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MDI vs. pump

Discussion in 'Parents of Children with Type 1' started by Darryl, Nov 13, 2016.

  1. Darryl

    Darryl Approved members

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    We didn't see things calm down at all... less insulin is needed (no more 70+ unit per day) but variability was actually getting harder to control. When she started experimenting with Levemir she noticed that variability stabilized a bit, there were far fewer sudden high spikes. I could only guess as to the reason, whether it was pump sites being less consistent, or whatever. She is very interest in an AP system but none of the hardware configurations currently available are appealing. We want it to be with the dexcom sensor, and a wireless pump. Ideally, the Nightscout group will someday hack the pod protocols and design a new PDM that will interface to the Dexcom and not have any of the self-defeating restrictions that exist in the medtronic closed loop system.
     
  2. Darryl

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    Great to hear from you too and glad that she's enjoying living in such a beautiful place!
     
  3. Just Jen

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    Would love to know how you calculate that out. Because our T1D girl is so thin, her behind is the only spot that we can put a set in. But she keeps having issues and I'm considering trying out a pump break after the holidays. When we used levemir in the past, I found a morning and evening shot to be more effective, but gave equal amounts. So how would you figure out more accurate dosing for that?
     
  4. Sprocket

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    I would say by trial and error. Try with an even split, but we used to find that she would creep up late afternoon and into the evening or she would creep up in early morning if the dosage wasn't high enough. We find (at least for us) if the dosage isn't high enough, it wears off too early. If it's too high, it just brings you steadily lower throughout the day, peaking about 3pm or am (we give shots at 7am and 7pm + or -). You can also play with times of injection depending on how long you see it lasting.
     
  5. mom24grlz

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    i agree with starting with an even split then going from that point. Ashleigh is on Lantus but splits her's 19 units at 7AM and 15 units at 8PM. splitting Lantus seems to work well for us, vs just one shot. We've found the Lantus doesn't seem to last the full 24 hours. When Ashleigh first went from pump to MDI we did an even exchange. She was on like 22 units pump basal. So we did 11 in the AM and 11 in the PM. We soon found out that wasn't enough Lantus, so eventually had to increase. But i have heard that you generally need 20% less pump basal than Lantus basal.
     
  6. rgcainmd

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    You may want to consider asking your endo to prescribe Tresiba (off-label for pediatric use). I'm reading account after account of how steady this basal insulin is, and how lows are rare to nonexistent.

    We have a few Tresiba pens in the fridge and may try pumping untethered with Tresiba covering part of my daughter's basal needs.
     
  7. MichelleW

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    I'm new here but have bookmarked this thread. My gut this past week with all of the reading and education has been that the pump might not be a good fit for us. My DS is very skinny and does not mind shots. Getting rid of constant finger pricking with the Dexcom next week will make him happy, but the injections already seem a non-issue for him and we're only 9 days in (although it is hard to find fat on his tiny frame). Now that we are using a pen for the Humalog bolus it's even easier.
     
  8. Sprocket

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    My daughter felt the same way - finger pricks were the worst part of diabetes and she never minded injections. The Dexcom is worth it's weight in gold for us. If your son is okay with MDI, don't let anyone push him towards a pump. We're three years into it and our diabetic team continues to push us for a pump every time we're there and my daughter has great numbers on MDI. My daughter is adamant she doesn't want or need one, yet they continue to push. I really think if you master MDI and get a good understanding of how your child responds to different insulins, food, activity etc., you're preparing them well for life however they decide to manage their diabetes in future.
     

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