Having a real crap time with it at the mo, been brilliant for the last couple of years since starting on a pump but the last couple of weeks have been crap, tell me it is just one of those things and it will be fine, am currently going through all my pump downloads, test results etc to see if I can see a change but nothing immediate springs out 🙁

I’m in a semi-similar position…new blood testing unit that also recommends insulin dosages and I’m too scared to trust it so it seems to be all over the place…it’ll right itself, just needing to adjust slightly and see how it goes.

Chin up laddie, it’ll come good…you know it will (although it is utter mince whilst it isn’t good!).

Mrs PJM1974 is currently working in a reply to you, her son is type 1 (diagnosed March 2010) and he’s gone over to using a Medtronic pump this year.

Are you perhaps feeling under the weather? A virus or infection plays merry hell with insulin basal rates. Are you currently running high or are your blood sugars swinging all over the place?

I know it’s easy for me to say being a non-conscript, but I promise you that you’ll get the hang of it. Do hang in there and if you need any pointers then either mail me or Mrs PJM1974.

Sorry to hear that, what specifically is the problem?
I have had type one since I was 4. My control is generally pretty good, HBA1c hovers around the 5.5-6 mark, but some weeks I just can’t keep my blood sugar under control.

For me it seems to be weeks where I do much more or much less exercise, or have even a slight cold (insulin seems to stop having much effect).
Im on injections rather than pump, and very occasionally during the summer leave my insulin in the car or in the winter put my rucksack next to the radiator for a few hours, which buggers it, takes me a few hours to notice (then I change the cartridge and all is well), could something similar have happened? I haven’t seen one of the pumps up close, is there a cartridge? Have you been hugging radiators?

Must be shit, couple of close friends have it. Makes me very glad to be in good health as far as I’m aware. Hope things turn around for you (all)

Hi Votchy,

My son started on a pump back in February and the first few weeks were difficult because there’s so much to learn about pumping and also so many things that can be tweaked.
Have you got a copy of Pumping Insulin by John Walsh http://www.amazon.co.uk/Pumping-Insulin-Everything-Success-Smart/dp/1884804861/ref=sr_1_1?ie=UTF8&qid=1316466656&sr=8-1
That’s a really good place to look for hints and tips but I’m guessing that you’ve got a supportive team so let them know that things aren’t so good right now.
I’ve not read it, but I’ve heard good things about Polonsky’s book ‘Diabetes Burnout’ http://www.amazon.co.uk/Diabetes-Burnout-Preventing-Surviving-Finding/dp/1580400337/ref=sr_1_1?s=books&ie=UTF8&qid=1316466892&sr=1-1
It sounds like that’s perhaps what you’ve got.
Have you heard of Joe Solo? His name is actually Joe Solowiejczyk and he has lived with type 1 for thirty or forty years. He’s a DSN who now works for Johnson&Johnson (who make Animas pumps) and he recommends having regular diabetes duvet days. He warns his family and friends the day before and asks them to call him regularly during the day to tell him how brilliant he is because he’s feeling really low. He calls in sick to work, boluses for half a tub of Ben&Jerry’s, eats it while watching sad films and allows himself to feel sad and pissed off with diabetes. The friends phoning help to remind him how well he really is doing because this is such a horrible condition. Generally he doesn’t need the second half of the ice cream as he’s feeling better by then.

Sometimes you just need to give yourself a day off.

Hope you’re feeling better soon.

I shall crash your thread 😀 I don’t have diabetes but I do have lung disease amongst other things and have had a real down few days, can’t walk a flight of stairs without needing a break type bad day so as well as feeling Ill I’ve had a cry in the bath and started my weeks worth of drugs. Hope it’s just ‘one of those things’ for you so sorts itself sharpish and you feel better soon! Other halfs aunty has it and injects for meals etc but she gets caught out sometimes but manages it really well. You’ll be back on top of it soon and feeling much better. Big hugs x

As said earlier, can’t put my finger on it at the mo, no other health issues, feel fine but BS’s been all over the place, last week left home for a ride with BS at 8.9, 1/2 hr later it was 2.2, did everything that I always do pre-ride, reduced basal etc, went shopping saturday and BS generally high all day round the 13 mark, got home, did 1hr fettling in garage and it dropped to 1.8, 6.9 pre bed so had 20g carbs, took my wife 2hrs to get my BS back up to 4.9 when I hypo’d during night, everything hunky dory then on sunday, same again tonight until went out for a ride,again did normal reduced basal, had snack pre-ride BS was 8.2, legs felt heavy so tested 30mins in and BS was 3, suspended pump, treated hypo and headed for home

