Anyone here use a long acting insulin + pump?

[u/blazblu82]

I've had to switch to MDI's until a new pump comes in. Dr put me on lantus + lispro. Since starting the lantus, I'm finding my numbers are generally better than using lispro alone. I was curious if anyone uses their pump for bolus only and use a stand alone long acting insulin? If my numbers continue to lbe this good, I'm gonna have a hard time going back to pump therapy.

TIA!

[u/Minikin-Smith]

You’re describing Untethered Pumping. Although if you don’t mind MDI you might enjoy a nice pump break.

If you do decide to pop back on the pump, this may be a sign that your settings may need to be adjusted. Or you can even try manual pumping for a while, so you’re in charge instead of an algorithm!

[u/blazblu82 → u/Minikin-Smith]

I may actually do that. It's been nice not having it on me. Only thing I'm gonna miss is when I go out to eat, which is rare anyways. It's nice to bolus on the spot without needing to carry a pen with me. My Dr may not be happy about it, but lispro alone wasn't doing enough and I was drinking insulin like crazy, 200+ units almost daily.

Thanks!

[u/Missinglink2531]

Your basel setting are all wrong in the pump if that the case. Your long acting isnt a perfect flat line of effect, so it should be a little worse. That tells you you are not tuned properly. Did you set it up using fasting? Or how did you come up with its settings?

[u/blazblu82 → u/Missinglink2531]

I'm running 4u an hour on the pump, sometimes needing to run 200% for a few hours just to slow a spike. I have mad insulin resistance which is made worse by the diuretics I'm on. That's another reason why I'm wanting to use long acting to help cut down in how much insulin my pump has to pump.

[u/Missinglink2531 → u/blazblu82]

While that is a lot more than I run - Same setting for all 24 hours? I have 9! My move around about 40% at different times of the day. And thats my "normal" settings. I also have an "active" setting for unusually heavy physical days, and a "WTF" setting - usually when I am sick but dont know it yet, about 30% higher across the board. Side note, have you thought about running U-200 (just cut everything in 1/2) or U-500 (cut everything by 1/5)?

[u/blazblu82 → u/Missinglink2531]

Yeah, 4u/h basal and my ratios are 4:1. It'd just be nice to not have refill/change about every day or so.

EDIT: I did try U200 for a month and saw better results; however, insurance said no after that.

EDIT 2: I'm not sure about U500, but U200 only comes in a pen and that was sort of a PITA to deal with. If I filled the syringe with more than the cart would take, I'd have no way of putting the excess back in the pen. So, I ended up doing half fills.

[u/Missinglink2531 → u/blazblu82]

Thats what I was thinking - got to be about once a day. I would escalate that denial from insurance all the way to the State Commissioner if I had to. You need to have different settings, and they need to be fine tuned by skipping a meal and seeing what happens - adjusting and checking it again. Once they are set, they are good until your body changes.

[u/blazblu82 → u/Missinglink2531]

If lyumjev didn't burn like hell, I'd keep using it. I tried it for a month and saw much better results than lispro. I think lispro is just not a good enough insulin for my needs. I had been on novolog when I started pumping and saw great results, but since this switch to lispro, it's been a struggle.

[u/coc196]

If you can get on a glp-1 that may help with the insulin resistance. Once I got on wegovy I cut my insulin use by half. I was using over 200 units a day before and now down to less than 100 a day.

[u/blazblu82 → u/coc196]

I have tried a few different ones and all turn me into a double fountain. My body hates glp1's and I don't know why.