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How fast will BG rise without basal?

Discussion in 'Parents of Children with Type 1' started by Theo's dad Joe, Nov 28, 2015.

  1. forHisglory

    forHisglory Approved members

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    So strange and I'm glad to see others with this ratio. I read in "pumping insulin" that those with a 50/50 TDD have better numbers and a smoother ride but the harder I try to push DS towards that 50% basal the rockier things become. Even with backing down on the I:C we get more lows and more spikes. We have to stay around 30% basal. It's nuts! Or just YDMV.
     
  2. Beach bum

    Beach bum Approved members

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    I have one child, ten years in who if she's off basal for an hour, she will rise like a rocket. The other child, still in honeymoon and less than one year in can be off for several hours and only see a slight rise.

    Now, for the 10 year veteran, if she's doing activities such as dance or working out, she will hold her own. If it's just splashing around in the pool, that's where she goes through the roof. 1 year daughter, same scenario, will drop like a rock. Winter outdoor activities, both kids will be unplugged and both will see a drop about 2 hours after.

    So for us, there is no exact number that we will see. It just happens. Some days it may be a lot, others, not much at all. This is where the whole "diabetes is more of an art form than a science" comes in.
     
  3. Theo's dad Joe

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    Thanks. Funny, I took my son sledding for about about an hour after breakfast and we did a lot of runs, maybe 20 times up and down the hill, and while his breakfast spike was virtually non-existent, he actually started to rise after after we finished and came to lunch a little higher than usual (I thought he would head south and I'd have to give him a snack before lunch).
     
  4. Theo's dad Joe

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    This may seem odd, but do you correct the same at a meal (say if you are 60 points over you add a unit) than if it is not a meal time. Will you expect 60 points per unit 4 hours after a meal, and also 60 points to be corrected if it is added to a meal time bolus? It could be a honeymoon thing.
     
  5. msschiel

    msschiel Approved members

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    We just started pumping nearly 2 weeks ago, so we are still very new to this. Within a day or two of pumping we started seeing a lot lower numbers than we were used ti. We had just upped his levemir to 39 units a day the Monday before we started pumping. Clearly, that was way too much on the pump and we have been steadily lowering his basals since. We are currently about 50%, but we will be lowering it even more. I have to look at his numbers on t:connect to see where we need to tweak. We have been fighting quite a few lows, especially at night, which I don't like at all. We are running between 60-65 TDD.
     
  6. Theo's dad Joe

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    I was told that if I went to pumping I should start with 80% of the current basal level of lantus or levimer.
     
  7. jenm999

    jenm999 Approved members

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    And last year when we were planning a vacation near a pool and were considering switching to MDI for the week our Rx was for 80% of pumped basal via Lantus. I think we're all just flailing as graciously as we can.
     
  8. Theo's dad Joe

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    If you just keep switching back and forth I guess you could really take your TDD down.
     
  9. jenm999

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    Ha! A cure!
     
  10. Michelle'sMom

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    Something to keep in mind: my dd pumped 5 yrs on the Ping. When she switched to the t:slim last year we were told to use the same settings as the Ping. Big mistake! Her TDD is just under half what it was with the Ping. I've since learned that she's not alone.
     
  11. msschiel

    msschiel Approved members

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    That is interesting. I wonder why there is such a difference? At least you are using less insulin. Another reason I am glad we went with the t:slim.
     
  12. Michelle'sMom

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    From what I've heard from other users, & also from my dd's endo, it has to do with the efficiency of the basal delivery in t:slim. I'm just grateful to see the lower TDD (one of our goals for PCOS management), & smoother BGs overall.


    As for the OP, here's another twist to the rules:

    I took dd on a shopping trip several yrs ago. An hour drive plus just over 5 hrs of shopping later, we stopped for an early dinner...which is when we discovered her missing pump. We backtracked about an hour through all the stores & dressing rooms, before giving it up as a lost cause & heading home, where we found her pump on her bed. Breakfast was early that morning, around 6:30 or 7, her only bolus. When she checked after ordering dinner, BG was 130-something. It was just after 4pm when we arrived at the restaurant. I considered stopping to pick up some Regular at Walmart to get her through, but she opted to take dinner home & eat there, so we hurried home. BG had only risen to 150ish by the time we got home, but she did spike to the low 200s a few hours later. Blood ketones were negative.

    It's the only time we've gone anywhere without insulin & syringes. Lesson learned. Shopping was not in a mall, but driving from store to store, so not much walking. But shopping of any kind will guarantee a low, regardless of how much we reduce basal or how much she snacks. Every time...except that day.

    Yet a dislodged site overnight at a sleepover resulted in BG that only registered "high" on the meter.
     
  13. dpr

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    This should be a sticky!
     
  14. GChick

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    I'm not sure how it works exactly and I'm sure while certain situations usually have a certain end result if you do "this" or "that",.... and then, there are the outliers. I had an unexpected result last night for instance.

    Last night, right before going to bed I had a BG of 56. Bin trying to eat less lately so I said "I'll just do a zero temp basal for about 25 minutes (hadn't bloused for a while so figured it was from overbolusing a while before, not too much IOB in other words)... that oughta do it!" So I set it for 25 and went to bed... not worried at all as lows at night are generally never much of an issue for me.

    I wake up about 5 hrs later when I see the lil red "T" (for temp basal on the tslim).

    "Oh crap!" I think. Yep, I apparently had +/-20 hrs left of my zero temp basal (set it for 25 hrs, not 25 minutes). I woke up slightly early cus I had to pee, so I did know I was high, but also knew that I didn't feel "unwell", so I prepped myself for the dreaded number. 250. Yup, that's it. Not bad for 5 hours of no basal. Started low, sure, but not 5 hours of no insulin low. I have a tendency (not just in diabetes related stuff) to be lucky about my unluckiness (or in this case, stupidity). Also had no real difficulty of bringing it back down (which I usually might when detached for more than an hour when doing vigorous exercise etc)

    Edit: Result will vary wildly. Do not try this at home.
     
  15. wilf

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    Covered yourself in glory, you did. This is what it's all about. Making it work.. :)
     
  16. quiltinmom

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    It may be because the ping delivers boluses a lot faster. Maybe it's harder to absorb when given quickly so more is needed. That's my theory, anyway.
     
  17. quiltinmom

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    The phrase that came to my mind is "crap shoot." You said it so much more eloquently. :)
     
  18. msschiel

    msschiel Approved members

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    That is a good theory. I am thrilled (now that we have gotten his basal figured out for the time being) with how well he has been doing on the pump. We have our next Endo appointment in the beginning of January, so I am anxious to see what his A1C will be.
     

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