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Do you fully trust your pump?

Discussion in 'Parents of Children with Type 1' started by ashtensmom, Dec 13, 2011.

  1. ashtensmom

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    As I was bolusing my DD for a correction at 3 am in the morning, I got to thinking how much I trust that the pump will deliver the "0.10" u of insulin precisely and not "over" bolus.

    For those who's child uses very little basal and have a sensitive ISF, do you fully trust the pump to deliver precise "little" amounts of insulin? I was loving the fact that we could correct a ever so slight out of range BG by bolusing little amounts such as 0.10 unit to bring her down just a bit. But I am second guessing whether this is such a good idea if the pump would be able to consistent squirt such small amounts without error on the side of over delivering.

    Is it common practice to bolus only a little to, say, bring a 142 down to a 105, or do most people just leave a 142 ish number.... it's only slightly above range, but I prefer in range. I have heard people comment to not try to get BG so perfect.

    So, how much do you trust your pump? Is the pump so advanced that one should not worry about making multiple little corrections.
     
  2. MegaPug

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    I trust Meg's pump, but I trust my gut more... does that make sense? There are times when the Ping suggests a certain amount for correction or carb ratio, but I override its recommendations about 10% of the time. I was actually praised for this by the pump rep during a follow-up training session because he said it's important that we don't allow the pump to do ALL the thinking for us.

    With that said, I trust the pump to be very accurate at very small increments, but ONLY if I know the inset is seated properly and in a reliable location on her body. I learned through trial and error over the course of many sleepless nights.

    If you're ever unsure, you could always do a .05 until you really feel good about the decision to go to .10.
     
  3. Jakethesnakesmom

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    I do trust that our pump delivers precisely what you want it to (I really haven't heard of instances where a pump has over-bolused (Jacob uses MM-Revel). I don't think I would correct a 142 at night though (that's just me) - I would correct something above 170-180ish. One thing to keep in mind is the BG reading from the meter is sometimes a bit off, so your 142 could actually be 120.

    I suppose I'm not one to strive for a really tight control at night - I feel comfortable somewhere in the 105-160 range.

    Stephanie, Mom to Jacob, age 9
    Dx since 2005, Pumping with MM-Revel
     
  4. Sarah Maddie's Mom

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    It's really two questions. Yes, I trust the mechanical accuracy of the pump to delivery what it says it's going to deliver. But I also override it all the time. It's nothing more than a delivery device: it doesn't think and it doesn't take into account all the extenuating circumstances that impact insulin needs, obviously.

    As for correcting a 142 in the middle of the night? Your call. I don't. I like to sleep. Correcting a 142 would mean rechecking later and possibly having to then turn down a basal or treat with juice. Meter inaccuracy would probably also keep me from correcting that. I trust the pump far more than I do the meter.:rolleyes:
     
  5. McKenna'smom

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    Not sure what her range is, but I don't correct at 142.
     
  6. mandapanda1980

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    Ditto ditto, ditto and ditto ;) :)
     
  7. Lisa P.

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    No, which is partially why we are on a pump break.
    My mechanical engineer brother explained to me in convincing detail about how the mechanics itself were, in fact, capable of the kinds of delivery it promises. However, what I believe is that it can deliver as "precisely" as it wants but then mechanics hits biology and the variables make absorption something of a crap shoot. I also have read things like the fact that bubbles expand during altitude climbs on flights affect delivery up to 1 unit in both directions and I realize what gets you is not what you know, or what you don't know, but what you don't know that you don't know. :eek:
    I think the best way to use a pump is with an understanding that it works like it works and if you can work with it, all's good. But I do think it's a bad idea to use a pump as if it were perfect and infallible, I think you'll get into huge trouble that way.
     
  8. StillMamamia

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    I trust it most times. I override it often. But, besides any possible malfunctions, it's just reflecting the basics of what I programmed it with, so best to doubt it sometimes.:D
     
  9. spamid

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    Ditto here as well. My DD is back on shots now (her choice), but we have been on the Cozmo and the Animas. Trust your gut if you think the suggested bolus is off. I do trust it to deliver what it says (barring an error/site issue/alarm). You are still the human in charge. I will never blindly trust any technology (computers, facebook and cell phones included).
     
  10. manda81

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    I was going to start a post related to this to see how many night people do "nothing" at the night checks.

    It took me a long time to trust our pump, but I do, yes. I correct in the middle of the night all the time, sometimes as little as .05, sometimes more. Our "normal" nights are either decreasing basal by maybe 20% for 30 mins, or issuing a correction of .25u or less.
     
