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The Question
02/18/10
12:33 PM
"Is it ok to make small adjustments to my basal levels myself as i see the need or do i really have to contact my Dr everytime?"
Asked By:
rivierasrider
Category:
Pumping Issues
Background Info Hide
I'm 28 and have been on the pump for about three weeks after having been on insulin for a couple of years. I want tighter control so I'm working out the high spots and am at the point of slowly raising my basal levels to tighten control (along with diet and exercise adjustment ofcorse!) Is it ok for me to make small changes every few days to "dial in" my basal rates to maximize control or do i need to call my doctor everytime a change is needed? I dont like having to wait on my doc, but I dont want to harm myself inadvertantly either?
Expert Answers (1)
02/23/10
06:22 PM
Dear Rivier- Thank-you for contacting dLife.com. When you were first set up with your pump, what were the instructions. Do you have a follow up appt with the Pump technician or with the MD? Did they give you any parameters to work within.
What is customarily done it that you give your pump therapist a call and report your glucose readings. They will them make small recommendations for the basal rates at various times or intervals of the day depending on your trends. They then give the MD a call to review the recommendations.
IN order to maintain a good patient MD relationship, it would be good to give the MD a call and ask to give you some small parameters for raising your basal rate since it is done in tenths and what glucose levels he is looking for.
There are trends and there will be times to make adjustments. That's the beauty of the pump to have staggered settings. It is a great step toward self management. But it would be prudent to maintain a good relationship as well.
Stay well and Stay self managed.
Answered By:
Janet HowardDucsay
Accreditations: RN BSN CDE
Sources Show
(1 Answer)
Community Answers (4)
03/31/10
12:30 AM
When I was first diagnosed, I pretty much relied on my doc or the CDE to make my decisions for me, but as I became more comfortable with the insulin and dosing, I began to make changes on my own, but kept my doc informed. I fax him my blood sugars every week, along with any changes or what I am currently dosing. He generally has his nurse contact me if he has any questions or concerns and he feels comfortable with me adjusting my settings myself. It depends on the person. The ultimate goal is that we understand our diabetes and how to treat it independently. However, if you're not comfortable, then definitely call. Good luck!
Answered By:
pdewey1969
FLAG
SourcesShow
03/31/10
12:29 AM
When I was first diagnosed, I pretty much relied on my doc or the CDE to make my decisions for me, but as I became more comfortable with the insulin and dosing, I began to make changes on my own, but kept my doc informed. I fax him my blood sugars every week, along with any changes or what I am currently dosing. He generally has his nurse contact me if he has any questions or concerns and he feels comfortable with me adjusting my settings myself. It depends on the person. The ultimate goal is that we understand our diabetes and how to treat it independently. However, if you're not comfortable, then definitely call. Good luck!
Answered By:
pdewey1969
FLAG
SourcesShow
02/27/10
11:32 PM
The simple answer is "No, it's not ok to do it on your own-yet. "
Your basal delivery is a constant flat amount of insulin you need regardless of food intake to maintain your basic metabolism and autonomic functions. You don't tighten up your control with basal adjustments. You do it with bolus adjustments, which incorporated into the non-flat profiles on your pump.
At 3 weeks on the pump, if your morning BGs are running consistently high or low, your endocrinologist should be calling you about a basal adjustment. (You are sending in your BG logs weekly - right?)
This is true whether you are on MDI or on the pump. Using a pump does not free you from the need for a consistent daily diet and exercise plan; it only gives you more flexibility in your eating and exercise schedule.
Unless you maintain a consistent overall daily intake and activity level, your required basal dose will vary as you gain or lose weight. Varying your diet, activity and insulin dosage simultaneously is a very bad idea for anyone with diabetes.
What you can do now, is learn to control your _bolus_ values, profiles and calculate personal correction factors, measuring your actual caloric and carb intake, measuring your weigh weekly, and recording all your BG test results, and sending everything to your endocrinologist each week. Write any questions on the cover page.
Once you've done that, your next scheduled quarterly visit to your endocrinologist would be a great time to discuss adjusting your basal rate, and how to do it rationally.
Answered By:
psdaengr
FLAG
SourcesShow
02/27/10
11:31 PM
The simple answer is "No, it's not ok to do it on your own-yet. "
Your basal delivery is a constant flat amount of insulin you need regardless of food intake to maintain your basic metabolism and autonomic functions. You don't tighten up your control with basal adjustments. You do it with bolus adjustments, which incorporated into the non-flat profiles on your pump.
At 3 weeks on the pump, if your morning BGs are running consistently high or low, your endocrinologist should be calling you about a basal adjustment. (You are sending in your BG logs weekly - right?)
This is true whether you are on MDI or on the pump. Using a pump does not free you from the need for a consistent daily diet and exercise plan; it only gives you more flexibility in your eating and exercise schedule.
Unless you maintain a consistent overall daily intake and activity level, your required basal dose will vary as you gain or lose weight. Varying your diet, activity and insulin dosage simultaneously is a very bad idea for anyone with diabetes.
What you can do now, is learn to control your _bolus_ values, profiles and calculate personal correction factors, measuring your actual caloric and carb intake, measuring your weigh weekly, and recording all your BG test results, and sending everything to your endocrinologist each week. Write any questions on the cover page.
Once you've done that, your next scheduled quarterly visit to your endocrinologist would be a great time to discuss adjusting your basal rate, and how to do it rationally.
Answered By:
psdaengr
FLAG
SourcesShow
(4 Answers)
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*** All information contained on dLife.com is intended for informational and educational purposes only. Our Expert Q&A is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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