Pump question...

[Carrie]

Let's see...I just spent about 15 minutes trying to get a 3 1/2 year old awake enough to drink 15g of apple juice in order to correct a low. Stupid thing is, I think I caused it by not paying attention to when I last gave her a corrective dose of insulin prior to her bedtime snack (please tell me I'm not the only one that has done this!!). :( (Scarey thing is, I aimed low when I gave her the insulin.) With the pump...are there safe guards so that you don't give them too much insulin? If so, are all pumps like that, or only certain models? We are doing a saline trial in a couple of weeks. Starting to do my homework. Any good suggestions for when you can't rouse a sleepy one? It was a 72. Not super low. She had only been asleep about an hour. Long enough to make her good and mad when I was trying to wake her.

Gotta go recheck her BG. Thank you in advance for any information you might have. :)

[Carrie]

That was enough to shoot her to a 208. :( Argh...stuff like this makes me really hate diabetes and what it does to their little bodies!

[rsmom]

I'm far from an expert as we aren't pumping yet, either, but if I recall correctly from all the reading I've been doing :) it is possible to set maximum bolus parameters (at least on some pumps). I don't know if you're able to set them for different times, or if it's one maximum overall, though.

You have my complete sympathies!! I've had countless nights where I've had to wake up my soundly sleeping son to try to get him to eat a little something - not fun!! Sometimes he's sleeping lightly so waking is easy - other nights it takes 20 minutes or more to get him to a point where he's awake enough to eat or drink. It makes him cranky as heck...the other problem is that getting him to go back to sleep afterwards is always a challenge. I don't have any real solutions - just know that you aren't alone! ((hugs))

And, if it makes you feel better, I think we've all screwed up with the insulin at some point - I know I have!! I forgot to bolus the other day at lunchtime....had no clue I'd forgotten until I saw his numbers at snacktime :eek: :eek: Not a mistake I want to repeat again! All we can do is the best we can do, and learn from the mistakes that we make. It's not easy, though.

[twicker1]

I have no definitive answers on the pump, but from what I have read, certain pumps, or maybe all of them, will alert you to how much insulin is still working in their system when you try to bolus too soon. Well, I guess it wouldn't be too soon if they need it, just keeps you from doubling up on insulin in the system. Kinda scary that there are pumps that can tell you how much to give. I think it is great, but I am also afraid that I would get out of practice not doing it in my head.

[Tamara Gamble]

Hi guys, my son is a pumper. The pump will only allow you to do certain things. It depends on how you and your endo configure it. It will remind you when your child still has insulin on board. It's not an alert, it's a screen that tells you. You still have rules though. Like for example, we are not to correct for anything under 190 mg/dl at bedtime snack. I noticed that it's different for each child. We still use the four hour rule. Some parents, actually quite a few use 2 1/2 to three hours. For Ty his body takes a minimum of three hours to work it all out and he's so sensetive to insulin the four hour's is right for him. When your child needs a correction the pump tells you what they should get based on what you have preentered. When they go to eat a snack the pump tells you what your child should get based on what is already in the system.

As far as forgetting, you just have to keep track of the changes that you have made. Correction bolus, Insulin to carb ratio and basals. Ty waterlogged his supposedly waterproof pump when we were on vaca and we had to do it the old fashioned way. If you need a reminder just call your endo. I hated going back to the shots. It was only for a day until we got our new meter but I felt like we didn't have the control and were stuck with whatever was already in his system (lantus). The basals are changable in the pump so it can be adjusted for each child. And you can configure the maximum bolus.

You will like the pump much, much better. It's a little genius. We use the cozmore system but I think that all of the pumps work the same way. For a child that young alot of parents recommend the Animus because it can be a little more fine tuned as far as what's delivered. I can't speak for the Omnipod I don't know. The minimed is a great little unit too. I think all of the pumps are great, I think you need to see what your insurance will cover, look at all of them and pick which is right for you. I like ours because it spells it all out in easy to read format for my son. There are alot of things I like about it but they are all good in my opinion.

As far as waking a child up at night I don't have any great suggestions. My son is eleven and still is not quite with it. Juice is the obvious choice, it's fast and easy. I just make sure it's room temp so it goes down quicker. We don't have to deal with the fit throwing at the age my son is at so I can't really help. It stinks though. I remember when my kids were little and they didn't care for being woken up for a temp check when they were ill that's for sure. Of coarse I didn't really appreciate being woken up for hours on end when they were little either. One advantage of getting older I guess.

