Wednesday, May 28, 2008

I Sort of Missed You, Pump

After about a month of using Levemir 2-3 times per day, I am back on the pump. Trying to figure out how to take enough to prevent highs without crashing was tough. I found that about 3-5 hours after a dose that was too high, I would drop at a remarkably constant and steady rate. It was sort of cool to see such a straight, downward-sloping line on the Dexcom, but not if it was 1 AM and I was waking up with another BG of 39 and knew that after I blew the diet by eating 200 calories in GU, I would wake up in another 4 hours with low BG again. Still, I was impressed at how much steadier Levemir is than NPH, which was the long-acting insulin I used when first diagnosed.

The Levemir regimen we finished with was 6 units between 5 and 6:30 AM, 3 units between 1-2:30 PM and 2 units before bed. This worked fairly well although by the morning, my BG would start to rise. Increasing the evening dose to 3 units led to unpleasant lows. I had similar issues with the morning dose.

Although I am not continuing with Levemir for now, I definitely think it was helpful to take a break from the pump and to figure things out with a long-acting insulin. I have a much better understanding of my insulin needs throughout the day and during exercise and hope to be able to transfer this knowledge over to a more effective use of the pump. One of the biggest discoveries was that, if I want to eat anything during exercise, I need a lot more insulin than I had been taking, and definitely more than I would need at rest.

The mental freedom of being on a long-acting insulin was nice, though. There is some comfort in being "good to go" for many hours and not needing to be connected to anything (although I was using the pump for boluses and also the Dexcom).


Scott K. Johnson said...

I too think it was an interesting experience for you to go through. If nothing else you learned a little more and added to your mental diabetes toolbox.

I too find it interesting that you need more insulin while exercising. It's kind of counter-intuitive, at least to what "they" teach you!

Thanks for sharing so much of the experience with us. I think you and Ed need to put your heads together and write a book about all this stuff! :-)

Wingman said...

What is the ratio difference for a workout bolus compared to a rest bolus? My experience has been totally counter to that - interesting! Although that could be because my islet cells refuse to die completely.

Maybe Scott can find us a book deal!