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Insulin Pumps

Discussion in 'Parents of Children with Type 1' started by JohnT, Jan 19, 2013.

  1. JohnT

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    This is my first time using a forum. I live in the Scotland, UK. My daughter started using the pump in October last year. We're still having to do numerous nightly checks & we all are finding this very tiring, especially my daughter being woken up! Can anyone tell us how long this could go on for?
     
  2. Sarah Maddie's Mom

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    If you were led to believe that pumping would reduce or end the night bg checks then I'm afraid you were ill-informed. My DD has been using a pump for 8 years and I still check her at least once a night.

    If the closed loop pump ever hits the market then perhaps we'll all sleep better, or if you have a spot on CGM with loud enough alarms that could do the trick as well, but for now, with a pump being nothing more than an insulin delivery method, I consider nightly checks necessary for her health, and my peace of mind.
     
  3. danismom79

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    Yeah, what she said. Sorry.

    Are you waking your daughter up to check? If so, there's no need. There are numerous lancing devices, maybe try some others that she won't feel as much. Then you can just go in and grab a finger (or toe) and check yourself.
     
  4. nanhsot

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    Can you give a little more detail? What is the age of your child, what sort of issues are you having? For very young children and during times of growth and change it's common to have to night check, every night, but "numerous" checks seems a little outside the boundaries. How often do you check and why?

    It sounds like maybe you have some basal issues, if you could post some specifics and even report her numbers here I think more useful advice would help.

    Most parents of very young children check at least once per night. My son is older and was diagnosed older so we have never checked every single night, but we do check when things warrant it.

    Pump transition for him took several months. He needed a LOT more basal via pump than he took of lantus and it was a rocky road to find the perfect dosage. It was a frustrating time, but at almost 3 months in things should definitely be getting close to being set.

    Have you considered CGM?
     
  5. ecs1516

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    Exactly what they both said. Mine don't wake up when checked at night. Guess they are used to it? Yes it is very tiring. CGMs can help some .
    I still have to get up most nights even with them.
     
  6. Christopher

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    Just wanted to chime in with my experience. In the early days and weeks after dx, checking at night was horrible. My daughter would wake up and scream and cry for at least 15 minutes. I couldn't comprehend how we were going to live like this, it was a nightmare.

    Eventually she stopped waking up and things got into a routine. I got a headlamp so I didn't need to turn her light on, I use a Delica lancer that is much less painful, and I became adept at getting in and out in a minute or two without her even stirring in her sleep.

    I am of the opinion that it is a crucial part of diabetes management to test at night. I test her every night, multiple times a night for the past 6 years and have caught MANY lows/highs that I would have missed. Is it tough? Yes. Am I tired during the day? Yes. But to me it is worth it to know I am keeping her as safe and as healthy as I possibly can.

    Good luck
     
  7. Christopher

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    Respectfully, I disagree. It is not "outside the boundaries" to check numerous times during the 8-10 hours during the daytime, so why would it be unusual to check numerous times during the 8-10 hours during the nighttime? To me it can be even MORE crucial to check because the child is asleep and may not feel being low, as opposed to when they are awake and would often times feel it and be able to treat it before getting into trouble.

    Clearly, each person dealing with Type 1 diabetes needs to determine what works best for them and their family, and there is no "right or wrong" way of doing it. I am not criticizing you at all. I just don't want the OP or any other person dealing with this to feel that checking multiple times a night is out of bounds.
     
  8. nanhsot

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    I'm curious what "numerous" is. Checking many times, every night does seem like there is something wrong. If numerous=2, that's within reason, if numerous=4+ to me that is excessive on a DAILY basis. If the child is having numerous spikes or lows every single night, clearly something is wrong. Yes, we do see it happen, but not every night, with regularity. There have been many nights where I woke and checked every 2 hours, even every hour. But that's outside the boundaries of normal, and was an exception, not a rule.

    My understanding of most parents who check nightly it's usually just one check unless something is off, usually in the 2am range, then another only if something is off. Am I misunderstanding how most of you do it?

    If a parent chooses to check, that's one thing, but if a parent is forced to check every 2 hours all night long because things are unstable on a regular/nightly basis, something is wrong.

    If pump transition has caused unstable numbers and a need for multiple night checks, it seems to me the basal has not been set. Seems to me that we are doing this family a disservice if this is true by just saying "yep, that's the way it is" rather than maybe helping tweak the settings.
     
  9. swellman

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    Certainly, Christopher, you aren't suggesting that night time testing is as frequent as day time testing? Certainly if it's warranted as in sickness, growth, fat/carb spikes, etc. but normal?

    To the OP getting things dialed in with a pump can take some time but you should be able to get some sleep after adjusting the basals and ratios and getting to know night time patterns with different foods and such.

    EDIT: Edited to laugh at nonshot's comment that 4+ is excessive on a daily basis.
     
  10. Christopher

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    I agree, it all depends on how you define the word numerous.


    You are correct, I am not suggesting that nighttime testing is as frequent as daytime testing.
     
  11. JohnT

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    Nightly Checks

    We always check at 9pm & the again at midnight. The midnight readng is the one that determines when we next check. We have found that if the reading is at the lower end of her range then she will definately go into hypo before 2am, so we then find ourselves doing 2 hourly checks through the night. With the result we have wake her & that doesn't go down well at all.
    There seems to be no rhymn nor reason as to why some nights everything goes swimmingly and the next night it's all over the place!
    We are in constant contact with our diabetes specailist nurse and the basal is being changed frequently, but still we have this uncertaintity.
    Just wonder it this will go on indefinately, any ideas?
     
  12. nanhsot

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    When you find her at the lower end at midnight, do you lower her basal? You could try that, doing a temp basal for a few hours. That at least may prevent a true hypo and it would only be a check and not having to wake to give glucose.

    If the lows happen more often than not, I'd lower the basal beginning around 11pm.

    Unfortunately sometimes there are just unexplained swings. How old is your daughter? When was she diagnosed?
     
  13. nebby3

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    I second trying a temp basal for numbers that aren't truly low. I don't know how old your dd is but mine will drink juice boxes in her sleep. It should be possible to at least not wake your child even when you have to be up.
     
  14. momof2marchboys

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    We check around 10:15-10:30 pm and again sometime around 2-3am, if I hear the alarm. I love when my son will wear his CGM as we have the mysentry and it will alarm when he is too high or low and I can hear that! There was a stretch of a few days where I didn't sleep for about 4 days b/c he was running high 325-500 over nights and would spike about 2:30am.
    I guess in my theory is if the numbers are off that i want to know about it and be able to do something about it
     
  15. JohnT

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    Thanks for pointers

    Thank you for that, will try temp basal and see how that goes. My daughter is 5 years old and was diagnosed in August 2011 when she was 4. She was on MDI until Oct & then started on the pump. She is copinbreally well and we do see a difference in her appearance & general wellbeing, so that helps when we're going through all this stuff.

    As you say there are unexplained swings, growing spurts, illness and so on. Fingers crossed things will improve.
     
  16. selketine

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    I agree with doing a lowered temp basal if you think the check is low enough that she will likely go low later. You can lower the basal to almost nothing or turn it off for 30 mins, an hour, etc. I also look at the IOB if I get a number lower than I like. If there is a lot of IOB then I set the temp basal to work against that.

    However even when you think you've got it - you won't have it. My son is on a cgms and even with that tool I can have days or weeks where nothing I do before bedtime keeps him at a good enough number that it doesn't beep overnight and wake us up because he is too high or low.
     
  17. Christopher

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    John,

    I would recommend creating a signature with some basic information about your child (age, type of insulin used, etc). This information will help people give you the best answers for your particular situation. Click on the "User CP" at the top right of the screen. Then click on "Edit Signature" and add the basic information. Then click "Save Signature".
     
  18. JohnT

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    I've updated signature as you suggested. thanks
     
  19. reaganrocks

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    Considering the OmniPod for 7y/o DD

    My daughter was DX with T1D 9/28/11 at age 5. We have done shots since that time but are now considering the pod. Her A1C has been 8.7 the last year and I am hoping the pod will control her blood sugar better. She only gets 2-4 units of Novolog three times and 3.5 of Lantus at night. She is wearing the demo now and has not had any problems adjusting to it. We have an endo appt. this week. Any advice???
     
  20. JohnT

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    Considering a pump

    Because we live in the UK I dont know if my advice is any good as I think things are different in the US. My Daughter's HbA1C has come down considerably in the short time she has been on the pump, which I have to say is what is keeping us going. She has adapted really well to it & certainly to go back to MDI would really upset her. It certainly hasn't been an easy ride for any of us but we have to keep telling ourselves that this is definately better for her and it should hopefully make her future better.

    Hope it all goes well for you all and that your daughter adapts well. Good luck
     

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