- advertisement -

Small basal needs and pump?

Discussion in 'Parents of Children with Type 1' started by BittysMom, Jan 11, 2012.

  1. BittysMom

    BittysMom Approved members

    Joined:
    Aug 21, 2011
    Messages:
    870
    Can we start pumping if Caroline's currently only on 1.25 units of Lantus per day? She's still honeymoooning, so what if her needs were to fall further at some point? Her current TDD is 4.25.

    I've just done some reading on the tiny increments of the ping, but I don't have an understanding of how often those tiny increments can/have to be given.

    Thanks :cwds:
     
  2. JaxDad

    JaxDad Approved members

    Joined:
    May 24, 2010
    Messages:
    280
    The ping basal rate goes as low as 0.025 U/Hr. and can step up from there at 0.025 U/Hr increments. For the basal rate you don't give anything, the pump does it automatically.

    It can only adjust in 0.025 increments also, so for example if your usual rate is 0.05 U/hr you can't do a +/-10% temp basal because it can't add or subtract 0.005 U/Hr. You would have to do a percentage of your normal rate that is at least a step of 0.025 U/Hr., which in that case is 50%.

    My son, who was about 30 odd pounds when he started pumping had basal rates around 0.075 to 0.150 units per hour depending on the time of day. I think he was taking around 1.5 to 2 units of Levimir once per day before we started. Levimir is considered a twice daily basal insulin but he didn't even need that much.

    I'm sure your endo can tell you better but I'm thinking the Ping could handle the basal rates Caroline would need. That said, many insurance companies won't do a pump with less than one year post Dx.
     
    Last edited: Jan 11, 2012
  3. Mommy To 4

    Mommy To 4 Approved members

    Joined:
    Sep 17, 2011
    Messages:
    93
    Em's TDD is about 10 units a day. (Currently seeing and increase to about 15 though.) At our evaluation that worked out to be .016 units per hour for her basal. Her current Lantus dose is 3 units, so yours is about half. Hope that helps. I don't have my paperwork in front of me so I don't remember what the smallest dosing abilities are. I think we are leaning toward the minimed because of the integrated CGM and now with the parent unit, it seems to fit our needs pretty well.
     
  4. emm142

    emm142 Approved members

    Joined:
    Sep 7, 2008
    Messages:
    6,883
    The Revel also has minimum basal rate of 0.025U/h and it has minimum bolus increments of 0.025U/h. 0.025Ux24h is 0.6U/day, so the minimum basal assuming continuous basal flow is 0.6U/day. If it turns out she needs less than that, you can always alternate one hour of 0.00U/h basal flow with 0.025U/h.

    I think pumping is generally good for people with low insulin needs, with small and accurate dosing.
     
  5. tom_ethansdad

    tom_ethansdad Approved members

    Joined:
    Apr 24, 2009
    Messages:
    676
    I agree with the others, the tiny basal rates and increments supported by both Ping and MM pumps makes pump therapy a good option for those with very small insulin needs.
     
  6. BittysMom

    BittysMom Approved members

    Joined:
    Aug 21, 2011
    Messages:
    870
    Thanks everyone. I scheduled Caroline's next appointment with the CDE today (for next Thursday) and she seemed quiet when I mentioned that I wanted to start the pump process. I'm just trying to figure out what if any road blocks there are. ;)
     
  7. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    Using the small basals on the Ping didn't work for us, don't know why.

    But two notes:

    1. We needed far more basal on the pump than we needed from Lantus, so just because she needs 1.25 of Lantus doesn't mean she'll necessarily need 1.25 total basal on the pump.

    2. You can give a shot of Lantus once a day and no basal through the pump and just use the pump for correction boluses and food boluses, if it does wind up being an issue.
     
  8. mandapanda1980

    mandapanda1980 Approved members

    Joined:
    Oct 28, 2010
    Messages:
    642
    I agree with all of the above...we started off with very little levemir.

    I wanted to mention that your rates will change when you start pumping....we went up quote a bit when we started
     
  9. BittysMom

    BittysMom Approved members

    Joined:
    Aug 21, 2011
    Messages:
    870
    Hadn't thought of that:)
     
  10. ashtensmom

    ashtensmom Approved members

    Joined:
    Jun 24, 2011
    Messages:
    551
    We went up quite a bit too when we started pumping. Also I noticed you're on humalog. Our nurse told me you can dilute humalog in the pump... so that's another option if you need it.
     
