Good evening everyone!
I am recently diagnosed T1D, and have been on the pump only a week. I have a couple questions I am hoping some more experienced pumpers can help me with!
About correction boluses --how long after eating (lets say, end of meal) should I wait to correct a high blood sugar? If it is high after 1 Hour should I correct right away? or only if it is still high at 2 hours post meal? How high does it need to be to correct it? Anything over my post meal target (140 mg/dL)?
2nd questions is about the threshold suspend feature. Does that only work with the CGM? Twice I have had blood sugars under the value I set with my trainer for the threshold suspend. My pump says that the low should be treated before taking a bolus (duh)… but, it doesn’t seem like it stopped my basal. Should I suspend it while treating the low? or should I treat it and let it keep going?
Thanks in advance!
FYI - I have the MM 530g, and have not started with the CGM yet.
Welcome to TypeOneNation! Congrats on pumping!
I don’t have the 530g I am on the MM522 but I know @ScottT has the Minimed 530g he may be experienced with the threshold feature. I can’t answer that. I tagged him so he knows!
But, as far as correcting after eating, two hours is the rule of thumb. Whatever your target is post meal should be something your doctor would have recommended to you. Most people have different target ranges. At the 1 hour number you may be still coming down so you don’t want to stack insulin and then in turn become hypoglycemic. There is a lot of trial and error in the beginning but, once you know the pump better and your body and how it reacts to certain foods it will be a piece of cake! (no pun intended LOL)
the suspend only works when you are using the integrated CGM (Enlite sensor) and have the threshold suspend set in your settings. It won’t suspend based on a finger stick reading.
here’s the minimed settings instructions
“it depends” is the only answer I can give you regarding a correction after you’ve bolused for a meal. the minimed uses an algorithm for figuring out how much insulin you have on board, and compares it to your current BS. you can test continuously after a meal if you want. I find it is more relevant to check at 2-3 hours because if I am tracking higher than I want, I can add insulin to help. the insulin on board algorithm can be adjusted by changing your “active insulin time” set point.
don’t sweat it for now - you have a lot of adjusting to do, you will learn everything you need to know about your pump over time. I think it’s a great little tool and it allows me great flexibility. please get a copy of Pumping Insulin by John Walsh/Ruth Roberts if you would like to learn way more about pumping.
Thank you Gina! I meet with my doctor next Wednesday, and will make sure I am clear on what my targets are. Thank you for the response and the encouragement!
@ chem Dracula the threshold suspend will not work unless you were using your CGM. I have mine to stop when it goes below 60. While it is alerting me below 90 I sometimes don’t hear the alarms especially if I’m sleeping. At 60 it turns off your basal and they estimate that you’re blood glucose will go up 20 points every hour you’re not getting your basal rate.
Do not suspend your pump when you’re treating a low. In fact I try to eat 15 g of sugar or more and I interact into my pump using the bolus wizard. Of course being so low it does not give me any insulin but I am at least tracking the amount of carbs that I’m consuming. It also helps my Indo when he is trying to make eight bolus or basal adjustment for the amount of carbs that I’m eating.
Good luck it takes a little bit of time getting used to the CGM even though I will say the 530 G Enlite system is far more comfortable than the previous sensors I used to use from Medtronic.
Thanks for the responses! I have found them very helpful. I feel like already I am becoming more comfortable using the pump! I Hope adjusting to the CGM isn’t too bad.
Welcome to pumping and learning how your body reacts to insulin at the present time. I recently upgraded to the MM523 and do not use CGM so I can’t answer that question other than to say that the suspend feature [according to the MM530 spec sheet] works only with elite sensors.
As far as “corrections” you first must determine how long insulin is effective in your body and when the insulin you have taken is at its peak. I’ve documented during ten years of pumping that the peak action of Novolog is moving further away from the time of bolus. To avoid stacking of insulin, I recommend that you wait more than two hours after a meal before you take a correction bolus and NEVER take a correction based on a single time BG reading; observe first how much your readings decrease over an hour interval.
Actually Dennis I have the 530 sensor with the in Enlite system and I was on a trip and my sensor died after three days!
Well I looked in my bag and I had an old sensor and I connected it to my 530 pump and it worked fine.
I called Medtronic to ask them if they would work. They simply responded that the FDA only allows the use of the end light sensor with the 530 pump. It’s the exact same technology nothing really changed all that much. Even with my old sensor I used to get six days out of them while they said you shouldn’t get any more than three days out of them.
I hate to be the skeptic but I do believe there’s a lot of BS being thrown out there!
Oh and my pump did go into threshold to spend with the old sensor!
I can’t get this thing to post medium same too much, but I was saying that my 530 G sensor stopped working after three days. So I checked in my bag when I had available was with an old sensor and I attached it and linked it to my 530 G. Everything worked well. Plus I got a full six days use out of using the old sensors! They say they’re only get the three but I’ve been using it for years I always get five or six days.
Enlite sensors only give you six days and I’ve been unable to get them to last any longer. I think it’s because of the size of the cannula it’s very tiny and it doesn’t go in his deep.