  11. JaxDad

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    Ditto, I don't trust the pump to manage my son's diabetes, I trust the pump to do what I tell it to do, so like many others, I over-ride it all the time.
     
  12. Butterfly Betty

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    I trust the pump enough to take what I put in and give me a suggestion on how much insulin I should give her, but sometimes, I know that it's going to be off, and I make that adjustment.
     
  13. Flutterby

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    Do you fly often enough to be concerned with the expancing insulin, or airbubbles that *may* occure?

    We flew and didn't have a problem.. its not something that I get overly concerned about because we hardly ever fly. Certaintly wouldn't make me stop using the pump on 'what if'... if I did everything on 'what if' then my kids and I would be wrapped in bubble wrap and sitting in the corner, lol.;)
     
  14. Flutterby

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    Like others have said I trust the pump, but I also use common sense and the cgms. I 142 Iwould most likely leave alone at night, UNLESS the cgms is indicating that she's climbing... if its a flat 142, then it gets left alone. A downward 142 would get a slight basal reduction.

    I trust the pump to give the .025 that it says its going to give... but there is ALWAYS insulin absorbing at the tip of the cannula, from the last basal, bolus or correction.
     
  15. ashtensmom

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    This is what I am referring to actually. Being such a small, minute amount... would it be accurately dispensed, absorbed, etc. and mechanically accurate to move the plunger to dose such a small amount. I am not questioning the ability to caluculate doses... just the mechanics of it all, especially for teeny, tiny, doses.
     
  16. Flutterby

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    If it couldn't do it, it wouldn't have been approved by the FDA.. machines do amazing things. :cwds:
     
  17. mommabear

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    I do trust the pump, but like others have said I trust my gut more also. Sometimes I do the same..If I question the about of bolus I will adjust it. As far as the 142 at night I would leave it alone..I would leave a 142 alone during the day to but that may just be me..If you are second guessing the amount the pump is giving, I would go with your gut first..:cwds:
     
  18. Lisa P.

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    Well, a study proved that it did occur sometimes. Doesn't mean it ever would for us.

    We do not fly, but we live at 9,000 feet and are surrounded by higher elevations, I doubt the elevation change in our trip down to the nearest city would make a difference, but I can say we have drastically more consistent numbers with MDI now than we had with the pump, so I considered this as one possible cause. I believe it's probably not the cause, but it might have contributed.

    What got me about this, though, was that this was not a mysterious physics principle, the idea that bubbles expand and contract based on elevation changes. This was kind of 101. And in all the years the pump has been used, no one ever thought of it. An independent researcher, not the companies themselves, found the problem. The companies still do not, as far as I know, note the possiblity of a unit of misdosing and my CDE had no idea what I was talking about, so it's not like the info is getting distributed. Do I think this is a huge deal in itself? Naw. But I do think that if something as basic as this can be first not identified and then not widely recognized it reinforces my belief that we don't know near so much as we think we know about the way our devices work.

    I will say this info turned up the same time we had several boxes of defective cartridges that we'd purchased directly from Animas (so they had our name, number, and the lot #s on file) and no one from Animas notified us -- we had to learn ourselves about the recall and call them.

    So I got the definite impression that the companies weren't necessarily worried so much about a unit here or a unit there, and since my kid was on TDD of 12 units a unit here or there difference could make a big difference. Plus, we were getting really, really bad results from the pump. I suspected it at the time but now we're back on MDI it's clear as day. Just us -- not trying to convert anyone. But if the question is whether I trust the pump to automatically do what they say it can do in every instance with every person, my answer is resoundingly no, based on my experience. I think that's pretty reasonable, and folks can agree on that tame assertion and still feel it's a great tool for themselves or their kid.

    How much of that applies to the OP question is something she'd have to judge -- maybe not one bit! :)
     
  19. Lisa P.

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    FWIW, our CDE mentioned that another family felt they had to quit using the Ping, and she thought it was an odd coincidence that this family also might have traveled in from the same area. I thought, um -- maybe not a coincidence, maybe altitude?

    By the end of the appointment, though, she had given me the impression that she thought the other family saw bad numbers not because of the pump, but because the child was sneaking food.

    Now, maybe that's true. Or maybe the pump doesn't work well at high altitudes. How would she ever know if the second was true, since her hard assumption for the first and her faith that the pump couldn't be functioning poorly meant she couldn't even consider the second?
     
  20. Helenmomofsporty13yearold

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    I trust the pump, but not how corrections will show up, especially at night. I would not correct a 142 at night, either. Any corrections we make at night, I check at the 1 hour, 2 hour and 4 hour mark as she can be very sensitive to corrections then.
     

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