Reduction in Insulin:Carbo ratios when changing from MDI to pump

[petmcgratt]

I have been doing DAFNE with MDI for 2 years until I got switched onto the Accuchek Aviva Combo insulin pump on Monday 4th Feb 2013. I would have been taking split dose Levemir (16 U am and 16 U pm) along with QA insulin:carb ratios 2:1 (breakfast & Lunch), 1:1 dinner time and 1.5:1 (bedtime).

Since starting the pump I have been put on a 1.0 u/hour basal rate in place of my Levemir and kept to the same ratios for my bolus injections. However for 2 days now I am constantly correcting hypos up until mid afternoon. I initially thought my basal rate was too high but having looked at my insulin and carbohydrate intake up until tea time over 48 hours my breakfast ratio has decreased from 2:1 to 1.5:1 and my lunchtime ratio has also decreased from 2:1 to 1.2:1.

has anyone else experienced such a quick change in some or all of their ratios going from MDI to the insulin pump or am I doing something fundamentally wrong

 

[everydayupsanddowns]

It isn't uncommon, but it will affect some people more than others. Some teams automatically reduce TDD by 60% when switching to pump, then you have to juggle/tweak those initial basal and ratio approaches in the first few weeks (and then on an ongoing basis obviously!)

I think it is down to more efficient absorption of the insulin - though I noticed little change myself and after 6 months my TDD was pretty much back where it started.

 

[novorapidboi26]

My background was halved and my ratios, which were previously 3:1, 1:1, 1.5:1, were all returned to 1:1.......

And my blood sugars are good, its amazing, just shows you how ineffective MDI is.......(50% I think I was told)......

Where does the rest of that insulin go.......?

I though it was common practice to go back to 1:1 ratios.......and there is a formula for working out your new pump basal rate to start on.....

Is this not others experience......?

 

[trophywench]

Does your hospital not use the pump set-up software which Roche supply with the 360 degree software?

You stick in your TDD basal and it tells you how much per hour it estimates most people would need, and if the TDD is 24u, it would NOT be 1u per hour .....