  11. Charliesmom

    Charliesmom Approved members

    Joined:
    Jan 8, 2009
    Messages:
    1,472
    We also went up on basal in the pump.

    I got the book Pumping Insulin so I could prepare for the pump discussion with the endo. She basically just wanted to make sure I had really put some thought into it and had a basic understanding of how pumping works and the pros/cons of it. It was 2 yrs into diagnosis though so that could have made a difference.
     
  12. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    We started pumping while still in honeymoon and took the same amount of Lantus you currently are using. Our basal did go up, but not a whole heck of a lot. At the time, Animas offered the only pump with the smallest dose, so that's why we went with them. We had no problem at all.

    We do the "untethered" route in the summer, so we do Levimere for long and then correct/bolus via the pump. It allows us to have her pump off for all her summer activities, gives her a break, and stops us from having to chase highs all night from lack of basal.
     
  13. BittysMom

    BittysMom Approved members

    Joined:
    Aug 21, 2011
    Messages:
    870
    I'm about a third of the way though it :)
     
  14. miss_behave

    miss_behave Approved members

    Joined:
    Aug 28, 2006
    Messages:
    2,217
    The only possible road block is your Endo's attitude. There is no medical reason why you cannot pump now. Babies with neonatal diabetes on miniscule doses of insulin pump from diagnosis simply because their tiny insulin needs are impossible to deliver via injections. As others have said, the Minimed and Animas pumps can do 0.025 units basal per hour and the Minimed also does 0.025 unit boluses. If this is still too much, you can alternate between 0 and 0.025 units every second hour, or even dilute insulin. If you want to pump, push for it. Don't let your Endo give you excuses like doses being too small or waiting for the honeymoon to finish, as these are simply excuses and not legitimate reasons to wait.
     
  15. BittysMom

    BittysMom Approved members

    Joined:
    Aug 21, 2011
    Messages:
    870
    Thanks for this. While we're seeing the CDE next Thursday, we don't see the Endo until March and I'm worried I'll be stuck waiting until then just to get the process started. That's why I brought it up to the CDE. Kind of like, "I know it's a process so I'd like to start now..." I'm also hoping insurance doesn't give us any grief. I mean, why do some make you wait a year? Perhaps they're concerned the child is just going through a phase and really isn't that into D :p
     
  16. destea1

    destea1 Approved members

    Joined:
    Jan 3, 2012
    Messages:
    33
    I do notice a lot of mentions for the minimed and ping here - but does the Omnipod offer low dose options as well? We're just starting to investigate the different brands and tubeless really seems ideal for our crazy pre-schooler... but I don't see it mentioned too frequently on the boards - is it less used or just newer so people have been locked into/like what they were using previously?

    Sorry - sorta hijacking, we just have similar thoughts on moving to a pump and our endos seem to support it...
     
  17. miss_behave

    miss_behave Approved members

    Joined:
    Aug 28, 2006
    Messages:
    2,217
    The smallest basal rate the OmniPod has is 0.5 units per hour vs the 0.025 on the MM and Animas pumps. There are quite a few people on here who have kids using the Pod, and a few with little kids, though some have had problems with the size of the Pod on a small child. I suggest you trial both a tubed pump and the Omnipod before you decide tubeless is necessarily better. Many crazy pre-schoolers use tubed pumps with good results :)
     
  18. emm142

    emm142 Approved members

    Joined:
    Sep 7, 2008
    Messages:
    6,883
    I know this is what you meant, and it's probably obvious to those who know about the pumps, but for anybody reading - the smallest basal on the Omnipod is 0.05, not 0.5. :cwds:
     
  19. tom_ethansdad

    tom_ethansdad Approved members

    Joined:
    Apr 24, 2009
    Messages:
    676
    I notice your child is 3 and a half. We started E on the pump at same age and used MM 522. The 522 is an older MM pump and has the same basal rate as the Omnipod, which is .05 units/hour rather than .025 on the current MM and Animas pumps. We never had an issue with the rate even though at the time his insulin needs were extremely small. The reason we ruled out Omnipod is that the size of the pod on his little body. It looked huge and he didn't like it. Tubing on the MM pump has never been a problem (other than one rookie mistake when we tried a site on his upper thigh and ran the tube down outside of his underwear to the site).
     
  20. cdninct

    cdninct Approved members

    Joined:
    Jul 29, 2011
    Messages:
    888
    My laugh of the day! Thanks!:)
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice