Pump / Insulin Settings

[Meadow]

Hi,

We're having issues getting our son's BG under control using the pump. I thought that maybe if we could share any info about our pump settings that maybe we could help each other identify anything that looked strange and maybe could give us something to target.

Right now he's consistantly high, although not always predictable. His mornings are usually high so we are thinking of giving him more insulin with breakfast. Also the night times are very unpredictable, sometimes shooting up sky during the night (even with greatly increased basal rates), and sometimes they're steady.

Parker - Age 2 1/2 - diagnosed at 18 months

Insulin / Carb Ratio
1 : 25g - Most meals
1 : 30g - bedtime snack

Basal Rates
Daytime - alternate between 0.100 units / hour and 0.125 units / hour
Night - 0.175 from 8-12, 0.100 from 12-6

Insulin Sensitivity
14 Mmol / L

Insulin On Board (Humalog) - 3 hours

[jeep_bluetj]

We just started pumping, and saw some similar problems.

Are you just starting pumping?
Were you basal/bolus before, if so does the pump basal keep in line with your previous basal dose (lantus)?
Do you see the exact same behavior after a set change/insulin change? Look at 6-9 days of data and see if the highs are following set changes. You may need to change the set more often.

We found that the pump basal worked out well set at 90% of what the lantus was per day, and that we had a few sets only last 2 days.

I always try to get the basal dialed in first (stable overnights are what I use to guage it) and then adjust the ratios. Pumping has been almost exactly like lantus/humalog, with a bit more fine tuning for the basal.

And, if we get a bit out of control, we reduce the variables: hold as much constant as possible. Food, excersize, etc... Same carb meals, no snacks, and no 'delayed' foods like pizza. Then the pattern shows up better. It's exactly what our CDE had us do when starting pumping, but we've done the same for 3 years when using MDI.

[TimO]

See if your Endo will prescribe Novalog. Our 4 year old son started on the pump with Humalog but we found MUCH better results with Novalog, including extending many of his site changes to three days from two. Supposedly the Humalog crystalizes in the pump faster than the Novalog.
This part may sound crazy but from day one on the pump we've had 24 BASAL SETTINGS. This way, if we're having high or low numbers at a specific time of the day, we go in and adjust the basal two hours earlier than the suspected high or low. We're also on the 3 hours active insulin setting.
I hope this helps. We've found having 24 basals much easier to fine-tune the pump with, although as we all know every day is different with diabetes.

[Eoin'sMam]

Our son Eoin is also 2 1/2 he;s been pumping for 3 months now and is on very similar boluses but we have 8 basal rates set up (they range from .05 from 3am to 6 am and .3 from 8am to midday). It took us at least a month to fine tune it all with testing every 3 hours initially to see what the effect of each basal was.

I like the last posters idea of 24 basals too...that would be mush easier to fine tune when their patterns change...i think i'll give that a go myself

You'll still have off days and out of the blue weird readings but if a pattern develops adjust your basals

Best of luck with it and enjoy this new lease of life (no more force feeding a 2 year old...yippee!!!!)

Lou