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Snacking- Pumper Question

Discussion in 'Parents of Children with Type 1' started by Abby-Dabby-Doo, Aug 10, 2007.

  1. Abby-Dabby-Doo

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    When your child eats anything outside of a meal- whether it's an hour after or 30 minutes after eating do you manual bolus or use the wizard? I'm sorry for not knowing the proper lingo for the other pumps out there, I would assume all pumps have this function, or something close to it. My thoughts on this are, if you manual bolus aren't you stacking? But if you use the wizard, do you find them high later?
    (When it's after a post meal check, I'll retest the blood sugar and use the wizard).
     
  2. Mama Belle

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    I only consider it stacking insulin when used for a correction. I am of the opinion that you must bolus for every single carb consumed, therefore it is impossible to stack insulin with meal boluses. We always bolus for every single gram of carb (even if she just ate and bolused 15 minutes before) without taking into consideration IOB. This works great for us. Sam would be constantly high if we did it any other way.
     
  3. Flutterby

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    we don't ever use the manual bolus.. we always use the wizard, no matter how far inbetween each eating session LOL.. we skip the BG part if it hasn't been at least 1.5hrs since her last bolus.. so if we check her and she eats lunch.. we enter in her BG then her carbs, and 10 minutes later she wants something else (which is typical) I will then cover her carbs only, since I've already put in the BG once.. but I still use the wizard, just hit act at the ---..

    :)
     
  4. bz'smom

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    This is what we do, too. :)
     
  5. Lee

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    Use the Wizard-it knows...didn't you ever watch the Wizard of Oz? Actually, we do just like everyone else. I haven't given a manual bolus yet...and I am not sure when I should. But she almost always within range. Except when Grandpa let her have a serving of doritos, and then another, and then another, and then another, and wrapped it all up with a whoopie pie! I guess they were testing the she can eat anything she wants theory :p
     
  6. Carrie

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    We only use the manual (so far) if we pre-basal her before taking off the pump for an extended period of time. The wizard wouldn't be stacking, would it?!? Whatever they eat, they need insulin for, right?
     
  7. Mama Belle

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    That's the way we view it. But we also have a different pump, so we do things a little bit differently.
     
  8. Momof4gr8kids

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    The way our pump figures it is that if the bgl is high, or normal, assuming you put that in it will bolus for all carbs eaten. When you bolus with a low it will subtract the insulin on board from the new carb bolus.

    If your child eats say 30 carbs at a meal and then an hour later wants another 20 and you do not do a full bolus for them with he exception of low bg you will more then likely see a high later. Bolusing for new carbs in not stacking insulin in the way that you are told not to. The way it is meant most of the time is correcting for a bg over and over without taking into consideration the amount of insulin on board.
     
  9. missnme

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    Jessica gets insulin for every carb. I only reduce it to correct a low. Her pump lets you input the carbs and then asks if you want to correct. If it's only been a short while since a meal, we always say no. If you say yes and enter a blood sugar, it usually decreases the amount of insulin based on the previous IOB and then she goes sky high later.
     
  10. liasmommy2000

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    I am so confused on this issue. I want to pre-bolus for part of Lia's meals and do. Well for the pre-bolus part I use the EZcarb (Animas pump) where you put in the carbs eaten and the BG and it calculates it all etc. But after she's done eating, when I know for sure how much she has eaten, I don't know if I should do it the same way or just put in the carbs and *not* the BG?? At first I wasn't putting in the BG for the second round, but lately I have.

    I'm hoping it's smart, and figuring it out correctly for me....., so far so good.

    That's for meals, before and after. For snacks I sometimes use the EZ carbs, but sometimes I will use the manual bolus. Just depends.
     
  11. Abby-Dabby-Doo

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    For meals, we started PRE bolusing 1/2 of the carbs for the total meal. Abby's eyes are always bigger than her stomach. After she's through with the meal we give a manual bolus for the rest. So another words, we're not correcting again off the b/s number.
    For those of you who prebolus, and your child doesn't eat the total amount of carbs, what do you give them to make up for the rest of the carbs? Let's assume it's a low number, like below 7carbs. Or a higher number like 13carbs. I'm trying to get some ideas so the nurse can have something on hand at school to give Abby. Kids will be kids, remember Abby is only 6, so I don't want her to get it in her smart head that if I don't eat all of this, I'll get some skittles (just an example).
     
