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How do pumpers treat lows overnight?

Discussion in 'Parents of Children with Type 1' started by ashtensmom, Oct 30, 2011.

  1. ashtensmom

    ashtensmom Approved members

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    When reading the "what number are you comfortable with" thread, I was surprised to read that most people will treat a BG number in the 80s and 90s while on pump. DD hasn't started the pump yet so I am inexperienced. But the thing I was looking forward to was, if when checking overnight and she was in the 80s or 90s, I thought I could just lower the basal to prevent her going lower. But in this thread, I am reading that people are "treating". So when you say treating are you actually giving carbs, or do you mean treating by using temp lower basal.

    On another note, would it be advisable to just use a lower temp basal if you notice your child in the lower end of range overnight, or is it imperative that you treat with carbs as the temp basal will not be sufficient?
     
  2. obtainedmist

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    I think a lot of it has to do with the age of the CWD and if they are on MDI or pumping. Younger children have a higher bg range to shoot for because of brain development and glycogen needs (that's what I've been told, at least!) My daughter reduces basals all the time instead of treating if she's not technically "low" but concerned that she's headed there. However, she's 19. She'll treat at night if she wakes up low or if she sets her alarm and discovers a low then.

    Those on MDI have to be more careful overnight because of the flat basal and the way the body reacts differently hour by hour...at least that's what we found to be true! =]
     
  3. McKenna'smom

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    If my DD's in a lower range before bed and she has a little insulin onboard, I will lower her basal temporarily to keep her in range. I generally don't treat unless she is below 80.
     
  4. emm142

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    It all depends on how my BG is moving. Apidra for me has a DIA of 3 hours, and basal changes don't really impact my BG until after an hour. If I'm 85 and going down by 50pts an hour, I would be 35 by the time a temp basal started to touch my BG. For that reason, I often treat with glucose - 5g carbs or so. But if my CGM shows me flat at 80, I might suspend basal for 30 mins and then hopefully I'd end up flat at 110 a few hours later. It all depends on how much I think I'm at risk of dropping.
     
  5. zoomom456

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    We actually will give a glucose tab for an 80 at bedtime. For us, a temp basal takes at least an hour to change his numbers. William can drop from 80 to much less in less than an hour, so we prefer to treat. I think having a CGM would also help with the decision of temp basal or treating since you can see if the is a rapid drop or steady 80's. We do not have a CGM yet, so we feel more comfortable treating.
     
  6. hawkeyegirl

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    With the CGM, I can see if he's holding steady, going down slowly, going down quickly, or going up. I treat an 80 or a 90 at night differently depending on which of those things is going on. An 80 or 90 holding fairly steady might get a slightly reduced basal. An 80 or 90 slowly drifting down might get a 0% basal for a half hour. An 80 or a 90 heading down quickly gets tabs or juice. An 80 or a 90 heading up gets a wait and see.
     
  7. MomofSweetOne

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    This thread is great! I have so much to learn about working with the pump. Two nights ago, I gave three correction doses. Last night I gave three rounds of honey. Same basal. It never occurred to me to try a temporary basal either night.:rolleyes:
     
  8. 3kidlets

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    For us, it depends if there is insulin on board still.
    If Hana is 80 at bedtime with no IOB, I will set a negative 20% temp basal for an hour and that will generally bring her up to around 110, which I'm comfortable with her going to bed at because I check her twice during the night.
    However, if she is 80 with IOB, I will usually give her a small juice or a glucose tab to bring her up in the low 100s.
     
  9. dragonfly

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    I've learned that she needs just one glucose tab if she is between 60-85.
     
  10. mom24grlz

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    I "treat" Ashleigh at night if she drops below 90. By treating I mean that I usually give her a small glass of juice/juice box to drink. So far I have not suspended the pump or done a temporary basal for a low.
     
  11. Lee

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    Coco has had night issues in the past, so I like her around 120. If she is borderline, like 90+, then I give her a small temp basal to bump her up a bit.
     
  12. jcanolson

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    I tend to temp basal for 80-100. Anything below 80, I'll give some carbs for.
     
  13. Flutterby

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    Some days a temp basal is fine, other times she needs a juice box. I'd love to leave her at 90 all night, but if she's not wearing a sensor then she gets a juice box, if she's got a sensor on I try a temp basal, if that doesn't help then its a juice box.
     
  14. William

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    Are you guys reducing the basal by changing it on the pump itself or remotely?

    We have the ping and I was disappointed to learn we could only bolus by the remote but had to remove the pump from the pouch if we wanted to change the basal temporarily. This is of course a problem when you have a light sleeping toddler.
     
  15. Flutterby

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    All pumps you have to change basal, or any settings, through the pump, except for the omnipod, because the 'remote' IS the pump.
     
  16. William

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    Thanks. It is too bad though as if we try to remove the pump, he wakes up. I don't see why the remote would not be designed to make temp basal changes.
     
  17. hawkeyegirl

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    Do you have a clear-front pump pouch? We push the buttons through the clear front, and he never wakes up.

    An alternative is to clip the pump to his pillow during the night so you don't have to move him to find it.
     
  18. William

    William Approved members

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    He uses black spibelts. He is an extra light sleeper. Will often wake up when the floor squeeks after walking in the room. He also rolls all round his crib so we have to keep it on him. Thanks for the suggestions. Luckily we have not had to treat too many lows at night of late.
     

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