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Pumping and confused! Maybe even irritated!

Discussion in 'Parents of Children with Type 1' started by cgbphp, Oct 30, 2011.

  1. cgbphp

    cgbphp Approved members

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    So my 2yr. old has been pumping for 20 days now. His blood sugars are still all over the place. Which as I have learned from this site is quite normal. I actualy have no idea what I would without this site at this point. Anyways back to my question during my pump training they never taught me how to set temp basals or when I should do it or for how long. My son has been going low at night 60-80. I have been treating with juice thus far. But he is so hard to wake up and throws a fit when I do so getting the juice in is quite a battle. So should I maybe back his basal off by 0.25 from midnight till 8am. He is going low between 12am and 4am. Or maybe just set a temp basal and see how that works and if I do how long do I do the temp. basal for? I loved my endo before he switched to a pump but now they are not near as helpful as they used to be. Not to mention his endo went on maturnity leave a week prior to his pump start so I am not even dealing with the only doc who has ever seen my child. I am just at a loss at this point any advice would be helpful.
     
  2. nanhsot

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    If he's going low at midnight I'd back down the basal beginning at 10pm. It usually takes a few hours of basal for the effects to be seen.

    What's happening after 4am?
     
  3. cdninct

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    More information would probably be helpful. Do you mean that, sometime between 12 and 4 he is going low, or does he drop throughout that period, only to level off (or go up) after 4?

    It wouldn't hurt to try using a temp basal to see if you can get the balance right. If you go into the basal menu, "set/edit temp basal" (I think) is the first option. Press the act button, then you can change the rate (in the form of a percentage of your present basal rate) for as long as you want. As nanhsot said, it takes a while for the basal to have an effect on BG, so we count backwards 2 hours, too.

    Sorry to hear that you are still struggling (remember, you are not alone!) and that the clinic is not being too helpful. Keep communicating with them--if it is a larger clinic, hopefully somebody there can help you out.
     
  4. SarahKelly

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    it it were me I would edit the basal and decrease it by half of what it currently is at from two hours before he is going low to about an hour before that time frame. So from 10pm to 3am decrease the basal rate. If after a few days you notice a reduction of half was too much, then only reduce it by a quarter. Take a lot of notes of the current rates, where you're making changes and the BG levels from those changes.
    I think one thing I realized after starting the pump for Isaac was that I would be doing the majority of the tweaking for him, not his endo with his basal and bolus needs...I feel safe doing this because Isaac gets checked so frequently that if I make a change in the wrong direction it will not go unnoticed.
    I also noticed that when Isaac started pumping he would have hours of 0 insulin needs, I believe part of it was him starting the pump so soon after dx and his body was still producing insulin, I also believe it has to do with the pumps great ability to give such small amounts of insulin therefor we weren't having as many scary lows followed by darn highs as we were before. The start up of pumping was awful, truly awful, for us - just getting it all figured out, but now I wouldn't want to go back to pumping for his little body. Right now the pump is definitely the better choice for him.
    I hope that helps a bit...take care :)
     
  5. cgbphp

    cgbphp Approved members

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    At 4am I was giving 2 onces of juice and when I would check at breakfast he was between 120 and 170. Last night he was 163 at bedtime and wouldn't take a snack I checked at midnight he was 104 so I attempted a temp basal took him down to 50% for an hour. I rechecked him at 4am and he was 106 I left it alone to see where we would be at breakfast he got up at 7:30am and he was 66. He doesnt seem to be dropping to 100 until around midnight with or without a snack. His basals start at 8am then change at 3pm, 9pm and midnight so I was thinking of decreasing the midnight bolus by half and checking frequently tonight. They just changed his settings for midnight this past friday before I was having to bolus twice through the night because of BG between 300-400.
     
  6. nanhsot

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    It you change it at midnight that won't be seen affecting his body until around 2am, so if midnight is the problem area you need to lower beginning around 10 or 11 at the latest.
     
  7. obtainedmist

    obtainedmist Approved members

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    Great advice from the pros! Also, I would really recommend getting the book Pumping Insulin by Walsh. There is information overload in it, but you will find yourself going back to it time and again to get clear on some things about pumping. It was fantastic. Also, have you done any basal testing yet?
     
  8. William

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    Our son is younger by a couple months and had a similar problem at night. His blood sugar would go high on its own around 10 pm so he had a higher basal in the evening but we dialed it down at 11:00 and then at midnight down to the smallest of .025. We keep it at .025 until 4:30am as it was in this time that he needed very little insulin. After 4:30, his bs would rise so he needs more basal then. We would make small changes and use the Dexcom to see the effect and go from there.
     
  9. Flutterby

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    They most likely haven't shown you temp basals yet because you don't use them in the beginning, if you are seeing lows like that then a basal needs to be changed as suggested above. If I have to set a temp basal for more than 2 nights in a row I change the basal that I'm correcting with the temp, whether its higher or lower. The beginning of pumping can be extremely frustrating because you have so many variables that you are trying to set just right.
     

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