The math of pumping

When I started pumping insulin in January of 2004, I didn’t know what I was doing. The year before, when my first endocrinologist visted me in the hospital he asked me when I would be ready to start using an insulin pump. I had taken my first shot only a day or two before, and here he was asking me about wearing a medical device 24/7/365. I was NOT ready. It took me about a year to come around to the idea.

I finally told him I was ready to pump, and he set me up with the local MiniMed rep. I did not even know there were other choices until long after I started pumping. The trainer came out to my house to get me set up, and I had an appointment with the doctor a few days later. In the time in between I would be ‘pumping’ saline to get used to the dosing.

At the doctor’s office, he looked at the amount of basal insulin I was using – NPH – at the time, and set up my basal rates from that. We did not look at any of my logs (I didn’t actually keep any back then!), or any additional information. The endocrinologist said he was an expert with basals and that he hardly ever has a patient that even needs an adjustment.

Well – he was right up to a point. Those first rates worked well up for a while. Then I gained weight, lost weight, the seasons changed, my sleep cycle changed, etc. I needed to adjust my rates, but I didn’t know what I was doing. I would just raise the basal amounts by a number I ‘felt’ was right for the amount of time I ‘guessed’ was right. That led to a lot of high and low chasing.

A little over a year ago, I found out about the book Pumping Insulin (if you are not pumping may I suggest the similar book Using Insulin). Even though I had been pumping for 4 years, the information in that book changed the way I approached my diabetes care. There are charts, graphs, and tables that actually explain what we are doing.

For example, there is a chart that you can using to determine how well your basal rates are working and when they need adjusting. I LOVE math – but this could not be easier even for someone who doesn’t!

January 18, 2008 - diabetes365 - day 102

This one was a good test, no change in the basal rates.

February 5, 2008 - diabetes365 - day 120

This one was not as good! Much like many other diabetes, I feel like I am always trying to manage morning highs.

*I obviously suggest making copies of the charts in the book – you will use them A LOT!

What’s your favorite little known/little used diabetes tool?


  • Of course these charts are used for “basal testing.” For the uninitiated, basal testing is basically skipping a meal and testing frequently to see how flat your basals keep you. It’s the foundation of good control. I have 16 different rates throughout the day. The benefit? An A1C of 5.9!

  • I too, like and use both books; “Pumping Insulin” and “Think Like a Pancreas”. I’ve been on the pump for 4 yrs., but sometimes I just need a little “refresher” on testing; exercise, etc. My favorite (and seldom used by most) tool, is my log book. I can look back and quickly identify trends. I can see how foods and insulin are affecting me. It can be time consuming to log all the info- but that little book is my “bible”.

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