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Accurate basal rate in small children, is the best strategy?

Discussion in 'Parents of Children with Type 1' started by Manuel, Jan 16, 2017.

  1. Manuel

    Manuel Approved members

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    Aug 3, 2016
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    Hi! We started Omnipod one month ago, and made a hard work to get the best basal rate as the theory says (+-30 point oscillation when not eating). And we get it right, if my son is not eating he will be flat. But, the problem is that he need a super bolus to avoid meal spikes....and I mean a BIG super bolus (40%-50% more) that usually have a big drop, and even with the super bolus there will be have a high spike. We tested everything to avoid spikes and maintain the "theory" basal rate: absorption sites, bolus timing (15 min, 20 min, 25 min, 30 min before meals) and increase of the bolus. No matter what, he always have a spike that he didn't have with MDI. (MDI: +60-80 points spike, Omnipod with accurate basal rate: +150-200 points spikes).

    For us, the only way to avoid the spike is with a higher basal one hour before the meal (from 0,1 to 0,15). And here is where I think that the accurate-basal-paradigm may not be the best for small children. A big meal-bolus could be dangerous, he still will have a spike higher than with "a higher basal" and a fast drop, and there is always the fear that your toddler will not eat the same amount everyday (meaning less). With a a higher basal he might be trending down, but very slowly and in a predictable way, and from the other-hand the boluses will be smaller with a more smooth drops.

    What do you think?. How was your experience?

    Thanks!

    ---------------------------------------------
    Son Benjamin DX 05/30/2016 - at 2 years Old
    DEXCOM G5 + OMNIPOD
     
  2. Manuel

    Manuel Approved members

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    Aug 3, 2016
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    Someone has an idea on this?.

    For me is making me a little crazy. If I don't have a basal trending down (very slow), the meal bolus and the corrections just don't work, I have to double the amount of them.
    I don't know if I am doing something wrong, I am not using correctly the omnipod, or the omnipod just don't work; some times I wonder if it has problems with the insulin delivery.

    What we have done is to set a higher basal 1 our before each meal. But the problem with that is that at the end you he has to eat every day at the same time, and if he wants to eat earlier it will spike.
     
  3. MomofSweetOne

    MomofSweetOne Approved members

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    I've heard of people using such a strategy before. If it's working for you, stick with it. The only downside that I can think of is that if the meal is at a different time, you could get lows if basal is too high.

    One mom here actually put the lunch dose as a basal dose during the middle school years to make sure lunch was covered. We do what works for us and our circumstances, not always what the books say is correct. Hopefully your endo will understand!
     

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