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Start Pumping a Week... Horrible Week HELP!!!

Discussion in 'Parents of Children with Type 1' started by Luiyo, May 29, 2009.

  1. Luiyo

    Luiyo Approved members

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    When my 8 years old son start on diabetes three months ago evrything was horrible starting with large ketones and being 4 days in a PICU. Before last week everything was perfect BG and everything, except for the NPH strict food intakes, we decided to start on medtronic 522 but this week was horrible last night his Bg went to 311, our diabetes educator doesn't even anilyzes his Bg on the carelink papers, and his adjusting I don't know how, The only thing I need is advice on buying a complete book that could teach about basal rates, and carb factors, because at two hours form his food intake his bg is high but keep rising so his basal also needs adjustments.... Well I accept any book sugestion ,,, my endo appointment is next week so I could start reading... Thanks...
     
  2. emm142

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    I'd recommend Pumping Insulin, by John Walsh. I always go back to that book when I've got a control issue, it's very good.
     
  3. StillMamamia

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    Hi,

    Are you writing down all BGs, foods, etc? If so, then that is going to really help you when you see the endo next week.
    I would also look for another CDE, if this one is not being very helpful.

    The book Emma suggested is a really good one.

    You may want to take a look also at:

    "Type 1 Diabetes" by Ragnar Hanas
    and
    "Using Insulin" by John Walsh

    Of course, you could always ask for suggestions by posting your questions here, along with seeking your endo's advice.

    Good luck.
     
  4. Denise

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    your diabetes educator doesn't help analyze the bg's? What on earth do they do then?! Their job is to be there for you and help teach you how to do things! :confused: Sorry but I can't imagine not having our CDE on call 24/7 (or the hotline)to help me with whatever I need. She has been very patient with me and has taught me how to do adjustments...but before we were allowed to go on a pump, we had to attend a class and during this class they went over how to make adjustments....
     
  5. betty6333

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    If you read nothing else.... MEMORIZE this book.
     
  6. Luiyo

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    Thanks I will order the book now on ebay... about my CDE ... he was the same one that sells my child pump. I look him like a seller not like a coach after he closed the case and I pay for the pump he is exiting little by little. I don't know He is the one that medtronics assign to my area. I keep all the information on carelink software that I download every other day.
     
  7. Denise

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    isn't there someone at your endo's office that is assigned to you? The person you are speaking of is your sales rep..the CDE is a Certified Diabetes Educator..normally a staff member from your doctor's office....
     
  8. StillMamamia

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    Write down all your questions before seeing the endo. I'm sure you guys will come up with a good attack plan ;).
     
  9. Luiyo

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    Yes he is a CDE, WHen we were on NPH and Regular everything was right ,,, but a whole mess with basal rates and carb ratio ... I'm getting stressed!! I could saw my child temperament starting to change he's getting upset and yelling always.
     
  10. Charliesmom

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    We had a horrible start too. The trainer wasn't a whole lot of help. I finally took over and started making changes on my own. It was scary but I checked often and he was okay, lol.
    Do a basal test asap. Get the basal figured out and life will be easier.
     
  11. wilf

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    Don't be afraid to use the experience/expertise available to you on this site.

    My guess is that the majority of people on here have their children on pumps, so they may be able to provide good tips on where to start in getting things sorted out.

    Try posting a day's BG numbers, your boluses, and your pump settings - you may be surprised at how much help you can get here.

    Also keep after your CDE - it is their JOB to help you. And if they don't, then you contact the pump company and complain.

    Good luck! :cwds:
     
  12. tiffanie1717

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    We started the pump about 2 months ago. the first few weeks were hard and Kylie ran high a lot of the time until we really figured out what was going on and could adjust her basals accordingly. It sounds like you already understand the concept, so you are doing really well!! Don't worry! The bgs will lower when you get the basals set to a better rate for your son. I have heard many wonderful things about the Pumping Insulin book and have it, but haven't gotten through it yet.

    Good luck and hang in there! I'm sure it will get better - and the freedom your son regarding eating will have will be a huge benefit!
     
  13. Lee

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    I also say - start writing down your questions.

    Post them here - we will all give you answers. They might not be the same answers, but they will be the answers of experience. You are empowered! Educate yourself - like you are wanting to do by reading Pumping Insulin and asking questions - the more you know going in, the better you will feel!
     
  14. Luiyo

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    Thanks everybody... I know the best diabetes educators are here.... so I wouldn't feel alone... I already call my brother in savanah georgia to see if he could find the book because on my local borders is not available... But thats the trick adjusting first the basal I think is the bad part but when is done adjusting the bolus I think it should be easier. right know he is getting higher after dinner and besides that he continues to rise so maybe he need a higher basal there. His adjustments right now are

    12am- .25u/h
    3am- .15
    6am- .25
    6pm- .35


    Carb ratios
    12am- 15
    9am-20
    6pm-15
    sensitivity is set at 70

    any advice or flags let me know... all of this was made by CDE Medtronics
     
  15. wilf

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    Last thing we need are his blood sugars for the last 24 hours.. :cwds:
     
  16. Luiyo

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    Ok this settings was made yesterday... I'm waiting the two hours for the dinner postpandriar number. so I could post .. Thanks!! For your help!!
     
  17. Jacob'sDad

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    Sensitivity of 70 for an 8 year old is a red flag for me. That doesn't mean it's wrong. It's possible, but it just seems low to me. I would want to start out at at least 125 to prevent possible lows when correcting high BGs. I would also go with an even higher ISF at night; probably at least 150 and adjust from there. This is just my opinion and others may disagree.

    Jacob has multiple ISF's set in his pump and they are all his carb ratio multiplied by 8. So if his carb ratio is 1:13, his ISF is 104 (13 X 8).
    If his carb ratio is 1:16, his ISF is 128. (16 X 8).

    The carb ratios are a little confusing too.
    Most people have a carb ratio at breakfast (meaning MORE insulin) that is the lowest of the day. In fact there was a recent thread on that topic and at least 80% said their or their child's carb ratio was the lowest at breakfast.

    For example if you had said:

    9am 15
    12pm 20
    5pm 15

    It wouldn't have red flagged me at all.

    AGAIN, anything is possible. I'm just stating what looks a little uncommon to me, but everyone is different.


    The basals you posted look possible to me. A little on the low side but entirely possible if he is honeymooning.
     
    Last edited: May 29, 2009
  18. Luiyo

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    look what happened today after this changes were made this morning, he had a bg of 114 before dinner ... perfect... right after two hours he's bg was 74... low ...without I didn't give him nothing and 45 minutes later he's bg is in 117... I think carb ratio is two high and night basal too low... what you think...???
     
  19. wilf

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    I think you post the blood sugars (and the exact times they were measured) for the past 24 hours, and then people have the information they need to give you good advice.. :rolleyes:
     
  20. mph

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    I saw the same thing right away!!!!:eek: I agree, 70 seems like a low ISF for someone with such low basals. Our endo wanted to set Nick's sensitivity at 70 for pump start (based on total daily dose), but I KNEW that was too low. I have it set at 120 and it may be a bit too low still!

    I'd try to avoid lows first by perhaps changing that dinner ratio just a little;). It could just be timing of the bolus or type of food (digestion rate) that gave the dip and increase. But 114 to 117 at the 2hr and 45min point is pretty good even with a dip to 74!:)

    Think Like a Pancreas is another book to look up. :cwds:
     

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