  12. Traci

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    Correct for the bg once, then cover the carbs within a two hour window of the correction. So if ds eats lunch at noon and is 250, I will bolus him for all of his carbs and do a correction to reduce the bg. If he wants something else at 1pm, I will just cover the carbs and not check bg again. If he wants something else at 2 instead of at 1, I will re-check bg and cover the carbs.

    Hope this helps!
     
  13. MaggieM

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    We always bolus/correct after he has eaten his meal. Just in case he pulls a "I don't want this anymore." If at home I happen to prebolus him and then he doesn't eat the whole thing, his only alternative is fruit (grapes are easy) or a gatorade to make up for the carbs.
     
  14. Tori's Mom

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    We bolus for about 1/2 the carbs before the meal.

    For instance we have a 60 gm carb meal. Before eating she takes her bg, we enter it in the pump and bolus for 30 gms carb. After the meal if she has eaten, for example, 45 of the 60 available carbs, we skip the ---(bg value), enter the 15 carbs she had that we did not bolus for to start, and bolus for them--even if it is only 5 or 7 more carbs.

    That way you are bolusing for the carbs only when you bolus the second time because the pump already figured in the correction bolus when you entered the premeal bg and carbs.

    Same way with snacks. If it is before 1 1/2 hours after the meal, I do not take another bg and enter it, I bolus for the amount of carbs in the snack only. Which, when that happens, throws off your post prandial bg check a bit sometimes.
    If it is 1 1/2 hours post meal and she wants a snack I will delay it a bit until I get my 2 hour post meal bg check.

    As far as stacking, like the others said, I thought that term was meant in terms of correction boluses. You don't stack with food bolusing because you do need to give insulin for all of the carbs going in.
     
    Last edited: Aug 10, 2007
  15. Mama2H

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    Yeppers, same as Tori's mom here. And if we want to do a corrections without food we put in the bg and hit act on the carb screen --- and it will figure the correction only
     
  16. Mama2H

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    We use milk for unfinished carbs. For some reason Hailey only wants chocolate milk so we make her drink white for unfinished carbs :eek: I know, mean mean mommy... If she got choco milk for unifinished carbs she would never finish her meals :eek:
     
  17. sam1nat2

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    Here's a though, since you are going to be working with a nurse at school. Why don't you have her give the bolus as a square bolus over 30 min, I am guessing that they get less than 30 min to eat?? If she doesn't finish, you can cancel the remainder.
    Thankfully i did this the other day when I had him bolus for extra carbs and then realized the mistake I made, we were able to see how much he had gotten.
     
  18. Abby-Dabby-Doo

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    What is the difference between a manual bolus for the 15carbs left over from the meal (Tori's Mom example), or putting 15carbs into the wizard with NO blood sugar? That manual bolus is or isn't taken into consideration DOWN THE ROAD as active?
     
  19. Tori's Mom

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    Oops, misread about the unfinished carbs and prebolusing. If I need something to make up for what we have already bolused for, I use real food in exchange--grapes are one of my favorites-easy easy to figure....or a few crackers/graham cracker, cheez its,etc.
    Stuff that she has all the time anyway so it's not worth it to not eat the meal to get it......

    OKAY, the light bulb in my brain is finally coming on now....I see what you mean. I would THINK if you manually bolused it would NOT be figured into the insulin on board??!!?? VERY good question. My question is, when WOULD you manually bolusing other than to bolus for missed basal??? Do you use the manual at other times??

    Someone on this board will surely have been through the manual bolusing and be able to tell for sure :confused::confused:if it counts as IOB.
     
    Last edited: Aug 10, 2007
  20. Mama2H

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    I misread also *blush* we use the wizard and don't enter bs if Hailey has a snack 1 hour or less after a meal.
     

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