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Need help from those with pump experience please!

Discussion in 'Parents of Children with Type 1' started by momto4gr8kids, Sep 9, 2016.

  1. momto4gr8kids

    momto4gr8kids Approved members

    Joined:
    Oct 14, 2014
    Messages:
    8
    We are finding that the bolus ratios we used for MDI are too much on the pump. We have only bolused 3 times since getting the pump at 2pm yesterday, and she has gone super low every time. I don't think her basal rate is causing lows - it's hard to know because we keep having to do a lower temporary basal rate or suspend to avoid going even lower after a bolus.

    Any tips on MDI vs pump bolus ratios? Did you have to make changes? It seems to be a big difference - we normally do 1:5 for breakfast, I think we need to change it to 1:10 at least, maybe even 1:15. It took a 24g juice and 18g snack to get her back to the 80's (with pump suspended), then she dropped to the 50's again about 90 minutes later.

    We all know sleep isn't great with a T1D kiddo, but last night was very long night :)
     
  2. KHS22

    KHS22 Approved members

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    Oct 17, 2013
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    I'd go back to the "rules" - when we are having big problems like that! So generally 500/Total daily dose of insulin is ball park of carb ratio needed. So if she's on about 50 units a day 500/50= 10grams. For sensitivity, I believe its 1800 for you guys (100 here in Canada cuz our numbers are different!) So 1800/TDD gives you an approximate amount 1 unit would drop her blood sugar. See if these are in line with your settings. They aren't set in stone, you still may have to adjust, but good place to start!
     
  3. mmgirls

    mmgirls Approved members

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    Nov 28, 2008
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    Possibly some lingering effects of the long acting insulin you stopped. Same fast acting insulin that she had on MDI? if same fast acting then it has to be basal issue or an error in how the pump is suggesting a bolus, to the bolus amounts seem normal?

    Which pump?
     
  4. rgcainmd

    rgcainmd Approved members

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    Feb 6, 2014
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    I'd vote for lingering effects of the long-acting basal in light of the fact that you just started pumping yesterday...

    Plus most parameters change at least a bit once you start pumping: some kids need more insulin when compared to what they needed on MDI, some kids need less. After the dust settles, I'm sure you'll love pumping. Good luck!
     
  5. obtainedmist

    obtainedmist Approved members

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    Aug 3, 2010
    Messages:
    1,538
    We saw lows at pump start and freaked out and reset all basals...only to see highs and have to set them back. Definitely the long acting residual was what happened to us!
     

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