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22 Month Old Nephew Just Diagnosed

Discussion in 'Parents of Children with Type 1' started by CameronsMom, Jul 22, 2012.

  1. smcnair

    smcnair Approved members

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    Thomas was diagnosed at 4.5 months of age. . .if possible I would suggest they get a pump as soon as possible. Although I'm a diabetic myself, and didn't start pumping until about a year after Thomas was diagnosed, I'm glad I didn't have to give him injections. Thomas was so young that it was kind of hard to pick up on lows, but much easier now - even though he still doesn't say a lot of words - actions speak louder than words :)
     
  2. Dan

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    I would have to agree with the pump advice. It made it easier once we started with the pump. Life became less stressful when we added the Dexcom.
     
  3. SarahKelly

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    just a few things:
    push for at least 12-15 test strips per day right away
    if she wants to have her child pumping as to be able to correct highs more frequently and be able to accurately dose for insulin (without diluting) than she can ask for this NOW. We started the paperwork for pumping in the hospital as we knew that it was more accurate and would work better for our family, we were at a bit of an "advantage" since my husband has t1d and knew that the multiple shots with "wiffs" of insulin wouldn't work for our family.
    We started pumping six weeks after dx and have been very thankful for it as instead of ever worrying about meeting insulin with food, we are able to keep matching his food needs with appropriate amounts of insulin.
    Just what has worked for us.
    And as other have said reassure her that it will be fine, it will be tough, but it will get to be their new norm.
    Make a few meals with carb counts broken down.
    Oh, and carb counting is a bit silly at his age without a more accurate way to do it like a good scale, if you use one it would be great to show her how use carb factors.
    ((HUGS)) Glad you are there for their family.
     
  4. Christopher

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    Just a few comments in case people reading your post get the wrong idea:

    - I don't believe it is correct to say that pumping is more accurate than MDI.

    - You don't have to "meet insulin with food" on MDI, you can cover the carbs in food with insulin, just like you can with a pump.

    - I don't believe carb counting is "silly" at any age for a person with Type 1 diabetes. It is a key tool in managing the disease, whether you are 2 or 22.
     
  5. melissajm

    melissajm Approved members

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    Lilly was 23 months at dx.
    We definitely checked her more often then than now as she couldn't verbalize how she felt~so a script for testing 12+ times a day would allow her to test as needed.
    I think a CGM would have been a very useful tool!
    She started on the pump over a year after diagnosis~I really wish we had started MUCH sooner!
     
  6. MomofSweetOne

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    With such a little one, the ability to give tiny doses on a pump compared to MDI could make a huge difference. This is why so many prefer the pump at those ages. There's no way to measure .025 on a syringe.
     
  7. Christopher

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    I agree. And to me, the way to express that is to say that pumps can give smaller doses than a syringe, not that they are more accurate. Maybe it is semantics. Nevermind.
     
    Last edited: Jul 24, 2012
  8. hawkeyegirl

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    No, I've gotta say that I think that the pump is more accurate. I remember some study being done where parents were asked to draw up particular amounts of insulin in syringes and then the doses were somehow precisely confirmed. The doses tended to be off by as much as a half-unit either way. I mean, I got pretty darn good at estimating quarter units, but I can't say that I never gave 0.20 units or 0.30 units instead of 0.25 units. Our pump can accurately dose in 0.025 unit increments, and that's something no human can do.

    I really don't think that it can be argued that syringes or pens are as accurate as a pump. Now in older kids (like yours and mine), it doesn't matter that much. If Jack gets 4.2 units for his supper instead of 4.5 or 4.0, that's just kind of a rounding error for us. But for a little one whose ISF is something like 350, it does matter.
     
  9. Christopher

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    Understood.

    I wonder if the study took into account the ability of the person drawing up the insulin, number of years experience, etc. I know I have gotten pretty good at drawing up small increments in a syringe. :cwds:
     
  10. hawkeyegirl

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    Let's just say that I suspect that CWD parents would have significantly outperformed the study results and leave it at that. :p
     
  11. Christopher

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    :p Agreed.

    I really do feel for the parents of little infants who are incredibly sensitive to small amounts of insulin, that must be really tough. So anything they can use to make it easier (like a pump) I am glad they have in their arsenal. I am "lucky" that Danielle was 7 when she got this.
     
  12. hawkeyegirl

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    It's funny, but I feel "lucky" that Jack was 3.5 years old at dx. At least he was verbal and never overly insulin-sensitive. I also have a lot of sympathy for parents of the little ones.
     
  13. Dan

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    I remember being given a scale for our MDI program that required 1/2 and 1/4 units when Josh was 22 months. From my experience I can say that the pump is more accurate
     
  14. joy orz

    joy orz Approved members

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    Yes, toddlers are WAY more sensitive to every little tinsy dose of insulin as well as EVERY carb.

    For us, what also really helped was grapes. They are generally a carb a piece and I could always get her to eat a few. So if she was lowish, I'd give her three grapes and see what happened. 15 carbs to bring up a low is WAY too much.

    We also used fruitables and motts for tots for juice. Lower in carbs, but fast acting. So it would correct the low, but not over correct.

    Mini marshmallows are also a nice thing to have on hand.
     
  15. andeefig

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    Just another one agreeing to the pump comments...having one with a toddler does make certain things easier. DS was 12 mos old at dx and left the hospital on a pump. After 2 days of trying to dose with diluted, being able to program basals to be .025 one hour then 0.0 the next and back and forth like that for the evening made "controlling things" a bit easier.
     
  16. Cookie Monster

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    I would echo others comments about pumping. In my view the very young are the ones that can gain the most from pumping. My son has been on a pump since 10 days old and I credit much of his current health to being able to pump in the early months/years.

    The good news is that there are plenty who have been there and managed to safely raise a young diabetic. It will be hard but they will adjust. One of the hardest parts for us was the tiredness (much as for parents of diabetics at any age!). One piece of advice I'd give is for them to keep talking to each other and letting each other know how they are coping. Sharing the burden of night time checks etc, making sure the other one isn't becoming overburdened really helps. Working as a team rather than two individuals makes it so much easier. And having you there, someone who 'gets it', will be great.

    I wish you all well
     
  17. SarahKelly

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    In response to Christopher disliking what I had to say:
    when I said counting carbs it is "silly" at a young age it is because it is, at least IN MY EXPERIENCE,
    I would go through the effort of figuring out how many carbs were in servings by measuring them with normal kitchen gadgets and then look and see half the meal on his face, some on the floor, some smeared on the table and who the frick knows how much actually went in...however, with a scale I felt I could actually get more precise and would sometimes wipe food off the table, face, floor and remeasure after he "ate" to figure out that he really only consumed five carbs worth of food, nothing I could have given insulin for with MDI while giving "wiffs" of insulin, but with the pump and it's preciseness I might actually be able to give that dosage.
    So, for me counting carbs at such a young age (when for Isaac one carb would bring his BG up by at least 15 points!) the scale was a must because otherwise it was crapshoot of silliness in chasing the BG rollercoaster from guessing.
    So, yes, silly is a perfect word choice for me to explain my experience. :)
     
  18. SarahKelly

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    Please don't cut off my full statement, I didn't just say it was "silly" the complete statement was:
    It is silly at this age without a more accurate form of measurement without something like a good scale.
    AND if you had a toddler diagnosed with t1d than I would be more apt to understanding you picking apart my opinions and experience, but you don't and didn't, so please respect my experience and when my child is 7 and I ask your opinion on that age range of experience I will respect yours.
    THANK YOU!!!
     
  19. SarahKelly

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    me again,
    and I feel I do need to affirm by views on my first statement.
    First, we were given syringes that had half unit marks on them that weren't even straight - how are you going to accurately dose 0.25 units of insulin on a syringe that doesn't even have straight marks.
    And, when on MDI for those six weeks prior to pumping we couldn't give correction shots until his BG was above 350...above! We had to wait until then because otherwise we couldn't give him small amounts of insulin accurately without him crashing.
    And, when on MDI for those six weeks we were told to give him "wiffs" of insulin, for those of you never told about this that is an amount just barely there, just a tad bit visible in the syringe - and a wiff was to cover 15 carbs of food. 15. It took a lot for my son to consume in multiples of 15 carbs at that point, or 30 (then he got 0.25 units) or 45 (then he got a wiff over .25)...and if he didn't eat up to those amounts we tried to get to them by filling the gap with things like juice, grapes, and even mini marshmallows etc....
    So, for me, the ability to say that a pump is more accurate than "wiffs" of insulin on a poorly marked syringe is hands down an honest statement.
    And for me, a mother of a child who is still VERY sensitive to insulin (his TDD is 8 units still almost three years post dx) knows that the ability to give those small amounts for his small appetite is priceless, because before we were giving food to fill the needs of the insulin (so that he wasn't skyrocketing up to the 300's) - and with the pump we can just let him eat.
    That's it.
     
  20. Jeff

    Jeff Founder, CWD

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    To chime in on dosing ...

    The data on reproducibility and accuracy in dosing favors pumps, though I am unable to find the citations at this moment. Humans using syringes just have a hard time getting the same precision in a dose as a computer (the pump) can do. And this is a big deal when trying to deliver very small doses to a small person -- think covering snacks or correcting for high blood sugars. It's not as much of an issue, in general, for basal insulin dosing.

    Pens offer an improvement over syringes, and this has been documented by Novo Nordisk, which makes pens and also sells insulin vials.

    When our daughter was diagnosed at 24 months of age, we diluted her Regular insulin 1:10 to allow us better dosing granularity. So, to give her 1 unit of U100 insulin, we inject 10 units of the diluted U10 insulin. I highly recommend exploring diluting insulin when using MDI in infants or toddlers.
     

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