Mojo's mommy-Teri

[AmberO]

Sorry thought I'd start a new thread in case anyone was interested too.

http://www.childrenwithdiabetes.com/clinic/untethered.htm


In laymans terms it basically uses approx 70% of lantus to cover the basal, while 20% basal is covered by the pump and meal boluses.

From what I understand it isn't meant to be a long term solution, temporarily if you want off the pump for more then an hour or even a couple of days. But I feel that it does offer a plus because this caught my eye when I was first frantically researching pros towards my daughter going on the pump even though no one else in her clinic was keen on the idea.

The Un-tethered regimen offers a real buffer safety zone to avoid ketoacidosis for new pumpers or anyone who disconnects frequently.

However here at least in my area, my Endo isn't too pro younger pumpers. Plus my daughter tends to go DKA very fast if something goes wrong and 2 years ago we spent probably a month total in days in and out of the hospital when we had a whole bunch of problems that seemed to snowball. For that it turned him off the pump for her because she was 7 at the time and he felt that we needed to get under control before introducing something totally new and he wasn't comfortable with younger kids on the pump. Especially since you can go DKA very fast with the pump if there is a problem with the cannula getting bent, ect.

But it's worked out very well for us. They do a lot of activities during school which I feel is better for her to have the pump off then it possibly getting knocked around. Gymnastics, swimming (minimed not waterproof) ice skating. So she does have that lantus in the background. WE also have had cannulas bent overnight and the pump hasn't alarmed that there is a block. But unlike before the ketones are gone within a couple of hours of strict monitoring and treating.

Eventually we may go totally to the pump for basals and cut the lantus, but I like this feeling of a safety net. Her last 3 A1c's have been 7.9,7.6 and 7.4 last month.

In fact our Endo is so happy that he thinks that he can start other pumpers with this method.

[Boo]

This is a very interesting option and I wasn't aware of it. Do many endos use this method? It seems to be a combination that appears ideal for our stage of life right now, but I have a feeling it is still considered rather unconventional. I'll have to ask about it at our next appointment.

[BrendaK]

We have never tried it, but our endo has recommended it for days at the beach, sports, etc. I would love to hear from others who have tried it in young kids. If we tried it for a day at the beach, would blood sugars be totally off that day, or pretty similar to a normal pumping day. Would it affect blood sugars the next day? I know each child is different, but I would love to hear your experiences.

[AmberO]

It is an unconventional treatment. I had never heard of it before and neither had my Endo. One day when browsing the main site, I saw the link posted for this. I bout jumped for joy when I saw it because it solved my Endo's main concern of her going DKA very easily if there were a problem with the pump overnight.

Before we had insulin absorbtion problems, and she'd be DKA with a bg glucose of over 30 and ketones of up to 2.7 ,it was the hospital from there. Now the 2 times we've had a blockage overnight her BG was 16-20 and ketones of 0.8 or below and after a couple hours of strict monitoring with insulin and flushing of her system with liquids, they would be gone. I'm not saying it's a solution at all, but we'd be a lot worse off it there hadn't been that lantus in the background.

Anyway when I first submitted the link to our clinic, my Endo told me he was thinking this method sounds crazy! But then he started reading more and thinking about it and he did think it was a great idea. I think it's good for those Endos like mine who haven't had good results with younger pumpers. It offers the ease that there is insulin there at all times. I'm pretty sure my daughter was the first one in Finland to try this method and hopefully she won't be the last. I'll have to ask at our appt in May if he's had success with this method on other children.

She hasn't had the pump off for more then an hour, but that is always during a physical activity so her blood sugars haven't risen while the pump has been off. As far as swimming is concerned I have her check her bg every ½ hr because that is the one activity that really lowers her sugars even without the pump and a good snack before she goes swimming.

[maaike]

as for me, i'd love to try, but i have 'dawn effect' aka high bloodglucose in the morning due to the produce of certain stresshormones for waking up. i guess it's out of the question then?