I was teaching type 1 and 2 today to class. Enzyme denaturing and the role of insulin for all cells to respire. Explained to the students that type 1 required injections had to be diet and exercise calibrated. Good luck. Never really appreciated the bigger picture of it’s role until I taught it.

tell me it is just one of those things and it will be fine

It will in all likelihood be fine, but it won’t necessarily correct itself. All the above suggestions are possible causes of temporary instability. Don’t know if the unit that started you on the pump put you through DAFNE course or alternative pump training but there should be some guidance in corrective doses etc. either way. Unfortunately, the list of possible interactions both from lifestyle and disease is too numerous to go into here but they can be identified and sorted out. Finally, there may be some issue with the pump itself. Bottom line is that you need to talk to your Diabetes Specialist Nurse or Diabetes Educator and seek one to one advice from someone who knows your case. It’s highly unlikely that there is something going on that they have not seen lots of times before.

EDIT
OP, you reposted while I was typing. You do need to talk to your diabetes team and see if there is a reason for increased numbers of hypos as that seems to be what you are describing.

Must tell my boss about duvet days, am sure he will understand lol

I’m sure it will pass, thanks for the positive comments

mrspjm1974 – I do have the pumping insulin book and am currently referring back to that, am trying to stay positive as my son also has type 1 and is on a medtronic pump and he doesn’t need me feeling sorry for myself as he has had a hard time accepting being diagnosed. I have been type 1 since I was 7, 35 years now and I don’t remember anything this bad except when I worked 3 shifts which was a long time ago as it was pre multiple injections, was still on 2 per day.

I used to have easy, excellent control, even on the outmoded 2-a-day syringe-injected regime, but as I’ve got older it’s become harder just to have average control… Apparently it’s quite normal. Sometimes there genuinely isn’t a pattern to be seen, my clinic was quite open that they thought I was missing something obvious so we did detailed diaries and they admitted “No- it’s just weird”, which was nice at least. Sometimes all you can do is plug away and do the best you can with it.

I’ve recently been diagnosed as type II, which did not impress me. I wouldn’t have known but as I’m on meds for another condition, doctor decided I needed screening.

So far I’m still on diet control & I hope it stays that way; I have a colleague at work on the test kit & injections & I can see that it’s a total pain, I feel for you

Yep, diabetes sucks.

I wish there was a cure out there. At least we have pumps and CGMS but it still sucks.

🙁

Ice cream, duvets, sad films and friends telling you you’re brilliant are the way to go.

Damn, too late to edit my post… Here’s paragraph 2

Perfect control forever is not always an achievable goal IMO. There’ll always be slips or bad spells, and even if you find yourself doing less well than you’d like for a time, you’ll still probably be doing better than we were all doing 25 years ago. We can lose sight of that a bit.

The current push towards lower HBA1cs is great but I feel it’s become a little bit of an obsession, rather than an ideal. Sometimes, in my experience, it’s better to let it slip a little for a short period and regain control, then once you’re comfortable drive back down to the levels you want to have, rather than struggling with no margin for error and suffering frequent hypos. Medically it might not be the best approach, but it can massively reduce the impact on short-term day to day living, and at the end of the day the point of the exercise is to live with diabetes, not to live for diabetes.

What’s the common reduced basal rate to use during mountain biking?
I set mine on 50% a couple of hours before, get through a bottle of High5(50g CO) during a 2-3 hour night ride, and can still get low BS on that!
When I do hypo, I treat it with 30g CO, check how much “active” bolus I have working (and maybe have a biscuit to balance) and carry on with the ride.
HBA1c 7-8 at 52 years young. 😕

What’s the common reduced basal rate to use during mountain biking?

There isn’t a common one as far as I can tell, I set mine at 25% and don’t use any carbs in my drink anymore, I test about every 1hr and take on carbs as required to try and keep my BS around the 8-9 mark, any higher and I become lethargic, any lower and I get heavy legs. usual source of carbs are jelly babies for short rides up to 3hrs, longer rides and I add malt loaf or similar for a longer lasting boost.

I do like the idea of the duvet day but would be more inclined to watch funny films rather than sad ones 😀

Just to add, HBa1c was 6.8 last visit to the consultant

It’ll work out fine, you just need a big dose of MTFU. 😉 what you need to restore the low bullshit reading are more Clent Duffers rides, as there’s always an excess present.

Chin up , and catch you out and about either this Sunday/ monday..

i have nothing constructive to add.i just wanted to wish you all well and get well soon.

votchy – must be the week for it, I’ve had a few ups and downs this week with no obvious reasons. It will pass, important thing is to not let it get you down. HBa1c was 5.8 so not at all bad. 🙂

brokensoul/votchy – you would be surprised re the basal rates required. I am doing a research program at the moment testing various basal rates at different times pre exercise. The results are very similar with all of the participants so far, the bg traces show peaks/troughs at the same time.

