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1st day on pod - 306 post prandial, do I do anything?

Discussion in 'Parents of Children with Type 1' started by bnmom, Jul 20, 2011.

  1. bnmom

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    This is our first day with the pod (yay we're finally pumping) so please excuse my ignorance.

    We cheated. Trainer started him on saline yesterday, but Bobby wanted to start insulin - so today we filled a pod, changed 'em out and are rolling with it (sorry, but I just can't see the validity of wasting a week on salt water.)

    Anyway...Bobby ate 2 hours ago, just checked and he's 306. We never did post prandial checks before, since it wasn't like I was going to correct at 2 hours.

    But now that he's on the pod, is that any different? Is there anything I can/should do about a 306 at this point or do I still wait until 3 hours before checking bg and correcting at that point?
     
  2. alismom

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    That would depend on what your normal DIA is. I wouldn't do a correction at 2 hours.
     
  3. obtainedmist

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    If you've input in your duration of insulin (in hours) it should show how much insulin is on board and give a suggested correction if necessary. I'm assuming that you have already programed a correction factor, I/C ratios etc. The biggest benefit of using the pump is that it keeps tract of IOB and corrections so as not to stack. Another good practice is to double check a 300 number 2 hours after eating before correcting. Wash the hand to make sure it was correct. In our experience, 300 would necessitate a correction in most cases after 2 hours.
     
  4. swellman

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    We don't correct at 2 hours - in our case there's usually another hour left onboard. Since you have never checked before I don't know what to say except that some might give some and others not. It would depend on what he ate and how many carbs if a 306 was unusual. It's not crazy unusual to me.

    If it were me I would probably give a bolus but might not give the full recommendation. I hate bolusing on a spike and having to fight lows later.

    You may have to tweak basals a bit to get everything just right and several of your factors might change somewhat. You should increase testing if not on a CGM to tweak basals and IC factors.
     
  5. obtainedmist

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    BTW, we were told to always check 2 hours after eating once we were on the pump.
     
  6. obtainedmist

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    Good point! If your basals are set too low your numbers will run high. Did your endo talk with you about basal testing? There's a great chapter on Pumping Insulin that explains how to do it. Lots of good information on the internet as well.
     
  7. bnmom

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    Thanks for your replies!

    We actually used to do post prandial, but last visit to endo I asked the CDE why they wanted us checking at 2 hours if we weren't supposed to correct that soon after a shot. She said it was basically an FYI number, so we stopped doing it since it seemed pointless and pretty much just an extra finger poke.

    But, when we did do them his number was always high - so this 306 isn't out of the ordinary at 2 hours - I just wasn't sure if maybe we could/should correct sooner on the pump.

    So we'll stay at 3 hours for corrections and keep an eye on overall "valid" numbers to see if basal needs tweaking.

    In the meantime - we are already in love with this thing! This is soooo much more convenient for him than shots!
     
  8. obtainedmist

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    I'm confused...I thought you never did post prandial check before and so were concerned about the 306 number.
     
  9. bnmom

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    Sorry, my bad - we have done them before, just not for some time now...I should have been more clear. We did them the first few months (per endo instructions after dx) but stopped a couple months ago since they never wanted us to do anything about the number.

    I had just gotten home from work this afternoon and asked him to check, not realizing until after that he had eaten just 2 hours prior...so this one was an accidental post pradnial check. So that just led me to post...I was wondering if it was any different on the pump (ie if post pradnial was now a number we'd do anything about)
     
  10. lil'Man'sMom

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    Correcting that 306 at two hours would depend on his starting BG, what he had to eat, his activity level and how long the pod has been on.

    Being new to pumping I would hold out for a few days to see what pattern he has before I make basal changes.
     
  11. danismom79

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    I would have waited and checked at 3 hours. The first few days of pumping required a lot of tweaking. There's a reason for the saline trial. Did someone tell you when to stop giving basal via injection? It's impossible to tell why he was high at 2 hours.

    The pod will not keep track of food boluses, only corrections (unless you trick it into thinking regular boluses are corrections). It would have suggested a full correction, and that could have been the wrong move.

    ETA: I see now that a number like that was common 2 hours pp. What you can try is pre-bolusing by 15 minutes or so, or now you can even give a partial pre-bolus, and then the rest when he starts eating if you're concerned about him eating everything. No extra shots!
     
  12. obtainedmist

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    I'm sorry, I didn't realize the pod didn't track food boluses. I've never really paid attention to the differences in the pumps. I can understand why you'd want to wait past 2 hours then.
     
  13. bnmom

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    The trainer said we'd stop giving Lantus the night before the insulin start, so we did not give his usual 8pm shot last night. I just checked his bg and gave extra humalog every 3 hours as needed until we put the insulin pod on.

    I would love to know how to trick it so it tracks all boluses.

    I can't wait until I understand enough to know when to pre-bolus.

    I have no idea what a 2 hr number should look like. Is he (ideally) supposed to be in range at 2hrs? What is the point of the post pradnial check?

    I hopped on Amazon to get the Pumping Insulin book mentioned, but I closed my cart...I'm just going to drive down to Borders tomorrow morning so I can get it right away without waiting for shipping.

    I feel like such a moron sometimes with D management. I have read, studied, spent hours online, taken notes at every endo appointment...yet there is still sooooo much I don't know or understand. :eek:
     
  14. obtainedmist

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    Oh Jane...don't be hard on yourself! This is a hard nut to crack and don't let anyone tell you otherwise!:rolleyes: Plus, everyone reacts differently and when you are pumping, there are lots of variables at play that muck up the water. Sometimes you just have to be a Sherlock Holmes to figure stuff out. I loved the phrase "trial and adjustment"...we've done that tons.

    About the pre-bolus...it's not anything difficult...just timing when you give the insulin before a meal. We usually try for 10-15 min. if Molly is around 100-150...20 min. if she is in the 200's before a meal and 30 min. if she is in the 300's. Someone once wrote to just take the last digit off the bg and that's how much time you prebolus. If Molly is close to 70 before a meal, she won't prebolus at all.

    Also, don't feel as if you have to read the Pumping Insulin book in one session. It's rather intense. You'll find yourself going back to it time and again to clarify things. There is a learning curve with pumping and sometimes it just takes time to let it all filter through. Honestly, it took us almost 8 weeks before we had all the basals adjusted correctly and things seemed to be running smoothly. You'll do fine! :)
     
  15. Melissata

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    I doubt if you can get the Pumping Insulin book at the store. It is just not something that most book stores would carry. I don't blame you for not wanting to do the saline trial, but doing the start on your own without help from the trainer could be tough, especially since you didn't read the book. Most people need help in tweaking basals and ratios.
     

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