly. I think by the end I needed 8u for 10g carbs in the morning, injected 45mins pre meal. Bonkers, but doable, just about.

Good luck!

 

[Lizzzie]

Fascinated by this post. I'm sorry I can't be very useful to you but it put a lit of questions in my head that maybe you could help me with.

I was just moaning on another post because during my first pregnancy, I hypo -d all the time and this time round, I seem to be needing increasing levels of insulin. I'm not very pregnant yet- 6 weeks plus.

The major change between the two pregnancies is yes, you guessed it, I started on a pump. Is there something about the method of delivery I didn't know about?