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MDI question

Discussion in 'Parents of Children with Type 1' started by Artgirl, Feb 9, 2016.

  1. Artgirl

    Artgirl Approved members

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    For those of you on MDI do you bolus for a apple or small snack containing carbs around 15 g? We just switched over and my daughter is not sure if she likes it after all. I was wondering if you bolus for everything or skip for small nibbles here and there.
     
  2. mmgirls

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    what where you doing before?

    why did you make the change?

    I know people who over bolus if they are a frequent eater to cover a small snack at 2-2.5 hours
     
  3. Artgirl

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    We were on 2 injections daily and she wanted to switch for more freedom on the times she could eat but is realizing how many more injections it is.
     
  4. mmgirls

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    What insulin where you on before? was it working well?

    have you seen this? http://www.medtronicdiabetes.com/products/i-port-advance

    it is very similar to the idea of a pump infusion site, put it on every 3 days and inject into the same spot.
     
  5. StacyMM

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    Around here, yes. If it has carbs, it's a shot. However, MDI was how we started and we always covered snacks so it's just how it always was. Going from fewer shots to more would be difficult transition for a kid, I'm sure. Not sure how old your daughter is or how long she's been diagnosed, but is she at an age where she can make that choice between a no carb/no shot snack and a carb/shot snack?

    Also, if injections are hard on her, look into the Inject-Ease. We've been using it since very early on and it's fabulous at taking some stress and pain from shots.
     
  6. Michelle'sMom

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    The NPH she was on helped cover for some of her meals & snacks. Unfortunately, even if she goes back to that regimen, she won't be able to maintain control on it indefinitely, at least not on only 2 shots per day. If shots are a problem, the iport linked to above or a pump are both good options.
     
  7. wilf

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    Is your daughter a grazer? Mine is - and we developed an MDI regimen to allow her to do so. It involves using the various insulins which are available to their best advantage. If you give Regular insulin, it will cover grazing 2-3 hours later.
     
  8. Artgirl

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    Yes she is ....id love to know how you manage this. We currently use humolg and Lantus. I'd appreciate it if you could explain this method to me.
     
  9. Mimikins

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    It depended on my I:C and how much insulin the food required. I typically injected for anything that required more than 0.5 units of insulin (I was on the pen and would only be able to inject 1 unit at a time), so anything that required less than a half unit of insulin were "free foods". If my I:C was 1:20, then any snack that was less than 10g of carbs would be uncovered.

    I have to admit that cheese, meat, nuts, and other low-net-carb foods (nonstarchy vegetables, berries, edamame, Atkins products, etc) were my best friends while on MDI. Those often were free foods for me, and it allowed me to have a snack without injecting.
     
  10. rgcainmd

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    We bolus for everything over 4 carbs. I don't want my daughter's BG high when there is something I can do about it; there are too many unavoidable highs (from illness, growth spurts, puberty hormones, etc.) already. I always bolus (and correct) for what I know is coming...

    The two main reasons we switched to pumping were: 1) tighter BG control and 2) because my daughter is a grazer (you can bolus for carbs a bazillion times a day with no extra injections.)
     
  11. nebby3

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    My dd's I:C ratio is 1:4 so we really have to account for all carbs. But there are times, deliberately or not, when her basal insulin covers snacks. For instance one of the best ways we've found to combat the post breakfast spike is basically to overbolus and plan a snack later.
     
  12. wilf

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    When you bolus for a meal, you add some Regular to the bolus to cover grazing that afternoon. That Regular doesn't really start doing much until 1 hour after injection, and peaks at 2-3 hours after injection - allowing your child to graze as many carbs as you gave Regular to cover.

    So let's say for example I gave my daughter 3 units of Humalog for lunch (to cover 45 g carbs in the meal), if I add 2 units of Regular to the injection then those 2 units should cover around 30 g carbs later on (between 2 and 3 hours after lunch). That would allow a snack at that time of say an apple and a piece of toast, without a whole new injection being needed. :cwds:
     

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