Switching to MDI

If you’re temporarily switching to MDI from pump, what has been your experience as to when to take the first long acting (Levemir)injection after removing pump. I have my off-pump dose information, so I know how much to take. I’m just wondering how long to wait before I take it.

Hi @HighHopes In my opinion I would take long acting about an hour after going off the pump. That’s about how long it takes for a change in basal rates to show up as blood sugar for me. Good luck :four_leaf_clover:


That’s sort of what I was thinking.

I did find that when I return to the pump, I have to wait 24 hours after my last dose of long acting to restart pump. It seems like I’ll be really high by then. I take half my Levemir in morning and half at bedtime. So…does that mean I only wait 12 hours?

Thanks a lot.

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In my opinion, I would put the pump on and use a zero temporary basal. I’d use the pump for meal insulin and corrections. As soon as my bs started to rise, I would reset my basal. You might have to use 0% then 50% then 100% for basal as the long acting wears off. It would be easier with a CGM do you have one?

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Yes. I have a CGM and I’ll have that on so I’ll be watching the BG carefully. I guess I could start with a Temp basal to see how it goes. I’ve never used temp basal for more than a hr or so. That should work.

I have Basaglar and Admelog pens in case I need or choose to go off pump, and my doctor gave me timing instructions as well as dosing.
Suggestions and experience from forum members are things to consider and incorporate on your own depending on your level of experience. But some things should be discussed with your doctor as they depend on your body’s patterns which may serve as a guide for the timing - only the two of you are familiar with those.
I suggest you get specific guidance from your doctor about both going off pump and getting back on.

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Right. I have sent my Endo a PM with the questions as well. I appreciate the tips.

Dee @HighHopes following “logic” and knowing that the Levemir is replacement for the basal insulin you had been receiving from your pump, I agree with the suggestions given by @Joe.

Something else to keep in mind when using Levemir [Insulin Detemir], the Levemir IS NOT a true background insulin as is your basal - Levemir is a long-acting insulin with known “peak period”. Using your CGM you should be able to spot this and know how it affects you. Although I no longer use MDI, I believe that with good knowledge of insulin and knowing how foods and activities affect you, MDI can be the most effective diabetes management technique.

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I wish I could recall how my MDI was some years ago. I actually had a Dexcom CGM with MDI. It seems like I did okay. Who knows what the future holds I’m keeping an open mind.

I use Tandem T:Connect so don’t recall how far back Dexcom stores your data; but if it doesn’t go far enough you could ask to see records from your doctor’s office. Some of us went off shots in the last century😲 and it may be more challenging depending on how far back you have to go, but you could try.
If you don’t mind my asking, why are you making the switch? Not judging, just curious . Another forum member ( @pamklein I hope you find mind me tagging you here) wants to switch from pump to shots but can’t find a doctor who’s on board with her choice! I’m glad yours is - at least as a temporary measure.

Dee @HighHopes , have you had the opportunity to meet Dr. Stephen Ponder, MD, a practicing pediatric endocrinologist who has lived with his own T1D for about 55 years and is the author of “Sugar Surfing”? I had the privilege to meet Dr. Ponder on-stage during a JSRF Summit and also when he joined the Joslin Medalists.

He has shared his experience about dropping his pump and adopting his theory of sugar surfing as an extremely effective MDI diabetes management using continuous BGL readings. I began using his methods when I got my Dexcom G5 and had really good results; it was a lot of work and needed more attention, but had even better results [a narrower standard deviation] than I have now with my “Lazy-Man” automated control system.

I just took a glance and found the “Sugar Surfing” guide book to be readily available on line. I don’t know if the in-person training sessions have continued during the pandemic.

Yes! Dr. Ponder is a regular speaker with Taking Control Of Your Diabetes. He’s awesome. They have another virtual all day conference this Sat, Oct. 16, 2021, if anyone is interested. Endos, Dr, Edelman and Dr. Pettus, also, long term TIs head it up. I attend every year. It used to be in person. It’s FREE, if you have time. It’s very humorous, as well as informative. I’m not sure if Dr. Ponder will speak this time. Sometimes, he’s on a panel. Some things are pre-recorded and some things are live. Thanks for the tip.

I’d post the link, but not sure if it’s allowed.

I didn’t get the chance to go off pump. Mine was recalled, but they got a replacement to me very fast. I had to install all the settings into the replacement pump. Thank goodness, I got it done and am back with it and CGM. But, if I need to go off pump, I feel prepared. I may want a pump break indeed.

Bob Osthues T1D 66 years, I use Lantis, and take it same time each day regardless of the Dexcom reading. For the record, I have had to increase by 2.5 times since my Moderna shots.

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Do you have any idea how to change my email address on the site? I’m switching to a new one and won’t have access to this one much longer. I posted about, but it may not be in the right place. Thanks.

The most easy way Dee @HighHopes is to access your profile and in the “Preferences” tab to click on the wrench and change, modify, or add alternate email address. The Way:

  1. Click on your picture icon - for you, the “H” in a yellow circle. that will cause a bar with symbols to appear;
  2. Select the “person character”;
  3. Select “summary”;
  4. Select “Preferences”;
  5. Scroll down to the eMail section, click the tool and make your change.

While you are on that page, you can make any number of chances on how you appear. After making changes, be certain to scroll to the bottom an click “SAVE CHANGES”.

If you need assistance, please let me know.

there are at least 2 ways to do this - please reach out if you still have problems.

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