One thing to bear in mind is that the insulin on board and work rate/type has quite an effect. I would be willing to bet that your rides (and possibly your target bg) are quite different to have such varying basals.

A massive spanner in the works is if you have been low (ie less than 3.7ish) up to 24h before riding. You will probably find it really hard to maintain bg during the ride if you have.

brokensoul – have you tried taking on less aggressive carbs? You may be finding that the High5 is just moving through your system too quickly, hence the lows. Try a little boost of High5 when you start (if I have a hard ride my bg drops by 3-4mmol straight away but then stays steady) and then something like a flapjack/banana/energy bar to give you a ‘carb basal’ throughout the ride, top up with swigs of High 5 throughout. How hard is your ride, are you flat out all the time?

votchy – interesting re heavy legs, I find mine OK a little lower and a little higher than you but I do know I need to eat if I suddenly drop off the pace for no reason. I can test and be about 5 but I know that my ‘internals’ have already started dropping and to get a couple of gels on quick sharpish!

Northwind – agree totally about HBa1c, my consultant always seems to look at it without looking at the surrounding reasons. I’m happy to let mine move up or down and was surprised that it was as low as it was during my last visit. (Must admit, I would be mortified if it hit >7% !) 🙂

Our 4 year has Type 1 and has been on a pump for 18 months. We have pretty good control (last HBa1c was 6.5) but every now and then his bg will go high for no obvious reason and when exercising he can go from 12 to 2.5 in 20 minutes. We are constantly tweaking the basal rates but its a game of catch-up.
I’d second trying slower release carbs, you might be burning through the high 5 very fast which then means your bg just drops off a cliff?

The current push towards lower HBA1cs is great but I feel it’s become a little bit of an obsession, rather than an ideal.

I agree, although there are plenty of fellow diabetologists who would regard me as a heretic.

Problem with HbA1c is that it varies between individuals for the same level of blood glucose. Where it is helpful is that if you as an individual have a higher or lower Hba1c level than previously then that is a reflection of a change in your overall Blood glucose levels. Unfortunately, if 2 different individuals have identical HbA1c levels they are not guaranteed to have similar overall levels of Blood Glucose and very unlikely to have identical glucose levels. As an indicator of absolute levels of blood glucose it only works for populations not individuals.

Well, same again last night, bugger. Had a look at what was going on and noticed that I had bolus’d for a snack 2.5hrs prior to riding and so would still have active insulin. Yesterday did the same thing but only 50% bolus, basal set at 25% 2hrs pre-ride, BG was 8.5 pre-ride, had 4 jelly babies (20g CHO), went out, nothing overly strenuous (it’s very flat in my part of Worcestershire), 30 mins in struggling on a gentle climb, BG was 3.2, pump suspended, hypo treated, headed for home 🙁

went to bed with BG at 9.5, was woken by wife testing my blood at 5am, BG was 1.8, took best part of an hour to get back to 5.2 and now it is 18, not a fun time and I am losing my sense of humour at the moment, few more words of encouragement required please…

Lucky buggers to get a pump…complete lottery in Scotland!

sorry to hear you’re having a shit time mark.

think of positive things and good times and wait for your world to turn.

all the best from the monkey household.

cheers woody, hows things down your neck of the woods?

votchy – are you doing the same ride every day? Try skipping the ride and monitoring BG, you might be going low anyway and need to tweak your basals. If you’re determined to ride then skip the snack so you can get rid of the bolus, remove any variables that you can remove so it is easier to see what is going on.

If you dropped to 1.8 then you will go lower quicker for the next 24h or so and that will have a bearing on what goes on during your next ride. If I have been low I can take on board almost double the amount of carbs I would usually take. (I can’t remember the exact reason why but I seem to remember that our already muted glucagon response is even worse once we have been low, you might have to research that bit!)

Another thing to do (a complete pain in the behind but I was advised to do this when I was first figuring out basals) was to put an alarm on for 2am and do test then. You’ll see if you’re dropping steadily overnight or just having one big drop.

How much exercise are you doing now versus a month or two ago? I notice a huge difference in basal/bolus depending on my fitness levels.

hows things down your neck of the woods?

bits of ying, bits of yang.

just got back from my best ever week in the alps to find out that i’m laid off again 🙄 should only be for a month this time though.

at least i’ll get some decent revision in for my ou exam, so i can make something positive from it.

get yourself down here once you’re on form again. we’ve got lots of new stuff around lustleigh to show you 8)

The yo-yoing of blood sugar is a pain to get under control at the best of times, especially when the hypo is hard to treat and then all of a sudden the BG shoots up – so many times I’ve overcorrected stepson 2’s hypos.