Good Luck! God Bless! Tami

[zimbie45]

HI
Yes, most all pumps will have a calculator so some sort in it, so what will happen is you tell the pump.. what the blood sugar was and how many carbs eaten adn it will calculate it all for very accuratly.... MOSt will also have what is known as Insulin on board (IOB). The PUmps will also calcualate if there is any IOB that could be causing the Blood sugar # you have based off last dose if insulin adn will subract out if needed to prevent over dosing...YOU will also program the pump on what it needs to do and also set maximums and minimums the pump will also for insuin to be give at a time and in total for a day ( anouther safe gaurd )

TRicks to wake a little one.. thats a tought one... maybe instead of having to wake her completely for a low, use cake icing ( GEL) adn squirt some in her cheeks.. she wont choke and it will absorb thru her cheeks.. her blood sugers will increase an seh gets to sleeep.....ALso lets say you have a lower than anticipated # than what you want ( but not a low that has to be treated) lets say it the middle of night and you would like her to be around 180 since its middle of nigh an she is 105, still in normal but low end.. you can simply do a temp basels and turn down the basel rates so she doesnt get as much insulin and will cause her # to go up abit to a more better number and you dont have ot wake her to drink somethign....hope this helps

[Animan]

Even the "old-timey" pumps like ours have limits you can set for maximum bolus. The new one's have the "insulin-on-board" but I use a chart I printed off for how long insulin stays active.

For Adam I use skittles at night for lows, just cram a few in the ole pie hole at a time. Now, don't go choking your kid if your not comfortable with this, as we've been doing this for years with Adam. Every kids different on the chewing/gaging response. I measure skittles as one gram apiece and use my chart again. Here's a site below that does what the new fancy pumps do. Its fun to play with and is mighty handy in ways you can figure out for yourself.


http://home.comcast.net/~mtherieau/bolus/Bolus_Tables_Home.html

[pookas]

Yeah, our night time numbers have been crazy. Hunter was 68 the other night at 9:30am so I gave him 1/2 c. milk and he shot to 270 in 1-1/2 hours. Last night I had to wake him 1 hour after sleeping to give him milk and HE WAS NOT happy either. If I have a hard time, I put his bedroom light on and literally pull him up to sit, otherwise, I just put his reading light on.

[selketine]

The insulin on board feature is on all pumps (maybe a different name) - that is what it is called for the Animas pumps. It is helpful to some extent. We find that if William is going up after 2-3 hours it really doesn't matter (except after breakfast/before lunch) what the IOB says - we have to give him the full correction.

I also wanted to note that generally 15 grams of carbs is too much of a correction for a low for William. We generally use 4-8 carbs depending on the situation. I know that all the literature (and it even seems like we were told this) that 15 grams of carbs is the general thing to give but it is WAY to much for us. Sometimes even half a glucose tab (2 carbs) is enough. I just wanted to note that - I know how hard it is to correct at night when you have to wake them up - you don't want to give too much and have to give more insulin or too little and have to wake them up again - ugh!

[Mary Lou]

Everyone has given such good info. I know that, even with a pump, we have messed up on administering or forgetting to administer his bolus. The nice thing is, with the pump calculating how much insulin is active, it is easier to recover from these mistakes than it was with the injections.

At night, when Brian is dropping, but isn't too low, we can reduce his basal rate for an hour, check again, and often avoid having to wake him up at all. This is a really nice feature of the pump.

[AmyMcCracken]

Carrie -

yesterday I forgot to bolus my daughter until about 1 hour after she ate. It happens, but you don't have to like it.

My daughter is 6 but if I need her to drink something I can stick a straw in her mouth and she'll drink without ever waking up. I talk to her softly and tell her I need her to drink. It takes a few minutes but it much better than waking her up.

[jeep_bluetj]

My daughter is 6 but if I need her to drink something I can stick a straw in her mouth and she'll drink without ever waking up. I talk to her softly and tell her I need her to drink. It takes a few minutes but it much better than waking her up.

Same here. My son is 7, but he'll eat starbursts in his sleep, and drink a full juice in his sleep. 4 years of being fed while sleeping, and he's an expert :). I sit there and make sure he doesn't choke, but that's never been a problem.

If I go in to check him, and he's low, he'll make chewing motions while asleep.

It's MUCH better than the whole waking, drinking, not sleeping bit. The stress level goes way up when we need to wake him.

He never woke up for correction injections either.

Of course, he got his mom's sleep gene: he could sleep through a train wreck.