trusting the pump

[Mumlé]

Adrienne gave me a good piece of advice (thanks!), great for new users - which kind of sounds obvious, but is really hard to do! You have your routine in place using the injections, then this pump comes along and claims to do a better job. Read the info screen every time you use bolus wizard and really try to understand what it's doing. I get the bit where the active insulin may be cancelling out a high BG correction, but what about the active insulin reading itself? When is the active insulin level high enough to cancel out a correction?

I think the pump is going to be better but it is hard to start with that's for sure. And SO many finger prick tests. Lo's fingers are so small anyway she is just covered. I've had to crank up the depth cos I think she is already getting scar tissue?

 

[everydayupsanddowns]

Charlotte

Not sure about other manufacturers methods, but I use the 'Accu-Chek Expert' which is very similar to the Combo handset for Roche pumps. On the Expert 'Active insulin' only displays the whole or part of an 'Active Correction'. Insulin bolused in relation to carbs (as calculated via the bolus advice) is not tracked.

You'd need to know how the active insulin figure is calculated on your pump to know quite what to do I suppose.

M

 

[Adrienne]

Adrienne gave me a good piece of advice (thanks!), great for new users - which kind of sounds obvious, but is really hard to do! You have your routine in place using the injections, then this pump comes along and claims to do a better job. Read the info screen every time you use bolus wizard and really try to understand what it's doing. I get the bit where the active insulin may be cancelling out a high BG correction, but what about the active insulin reading itself? When is the active insulin level high enough to cancel out a correction?

I think the pump is going to be better but it is hard to start with that's for sure. And SO many finger prick tests. Lo's fingers are so small anyway she is just covered. I've had to crank up the depth cos I think she is already getting scar tissue?

I'm not sure I follow what you are asking? The active insulin will always be taken into account if you are using the wizard when doing a correction with no food bolus included. Is that what you are asking? There is no high level.

There is one pump (could be the Cosmo which is now obsolete) that also takes off insulin from a food bolus if there is active but the others don't, to my knowledge. I know the Medtronic pumps only minus insulin from correction.

If there is as little as 0.5 u of active and the correction total is say 1.5 u then it will minus that 0.5 and only give 1 u as the correction.

Is that what you mean?

 

[shiv]

When is the active insulin level high enough to cancel out a correction?

When it is higher than the correction amount - so if you have 1u of active insulin on board and the pump thinks you need 0.7u of a correction (just pulling figures out the air here), because you have more than the correction amount in active insulin, it won't give you a correction (of course, you have the option to override it and give the correction anyway).

 

[Adrienne]

When it is higher than the correction amount - so if you have 1u of active insulin on board and the pump thinks you need 0.7u of a correction (just pulling figures out the air here), because you have more than the correction amount in active insulin, it won't give you a correction (of course, you have the option to override it and give the correction anyway).

Ah ha, that is what was meant. I'm so tired today, am not concentrating. Jessica had a full on horrid big time shaking hypo last night and wouldn't come up and then did and hit the highs so spent all night trying to get her down ! Not a great night.

 

[novorapidboi26]

In the pumping world, in what situation would you be looking to correct a blood glucose reading knowing that you still have insulin working away from the previous meal........?

 

[Adrienne]

In the pumping world, in what situation would you be looking to correct a blood glucose reading knowing that you still have insulin working away from the previous meal........?

Good question. These are the rules many of us follow for hypers :

HYPER

If the blood glucose is above 9 mmol/L (9mmol is my choice), follow the ABCC for high blood glucose

Assess
Was a food bolus given within the last 90 minutes?
If so, do nothing and retest blood glucose level again in 1 hour.
If no do the following :

Is the pump running? Is there insulin in the pump?
Is the infusion line leaking or damaged? Is the needle/cannula OK?

Bolus
Give a correction dose of insulin using the Bolus Wizard
which aims to bring the levels down to 6.5 mmol (I tweaked this for my daughter)

Check
Check blood glucose level 1 hour after this correction bolus has
been given.
If blood glucose level is lower than the previous value, no action is required

Change
If blood glucose level is equal too or higher than the previous value, immediately telephone mum (I tweaked this bit, what is actually says is calculate dose and give injection of novorapid by insulin pen)
who will either give you more instructions or will come and change the set and site.

Check BG in 1 hour

(I then added in about setting an increased temp basal rate at this point​

I hope that makes sense and people do have their own ways, this is the way that our hospital follows and is a written guideline that others around the country follow 🙂

 

[bev]

Hi Charlotteking,

I think Shiv has explained it for you.🙂Regarding 'trusting the pump' - I do agree with this - but there are exceptions to this. If Alex has been very active and resulted in a high level - I wouldnt 'trust the pump' to work out the correction needed as it doesnt know that he has been active and might over-correct in these circumstances - but most of the time you are fine to 'trust the pump'.🙂Bev

 

[Mumlé]

In the pumping world, in what situation would you be looking to correct a blood glucose reading knowing that you still have insulin working away from the previous meal........?

Not sure why I thought reading these through at 7 am was a good idea - maybe because Lo woke up lo (haha) at 2.4 or so - the breakfast rush is over so it's a good time! (Apart from brain not really having kicked in yet). But the reason I quote you is because I think we probably rarely bolus without it being meal or snack time, because she is so little. Often her BG is too high, so we are frequently correcting at the same time as eating. Guess it will settle down a bit as she gets older.

 

[Adrienne]

I think the pump is going to be better but it is hard to start with that's for sure. And SO many finger prick tests. Lo's fingers are so small anyway she is just covered. I've had to crank up the depth cos I think she is already getting scar tissue?

Hiya

I've just picked up on this and I wanted to reassure you. My daughter is now nearly 11 years old. She had had finger tests since she was 1 year old. For the year up to 1 years she had her heals pricked. Her fingers are ok. She has had over 10 pricks every day for that long, normally a lot more.

You just have to be careful and make sure you rotate. I have my favourite fingers, the little ones bleeds lots. You can do all the fingers. Make sure you only do the sides though, not the top tip or the pad, just the sides. You can actually do right down to the first joint, I didn't know that until last year though. Just keep rotating. You can use Tea Tree cream on the fingers, it is a natural healing thingy. You use Bio Oil to help stop the scarring but that is very expensive.

I got a knack and used the first depth gauge no problem but no-one else could, they all used 1.5 or 2 maximum so don't worry about it.

Just keep an eye on them and make sure they are clean.

Hope that reassures you. 🙂