Help in re-starting tandem pump after being off for a day

Hi Everyone,

Been T1 for about 2 years after being T2 for 7 years prior. Went on Tandem pump in June 2022 and just recently, yesterday, after my site change, I started seeing my numbers rising to the mid to upper 200’s so I changed my infusion set and site. My numbers continued to rise, even with exercise, light lunch, until it was in the 400’s. I called my endo’s office and got the on-call endo who suggested I disconnect from the pump and go to basal/bolus injections. So I gave an injection of Toujeo, 26 units at 5p last night, and Humalog injections. The endo said I had to wait at least 24 hours before going back on pump. Today my numbers continue to be horrible, high 200’s into the mid-high 300’s. Have been doing Humalog injections for meals and corrections, but still not going down. I’d like to re-start my pump but unsure how to do that and whether I should wait the full 24 hour period from last basal injection?
Not sure what’s going on but wanting to get back on pump. Any advice would be appreciated. Thanks so much.

Hi @DFBB If I had a big shot of long acting in me, I would restart the pump using a temporary basal rate. There is a video for Tslim here

The idea is that you want to keep your basal rate very low, or zero, while your long acting is still working and then resume your pump basal when your long acting shot wears off. No you wouldn’t have to wait 24 hours, but you do have to be careful because adding your pump basal to your active long acting might be too much.

As far as really high blood sugars go, stress and illness can make me high. When that happens I usually use a temporary basal that is higher than my normal basal. For example, when I had covid, I used a 150% temporary basal to keep my fasting blood sugar from rising. When I was on prednisone, I used 300% basal.

If you are uncomfortable making your own pump decisions, it’s better to work with a doctor or CDE or nurse trained in pumps. Good luck :four_leaf_clover:

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Diane @DFBB, what @Joe wrote was what I was thinking how I’d respond when reading your post - so I second his thought.

Also while reading and seeing that you were taking significant insulin and you BGL remained high, you may want to discuss with your doctor the possibility of a “hidden” infection - an infection such as UTI where you do not feel anything wrong.

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Another possibility is a dental issue: I’ve had blood sugars that were mysteriously high and did not respond to corrections. Turns out I had a small toothache that went south and I needed a root canal.


Hi. I’ve had the same experiences. I leave my pump on. Don’t change any of the settings. I’ll take an injection on humalog. Sometimes two if necessary. Diabetes is not an exact science. What works for me doesn’t work for someone else. Just a thought.

I agree with Dennis. That is a good plan.