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For those with CGM...How high does your child tend to go post meal?

Discussion in 'Parents of Children with Type 1' started by rutgers1, Feb 4, 2014.

  1. StacyMM

    StacyMM Approved members

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    Still working on this. For now, my approach is to adjust the correction factor post-lunch. I have 1:100 going right now so any corrections would be reduced, but I'm not convinced that this is the way to go. A post-lunch 200 would only give him a little more than a unit (target is 90) instead of 4 1/2 units, off-setting the IOB that would be there if he bolused instead of basaled and was 2 hours post lunch, for example.

    Today was not a great day, but the lunch/afternoon/evening was fabulous so I'm sharing it. Based on today, this seems to be a possible solution for us. I'm attaching a picture but here are my notes:
    ~Ignore the midnight high. We had a pod failure (just another random "I hate OmniPod!!" moment) at 11:25 last night and I didn't know until the CGM alarmed, so he spiked until the new pod and correction kicked in)
    ~Mornings are usually better. He must have been feeling Hobbit-like this morning because he had Second Breakfast. Ate at 7:15 and 8:00.
    ~Lunch was at 11:48. The 3:45 dip resolved itself - we didn't feed the almost-low. Afternoon snack was 4:30. Basketball practice was 6:00-7:30. Dinner was 8:15. Went to bed at 9:30.
    ~No temp basals all day
    ~Calibrated this morning and just before bed, I don't remember how close the morning one was but the bedtime was 3 off.

    IMG_0479.jpg

    This is our best day yet so I think I'm getting closer on the basals :) Today's changes - I increased his 1100 basal, decreased his 1:30 basal and left everything else alone. Oh, and adjusted his midnight correction a bit since he didn't come down as far as I'd like, but that's unrelated.
     
  2. Dave

    Dave Approved members

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    If we go above 110 we correct and revisit whether the meal makes sense.
     
  3. Sarah Maddie's Mom

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    Dave, I have to ask. Does your son ever eat outside of your company? He's 12 or 13? Or am I mixing you up with a different poster...
     
  4. Melissata

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    110, seriously? Poor kid.
     
  5. mmgirls

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    DAVE (sorry forgot to hit quote)

    By all accounts you are very involved in the food choices that are made available to your family, let allone you T1 kiddo. Many people from this forum have tried to engage you in conversations about how you are controlling your child T1 diabetes and the possible negative consequences of your rubric of on BG control.

    Depending on so many variables a NORMAL person without any sort of diabetes may spike above 110, a spike is just that.
     
    Last edited: Feb 9, 2014
  6. jlh0920

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    Stacy, I think this is a great idea with the basals and something we have tried as well. One issue that always comes up for us is the difficulty in eating at the exact same time every day. We have been burned a few times by the basal kicking in and not eating at the usual time, resulting in a low. Do you set the actual basals with these elevated rates or do you do temp basals? Also do you start an hour before a meal or earlier? Thanks for sharing.

    Jen
     
  7. StacyMM

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    We only do this on his school basal rate, which we use Sunday night through Friday night. He doesn't remember to bolus so expecting him to remember to set up a temp basal would be a recipe for disaster!

    Because his school schedule is set and his morning routine has very little variety, it gives us 5 days of a consistent eating pattern a week, so that is our "School" basal program and we have a normal basal pattern ("Home") for weekends. Our dinners are too varied but we are with him and can enforce bolusing so they don't concern me. If there is a change in his school schedule, like a delayed start or a state test and his lunch is going to be delayed, we are supposed to get a call from the school to let us know. They know his basals are designed around his schedule and know that we need to change his basal program if it changes so he knows to switch to "Home" from "School" on those days. It's not perfect - we've had a few days with pre-lunch lows because no one told us about a change and DS didn't think about it, but we just feed the low, change the basal, use a temp rate, whatever the low needs...and everything is back to normal the next day. It would be a bigger issue now that he's going with a full bolus through his basals (prior to this we were running with a basal that included a basal build-up to offset the pre-bolusing that wasn't happening, and it's what we still do for breakfast) but it's still treatable. If I remember the program (I'm at home and he is not), I believe the basal adjusts at 11:00 for his 11:48 lunch time. Something like that, at least.
     

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