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High BG numbers

Discussion in 'Parents of Children with Type 1' started by brie, Jan 31, 2013.

  1. brie

    brie Approved members

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    I am new to this forum!! My 7 year old son got diagnosed with T1D in may and we have been pumping since December. Cooper loved the omnipod and has loved being on a pump!! But he has been consistenly higher with BG numbers and I have been so frustrated its like starting all over again. If his numbers are high do you switch your insulin to carb ratios or your basal rates???
     
  2. Charliesmom

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    Did you do basal testing yet? I think it's important to get the basals figured out before adjusting the I:C ratios.

    My son is also 7 and really wanting to switch to the pod. It's time for a new pump so we are going to talk to the reps at a diabetes summit in March. I'm kind of waiting to see if the smaller pods actually happen. =)
     
  3. brie

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    what is basal testing?? We switched his basal rates and he kept going low and would test over 10 times a day!! So I switched them back but now he is over 200 all the time!!
     
  4. nebby3

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    I agree, start with basals.
     
  5. obtainedmist

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    Your endo should give you some information about basal testing. Basically, you want the basal amount coming from the pump to cover the glycogen coming from the liver 24 hours a day. Sometimes it's less and other times it's more. There are times in the day when the body is insulin resistant and others when the body is more sensitive to insulin. Since everyone is different, basal testing is used to figure it out. Integrated Diabetes Services has some good information on how you do it in this link: http://www.integrateddiabetes.com/p_basaltest.shtml The short version is that you do some fasting and test often to see how the body is responding to the hourly rate of insulin coming from the pump. If there is over or under 30 points of fluxuation (I think) you make adjustments to the basal rate. First, though, make sure to discuss this with your endo or Diabetes Educator!

    When we did this, we would make changes two hours before the rise or fall in small increments. We'd wait a few days to test the new rates and then make further adjustments to make it better. It's not an exact science by any means...but you do what you can to try to match what a pancreas would do with insulin output during a day/night. It's easiest to do the night time first because we naturally are fasting during this time. Best of luck and don't give up!
     
  6. nanhsot

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    Definitely learn about basal testing and start there. Without that base in line, everything else is all wacky. My son needed a LOT more basal via pump than he did with lantus, it's not necessarily a straight conversion like they make it seem at start up. Look specifically at nights first to see how that's going, then look at tweaking daytime basals. My son needs almost double the basal at 5am compared to 10pm, so getting those nights set is important to start your day right.

    For my son his I:C ratio has been fairly steady, but his basals change fairly regularly. He did have to bump up his amounts for breakfast recently but otherwise I don't think his meal ratios have changed in some time (but he's also older).

    I think someone may have posted this already, I was reading rapidly and know I saw some links, but just in case, here is a good description of basal testing.

    http://www.integrateddiabetes.com/p_basaltest.shtml

    Good luck.
     
  7. Ali

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    If your Endo group gave you any books or print outs prior to starting the pump or MDI take a look at those. If not go online and order some books on pumping insulin to help figure out how to test for basal and bolus needs. The Integrated Diabetes reference site may have plenty so check that out first. But first call your endo team and ask about basal and bolus testing. They should have the information available. If not or no mater what they have checking out books and the Integrated Diabetes site will help. :)Ali
     
  8. Charliesmom

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    Get in touch with your endo and ask them about basal testing. I'm surprised that it hasn't been discussed with you yet. When Charlie first started pumping they just took his lantus dose and divided it by 24 and started from there. I was constantly correcting highs. It was awful. I had a diabetes trainer that I checked in with daily and she had me start doing basal testing. We started out doing the morning. Then we started working on afternoon, then evening, then night. We found that he needs at least twice the amount of basal in the morning than the rest of the day. It's often reffered to as a fasting test but our trainer said since it was a young child then we could do no carb foods if needed. Bacon, egg, cheese, etc. to get him through.

    I do agree that you should get the book Pumping Insulin by John Walsh. It is very helpful.
     
  9. maciasfamily

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    When pumping it really does feel like you're starting all over again in the beginning! For us, we adjusted the basal first. Since the ratios were fine before pumping, I knew it was the basal we needed to fix first. Great suggestions on basal testing, unfortunately it just doesn't work yet for us having a toddler that needs to eat every few hrs.

    If you're not already, weekly download his BG logs and review them. I like to highlight all highs and circle all lows. See if there is a pattern and work from there.

    If he is consistently high at a certain time 4 out of 7 days, or 3 out of 5 days, then make an adjustment in basal 2 hrs before the high up until the high. Make small adjustments, since little adjustments can make a big difference. Same principle with lows.

    Each week review and fix. With us, if he was super high 3 days in a row, I would make adjustments.

    Also, we only make adjustments based on weekday numbers, not weekend numbers. The weekday his schedule is set at pre-k so I know that is most often his routine. Weekend numbers are always a little wonky since we eat at different times, and eat out more.

    Once you get the hang of this, you will love it, and see the numbers settle down a bit more.
     
  10. brie

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    oh my heck you guys are awesome!!! This will help me tremendously!! When we got the pump in december they just took his Lantus dose and divided it by twelve to give me his basal and we have made one adjustment since. But he has been running high constantly so when he drops to 120 he feels super low cause he is not used it. I am going to call my endo team and see if we can figure something out to bring his bg down and in normal range and definatley look into basal testing.
     
  11. MomofSweetOne

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    When we basal test, I follow the guidelines in Think Like A Pancreas and then compare with Pumping Insulin and then follow my gut with their input. I think to really get the best grasp, parents have to learn to test and adjust basal on their own. I know that I couldn't adjust others if I didn't know fasting patterns, etc., so I'm amazed that CDEs do as well as they do with recommendations. Once you get the basal profile tested, growth spurts are much easier as you can raise the entire profile by a % that fits until the growth spurt ends. With puberty, the past year has been temp basal adjustments with 100% profile rarely actually used - but the basic times of when insulin needs increased or decreased usually stay steady.
     
  12. wilf

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    In the meantime, why not increase his basals 10% across the board?
     

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