I won’t tell you that you’re lucky for having a pump.

I will tell you that you’re lucky to live in Scotland with some ace riding up there…

Mark, stay off the bike for a few days.
The ride last night wasn’t in brill conditions and looking at endomondo, was a reasonable pace knowing where you were riding.
I admit my knowledge of diabetes is limited to making sure Jordan tests/ does his insulin etc ,( + quality control/nicking your jelly babies over the wyre) but the body still needs to rest in between exercise/ illness
.
Easier said than done but chill out for a few days, play the xbox etc… then do a ride.( with company) I’ll be free Sunday afternoon/night.

True, the quality of riding far outweighs the lack of a pump…

votchy – are you doing the same ride every day? Try skipping the ride and monitoring BG, you might be going low anyway and need to tweak your basals. If you’re determined to ride then skip the snack so you can get rid of the bolus, remove any variables that you can remove so it is easier to see what is going on

datsunman – this was my next step, am going to do everything the same today as if I was riding but not ride and then monitor by BG to see what happens, I will also be setting the alarm for 2am to see what happens tonight. The problem I have at the mo is BG running at 16, will change set when I get home to see if that is causing a prob (changed set last night after ride as it was due for change)

Mick – sunday pm/night not good for me this week, ok sun am though, have already dropped out of thurs with laney

Bad sets have to be the most annoying thing about pumps IMHO. Had a similar thing happen to me the other day, BG hit 15 with no real explanation, bolused 4 units, waited half an hour and was 18. Quick change of sets and re-bolus and a couple of hours later bg coming down nicely.

Good luck in sorting yourself out. Despite being a horrible burden there is a nice feeling of satisfaction when everything goes back to plan. 🙂

Another type 2 here..

Just trying to get my head wrapped around it all, not on meds, which as I’m just under the threshold for it, so I just struggle with it, and just have to accept it.

On top of mine I’ve an underative thyroid, so my weightloss issues are proving difficult.

I’m a type 1 and I have been very fortunate with my control over the (more than 20) years. I started self-regulating long before DAFNE and have remained on injections as I can’t see the benefit of changing to a pump at the moment. I’ve managed to do multiday bikepacking events, 12 hour races (as part of a team admittedly) and run the London Marathon twice so it works for me. I’m not a super athlete by any means but sadly I don’t think I can blame my diabetes solely for that!

Please feel free to ignore my account as it may not be applicable when using a pump. However, I use Levemir (equivalent to your basal insulin) each night, the dose of which I adjust depending on my exercise during the day(s). My ‘typical’ dose might be 15 units following a slothful Saturday, but if I were to go for a ride I would change that to perhaps 13.5 units to prevent night time hypos. I would also reduce the pre-meal injections of fast acting insulin (Actrapid) following exercise. I find consecutive days of exercise will have a increased affect (i.e. further reduction in basal and pre-meal insulin) but the effects only last for about 24 hours after my last spell of exercise.

During rides I don’t find I have to eat a huge amount to keep my blood glucose stable. A little snack every so often but rarely any more than my riding buddies to be honest. If an all-dayer then lunch will require only a small pre-meal insulin injection.

I hope you manage to get things back on track soon. I’ve had little spells where things have gone awry which I’ve put down to perhaps a change in insulin, a duff batch or maybe a virus. Occasionally I’ve had to do regular tests to get to the bottom of it but have managed to in the end.

Thyroid issues are also linked/related to diabetes as they are both auto-immune things…I think that is what they are, but they are linked…

Hi Fella…. I’ve only had Type1 for 18months and not a pump user but reckon control is as much art as science…what works one ride wont (always) work the next, Hypos for me (rare tbh) affect me riding the following day…reckon there is a seasonal aspect to it too, winter coming and your body needs change…. To cheer you up I got taken out in a road race last night, chainring holes in shin, cut nose and black eye…funny bit was my shorts lost a back panel so my arse was hanging out like I was wearing camp boys chaps 😆 mates threatening to get pics up on facebook…chin up fella its just a blip!

Sounds as though you are “re-bounding” quite a lot from your hypo’s and if you need assistance from your partner to deal with nightime hypos, ie her testing you and administering fast acting carbs I’d be talking to my DSN personally.

Basal rates are key in pump therapy. I am very insulin sensitive so very slight tweaks on the basal rate on my pump make huge differences. Riding my mtb I usually drop mine to 25-30%. Similar distance on the road bike, I zero the basal rate completely mainly because I can go from 15mmols to 3 mmols in minutes.

That said, early morning rides ie pre-breakfast and I leave the basal rate to run at programmed levels with little to no change in BS levels. trial and error as always…Good luck man…