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when did you start changing ratios/basals by yourself?

Discussion in 'Parents of Children with Type 1' started by 4monkeez, Mar 16, 2011.

  1. 4monkeez

    4monkeez Approved members

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    I know Matt needs a basal change, and probably some ratios too. Called endo yesterday, never got a call back. I'm not confident enough yet to do it myself, but just curious when people start to figure it out alone? Then when do you let your endo know the changes?

    Thanks!
     
  2. chbarnes

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    We started right away, but my wife and I have more background in diabetes management. I would say start with one problem time period and make a small change, say .05 u/h or less if your pump allows it. Test frequently during that time and see what happens. You can also try more formal basal testing, where your child eats a set amount of carb, then fasts for the next 8 hours to see that his BG returns to baseline then remains stable at a particular rate. We have only rarely done this over the protests of a hungry teenager.
    I think the secret is to start small.
    You will be more comfortable in a few weeks. Many parents here make day to day and even hour to hour changes.
    I would just tell your doctor the next time you see him.
     
  3. Denise

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    I believe we made changes a few months after but initially not without advice. We would suggest our change and endo would run over the numbers. Then after a few times of this when they were confident we had it, we would do them on our own. When we started pumping, we were making changes without help a few months after we started.
     
  4. Amy C.

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    You should let your endo know you want to be taught to make changes. It should be the goal of every endo that patients learn how to make their own adjustments. It is helpful to have enough blood sugar tests as evidence that a change is needed.
     
  5. Denise

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    Amy's post reminded me. When we started pumping, part of the requirement was we had to attend a class to learn the in's and out's of making changes. Fortunately we already had that down bc our endo/cde was great about teaching us.
     
  6. 4monkeez

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    Thank you all...I like the idea of initially making changes and having them approve them before I actually do them on my own...
     
  7. GaPeach

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    Good plan. Your Mommy instinct is valuable. You will gain confidence as you "see" what needs to be changed, consult endo, and they agree.
     
  8. badshoe

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    We were required to go to a pumping class before the rx fro the pump was written. It was not really hard but ot stressed how to look at data and adapt. We have since pump start made our own changes alto the first few weeks we would get a call asking us what changes we made and why.
     
  9. alismom

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    I read the book "Pumping Insulin" before we started pumping. I knew that the basal and bolus rates from the endo were not "tight" enough and made changes the very next day.
     
  10. JacksonsMom

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    I agree with pp about running the changes by your endo first. That way you will get your sea legs. We started just a few weeks after diagnosis but I know some who wouldn't make changes alone even 2 years after diagnosis. I also agree with others who suggested that you start very small in insolated instances. Maybe just start by evaluating basal needs by looking at your 3 am and wake up numbers.

    You will gain confidence over time and before you realize it you'll just be doing it! I found with my son who is was diagnosed at 3, changes are made frequently and I do think that parents should know how to do it at home. Eventually you will know more about YOUR CHILD'S diabetes than the doctor.

    Good luck!!!
     
  11. obtainedmist

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    After reading Pumping Insulin, we felt confident changing basals (conservatively, starting at .025 or .05) at the very beginning. We were sending in our logs once a week (after the 1st week which was every day) and I'd just note the changes on the log. We never asked permission to change the rates. At the pump class, they explained to us how to do the basal tests and how to switch up or down. Being able to switch ourselves was what kept me from going insane during the first 8 weeks.
     
  12. mom24grlz

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    I think i started changing basals and I:C ratios a couple weeks after diagnosis. I know that she had an endo appointment about a month after diagnosis and by that point I had already started doing some tweaking. I normally don't inform the endos of any changes until her appointments. If you're not confident enough to make changes then don't. It's only been a month since your son was put on the pump. I just didn't like waiting for the endocrinologist office to get back to me.
     
  13. hawkeyegirl

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    Within the first month instead of asking them what changes needed to be made, I'd fax them numbers and say, "I think he needs more insulin at lunch, do you agree?" After a couple of weeks of that, I stopped seeking their input, but it was a good way for me to gain the confidence to make changes on my own.

    We now give them the current pump settings at our appointments, but I don't relay changes to them between appointments.
     
  14. DsMom

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    Boy, do I feel like a scaredy cat!!:p I was glued to our pump trainer (by phone!) the first month or so after Daniel started the pump, and, after that, didn't make a change without his endo for more than a year! It was only probably around Thanksgiving last year that I realized I didn't always agree with the endo's suggestions and I should just try what I thought was right! I guess I had some good ideas, because his A1c dropped by almost a whole point. I think I was just in like a child/parent relationship with the endo, thinking I couldn't do anything without his say so. Duh!:eek: Much less frustrating now I can do it on my own.
     
  15. NomadIvy

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    no shift key so going to type really weird...

    had to learn how to change basals right away on the pump because the doctor here based his initial pump setting based on our lantus dose alone. so i had to suck it up the first couple of days because we were in the hospital being monitored. then i quickly changed the basal setting as soon as we got home based on the patterns i had logged.

    the endo we had upon diagnosis was a very progressive practice. they teach you from the get-go to learn how to adjust insulin to carb ratios and to make changes to the lantus dose. i was comfortable with changing the i;c ratios from the beginning but not the lantus dose. i probably called the 'hotline' every night for one week regarding night time corrections. the nurse one night asked, what would 'you' do... i shouted at her and said if i knew i wouldn't be calling! (ooo, i do have the right shift key, very difficult to use).

    but we do have gary scheiner and when i am too tired to figure numbers out, i email him almost a week's worth of numbers and current pump settings and he helps make changes. helps a lot.
     
  16. NomadIvy

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    ditto... read the book first and think like a pancreas and felt confident enough to make changes. just needed several sets of eyes to figure things out sometimes... and this forum helped a lot! especially with our issues with lantus. turns out it really didn't work for k.
     
  17. ShelbysMom

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    We starting making our own changes almost immediately after going on the pump. Get some good books like Pumping Insulin and Think Like a Pancreas to help you with how to adjust......getting your basals right first....then carb ratios....then sensitivity.
     
  18. saxmaniac

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    Probably 6 months or so after dx, long before pumping. Eventually I stopped calling the endo, because they only ever said "Good idea" and didn't offer any suggestions that I didn't already know.
     
  19. Midwestmomma

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    Right after Dx...and after we got out of hospital, we had to call in with EVERY MEAL for a week.:rolleyes:

    Then we had to call once a week with numbers. Then they would ask what I thought and tell me if i was right or not. I finally got tired of the phone tag, the 2 hour wait for a call back, and I finally jumped in with both feet and did changes on my own.

    The second Endo we had, she was all for me doing it all on my own. When we got on the pump. I had to call in once a day for a few days with numbers, and they would change ratios and basals for me.. Well the impatient person I am....jumped back in with both feet and did things on my own.

    Now that we are going onto our 3rd Endo (havent meet her yet..April 1st we will)... Our 2nd Endo said that she wanted us with this one cause we are very independent and I rarely call them for anything.

    I think every person is different on how they handle D care. Do what you are comfortable with.:)
     
  20. wilf

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    We started doing things on our own within 2 weeks of diagnosis, but we had excellent training from the doctors at the hospital where DD was diagnosed..
     

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