[alexvjr74]

I am type 2 diabetic and I am currently taking insulin my doctor has me increasing it 2 units every 3 days I am currently at 36 units after being at 10 for 2 yrs. My blood sugars are lowering but I am not there yet. At what point should I ask my doctor about a pump?

[dano]

Let me get this straight: Do you take a bolus injection after each meal or are you currently taking a total of 36 units per day?

[alexvjr74]

I take lantus I am now up to 38 units

[dano]

Originally Posted by alexvjr74

I take lantus I am now up to 38 units

Lantus is a long acting insulin, therefore, this must be your basal dosage. Honestly, I don't see the need for a pump. Generally pumps are utilized by people that are taking a short acting insulin. Since you obviously don't take a meal bolus, I don't see why you would consider being attached to an insulin pump, via infusion set, for 24 hours a day / 7 days a week, when you could just take one 38 unit shot a day and be done with it.

Please correct me if I am missing something.

[type1rachelle]

Are you taking short acting insulin for meal or correction boluses? Do you have issues with volatile highs and/or lows with the Lantus? As a T2, you wouldn't be a candidate for an insulin pump unless you answered yes to both questions.

To clarify, an insulin pump delivers a basal rate of short acting insulin hourly - so instead of giving yourself one injection of 38u of Lantus per day, you would set your basal "patterns" to deliver x units of insulin per hour between the hours of x and y and then y units of insulin per hour between the hours of y and z, etc. This gives you tighter control over the volatility when it comes to things like Dawn Phenomenon and your unique diabetic rhythms. Typically, however, T2s do not have these volatility issues as much as T1s, and insulin pumps and supplies are very expensive so you have to have a VERY good reason to get insurance to pay for it.

Also, the advantage of the pump is that it's an infusion set that you change out every 3-4 days instead of multiple daily injections. If you're just on one injection of Lantus a day, I have to agree with Danny, doesn't sound like the pump would be right for you. But if you're having control issues and are on multiple daily injections, you might want to talk to your Dr about it.

Lastly, with an insulin pump, it does all the math for you when it comes to meal and correction boluses (you program the insulin sensitivity factors and carb to insulin ratios) and with a few presses of a button, you get it to deliver the insulin you need - so it is more convenient than injections. But again, this is assuming you're already on multiple daily injections, as in Lantus once a day PLUS rapid acting insulin like Novolog, Humalog or Apidra before and after meals, etc.

To give you an idea - I'm a T1 and my pump settings are:
0.70u/hour 12am to 7am
0.80u/hour 7am to 11am
0.75u/hour 11am to 12am
Insulin Sensitivity Factor (ISF) = 1u/80mg/dL out of range 24hrs
Insulin to Carb Ratio (IC) = 1u/15g of CHO 12am to 9pm, 1u/20g of CHO 9pm to 12am

as you can see, I use it A LOT - I have my basal patterns running 24 hours a day, PLUS, I typically give myself around 5 or 6 additional boluses per day.

hope this helps, good luck!

[alexvjr74]

I am now at 40 units every night my doctor said he might consider changing me to take my lantus twice a day depending on where I end up at. My 30 day average is 152.9 which is down from over 350. I cant always take it at the same time I try at 9 but sometimes I dont get home until 10:30 at night.

[dano]

I am currently on a 60/40 split basal. I take 60% the first thing in the morning and the 40% before bed.

It appears that your and your doctor are well on the way to getting your numbers down to a more normal level. Please read through the first three threads in the Type 2 Section, when you get a chance, if you have not already done so. Counting carbs and an exercise routine will help you a lot. Good luck with your control and management.

[type1rachelle]

Originally Posted by alexvjr74

I am now at 40 units every night my doctor said he might consider changing me to take my lantus twice a day depending on where I end up at. My 30 day average is 152.9 which is down from over 350. I cant always take it at the same time I try at 9 but sometimes I dont get home until 10:30 at night.

yeah, you're not really a candidate for an insulin pump, but good luck with getting your #s down! hopefully you and your Dr can work it out.