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I need some advice. Please

Discussion in 'Parents of Children with Type 1' started by mapoe4, Nov 4, 2013.

  1. mapoe4

    mapoe4 Approved members

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    John's on the pump but he is old enough now that he can do it by himself.
    When he started kindergarten (5 years ago) I had to go every day any time he needed insulin.
    When he went into first grade they would supervise him doing it.

    There policy is that only an RN can draw insulin. For one thing John uses the Animas ping and they never had to draw insulin with the pump. Only time they saw the insulin is when his tubing would show. And you would have to have super vision to be able to tell what was tubing and what was insulin.
    Sorry that was a little sarcastic and it was meant toward the school not any one here. I am just so agrevated with the school because this has been going on with them for 5 years.
    I was also told at one time by the supervisor that only RN's can adminiter insulin. When I responded that I wasn't and didn't plan on ever being one, she told me that some parents take it in there own hands to do it themselves. I was also told if I took him off the pump and put him on the pen needle that they wouldn't have any problems.
     
  2. mapoe4

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    :) You are exactly right on both parts.
     
  3. missmakaliasmomma

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    Wow, you had to go in all the time? I OFFERED to do that with my daughters school (I had a bit of an issue letting her go to full time K lol) and they were like "the point of a nurse and a 504 is so you don't have to come in"
     
  4. wilf

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    Reposting this as I need the answers to help with what I think I understand what you're wanting to do.

    Some questions - does he get roughly the same number of carbs for lunch each day? If so how many? Does he eat all of his lunch?

    A sliding scale will only work if the number of carbs in the lunch is same each day, and if he can be counted on to eat his lunch.

    Let us know the answers to those questions and we can put something together for you. :cwds:
     
  5. mapoe4

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    Sorry thought I answered it.

    At school he gets between 40-50 carbs. (the chocolate milk makes up almost half of this and he likes his chocolate milk so I let him have it at school so he can be like the other kids )
    Majority of the time he eats all his lunch. If he doesn't eat it all there are things that I leave in the clinic for this and there is an aide in the cafe that if he doesn't will notify the clinic.
     
  6. wilf

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    OK, so sliding scales are generally only used at meal times.

    You are indicating he gets about 45 carbs for lunch, and can be counted on to eat it. Given his carb ratio of 1/2 unit per 30 carbs, that means he should be getting 0.75 units to cover lunch.

    The purpose of the sliding scale is to bolus for the meal AND also make adjustments for high or low blood sugars. You said his correction factor is 1:360, so that means that small amounts of insulin will lead to big blood sugar drops. To make the sliding scale work better (and build in a little safety factor) I will assume correction factor is 1:400. That means that every 1/2 unit increase above what he needs to cover his carbs will drop him 200 points.

    He is getting very little insulin, and is very sensitive to it. This means he is not particularly well suited to a sliding scale, because even a 1/2 unit increase in his injection has profound effects on blood sugar.

    That having been said, my recommendation for your sliding scale (based on the information you've given) would be as follows:

    BG under 75 - no insulin
    BG 75-175 - 1/2 unit
    BG 175-375 - 1 unit
    BG 375-575 - 1.5 units
    >575 - call Mom :eek:

    When you look at this, keep in mind he is needing 0.75 units to cover lunch.

    - So when he's in the 75-175 range, he's getting less than he needs to cover lunch and blood sugar will go up.

    - When he's in the 175-375 range he's getting an extra 1/4 unit, which will drop his blood sugar by 100 points.

    - When he's in the 375-575 range he's getting an extra 3/4 unit, which will drop his blood sugar by 300 points.
     
    Last edited: Nov 7, 2013
  7. mapoe4

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    Thank You. I so appreciate the help. I have been so frantic lately with making sure that I do things right with Billy. It has been a while since John has been on shots and I am scared all over again that I am going to make mistakes.
     

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