About to start pump, new stuff!

So we picked a pump for our 6 year old…tandem x2 slim basal iq since she is not old enough for control iq yet. Super nervous about starting this!! She is still running high after lunch (only in school) I have even come down to having a different ratio for the nurse to use, also some night she spikes, with changing the Lantus to 4 it was too much, so I went to 3.5 and some nights it’s high, they don’t me to deprive her of her snacks but I kind of feel if I give her a low carb snack it helps a little…now they are wanting me to possibly split up her insulin intake with this pump on the foods that make her run higher. How will I know to do that? How will I know what to split and how much?? I’m so scared I’m going to mess up!!!

Are they using the pump for basals only with Lantus insulin and doing bolus injections for meals, snacks, etc? Maybe to gain familiarity with pump while also deciding on carb ratios and sensitivity levels?

She won’t be doing Lantus anymore she will have 1 insulin that does both. We are doing it for everything. I can’t wait for her to get control iq in a few years. I think it will be easier, I don’t like change and now with wanting to possibly split up the insulin threw me for a loop and now has me worried

Hi Dee @Dee314, you [and your daughter] have taken a huge step and I’m almost positive that over time you will realize the benefits. It is a learning curve which you will master over time - just don’t rush into making too many adjustments in a short period of time and unless her BGL readings are way-off [causing severe hypoglycemia], do not adjust both basal rates ans bolus ratios on the same day. Best to wait at least two days between each adjustment.

As for “splitting” the amount of basal and bolus insulin you want the pump to deliver, think Lantus = basal, and Humalog = bolus. You are very new with insulin management so you should request that your doctor, or someone designated by the doctor, assists with pump setup. Your daughter’s meal-time insulin to carbohydrate ratios should be just as they have now been - that is, if those ratios have been working properly.

I wish your daughter well - and you eventually less worry.

1 Like

Synthia @synstokesyahoo-com , may I offer you some insight on pumps? If I’m out-of-place, just tell me to mind my own business.

It sounds as if your thinking about pumps is where my mind was 20 years ago when, through my mistaken opinion, I refused to use a pump - I found out my thinking was mixed up.

The basic theory of is an insulin pump is to use only rapid-acting insulin [Humalog or Novolog; although I also tried Fiasp] to help regulate Body Glucose Level [BGL] 24 hours every day - basal insulin, and also provide insulin - a Bolus dose - for food one eats and to make correction for a high BGL.

When using a pump, you would set up a “Pattern” or “Profile” that reflects how much background insulin your body needs at various time-periods of the day - this is called your Basal insulin - and the total delivered per day would be about equal [probably a little less] than the amount of Lantus you inject every day. The Basal runs continuously for 24 hours each day unless you “suspend” delivery if you think your BGL is going too low.

In the Pattern or Profile [pump manufacturers use various names], you will also enter meal-time insulin:carb ratios for the different times of day and also enter insulin sensitivity rates.

The pump’s built in Calculator will use your current BG, the number of carbohydrates you intend to eat and automatically calculate an ESTIMATED bolus infusion. From the calculated total, a deduction may be made for “insulin on board” or “active insulin” based on any previous bolus you may have [recently] made. It is up to yiu whether to accept that calculation, reject, or adjust, before you hit the “YES” or “Deliver”.

Pump software is getting better and better by the day and calculations are making my life much more simple. Also, now I just change an infusion set every three days instead of giving myself 6 to 8 shots a day.

Hi @Dee314, and thanks for writing in. It sounds like you are used to managing get diabetes with injections so far, which is great. But when she starts on a pump your doctor should train you or provide training to you on just how and when to make adjustments. The first thing they will need to do is determine her basal rate/s. Pumps use only short acting insulin. Our bodies need it constantly - diabetes or no - so she will have some flowing all the time. This is called background or basal insulin, and it takes the place of Lantus. Her endo will determine how much she needs - some people use the same basal rate all day, while others have a few or several. There will be some tweaking involved, so don’t be surprised. The endo, diabetes nurse educator, or pump rep will show you how to set the programming for basal rates, insulin to carb ratios, and other things. If they haven’t mentioned training, call to set it up. You might find it helpful to download the user guide in advance. I would suggest you read a little at a time so you can absorb it without getting overwhelmed. However it should not take the place of initial training.

Hello Dee, I’m going to throw in a little more advice here if that’s ok … we had Tandem training last year (after 9 years with another manufacturer, so I consider that we are fairly experienced pump users, and I felt like I knew what prep to do ahead of time.). The Tandem training as we experienced it —- a group setting in our endocrinologist office presented by a nurse-rep from Tandem — was one of the poorest training sessions I have ever experienced. If I had been a new pump user, I would have stood up and screamed in the middle of the conference room. What I am getting at — please be persistent in locating, or demanding, training that works for you, whether it is one-on-one or whatever suits you best. Please do not struggle through a group session if you don’t have to. With a good foundation of training, you will master the pump ! Best regards.