Today was my 3-hour pre-pump training. We didn't actually touch our pumps, though. The nurse went over our rates and plan for switching from the long acting insulin to the pump. There was a little talk on how to take care of high/low blood sugars. Finally, there was a presentation by a dietitian.
I'm not convinced about the transition...they told me to cut my dose down, but only from 36 to 30. The starting basal rate on the pump is the equivalent of 26... so in effect, I will have 56 units in my system rather than 36... I will have lots of juice on hand that day. The cross over will be about 12 hours and will end just in time to go to bed. My plan is to take my last long-acting insulin early the night before, which will at least save me a few hours of discomfort.
The thing that I'm most worried about is the fact that I'm not supposed to correct high sugars unless they are above 13. I currently feel uncomfortable when my sugars are anywhere above 10, and I always aim for my sugars to rest at 5. The reasoning is that they need to see how my sugars are reacting to single doses of insulin and it complicates it if you have multiples..
[Imagine one person trying to do a task. It doesn't matter if they suck at it, you have to just let them struggle with it on their own so you can see just how bad or good they are.]
Mostly, this is a control thing - I have been in complete control of my condition for so long... I don't think I'm comfortable with letting someone else make these decisions for me. Especially this last year, I've been constantly making adjustments and I'm learning a lot and improving because of it - now I have to throw that all away for a few weeks!?!
Nevertheless, I have to go through these hoops to get the pump up and running, so I'll suck it up and be submissive to the Assistive Devices Program master for a while.
Then I'll say, "I told you so" when things end up being what I expected them to be.
As a point of reference, these are my predictions:
Basal Rate - 1.4
Insulin Sensitivity - 1 unit = 1 mmol
what they are starting me at:
Basal Rate - 1.1
Insulin Sensitivity - 1 unit = 2 mmol
The Sensitivity number is the one that bothers me most - yes it is good to be safe, but they are cutting mine in half! That means that even when my sugar jumps to over 13, the correction will be only partially successful. For example, if my sugar were 14, I would want to take 9 units, but I would only be allowed to take 4.5. If I am correct, then it would take me 3 or more hours to lower my sugar down to 9.5 - still double the healthy amount of blood sugar. If I were wrong, then I would notice that my sugar was dropping too rapidly, and I would know better the next time. I understand that they need to be safe, but I'm not going to like the safeness!
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