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ACCU CHEK PUMP

Discussion in 'Insulin Pump Forum' started by stoney, Jan 29, 2014.

  1. stoney

    stoney Parent · Well-Known Member

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    Hi Everyone,

    James is having a pattern with his morning readings at the moment in that he wakes up with a good reading, then 1 and half hours later after having porridge and toast for breakfast his readings are sometimes in double figures, then even if he does not do a correction, he comes down with a bump 2 hours later. He is going to his clinic on Monday but in the meantime the DSN has suggested he does a multiwave dose. On reading the instruction manual we are both lost in that he was not sure if he would give himself too much insulin and have a problem during college.

    His dose for the morning was 7.5 he wanted to give a 5 dose straightaway and then a 2.5 - 4 hours later, but he was a bit unsure about it and wondered if anyone on here is using this type of drip feed and could give us an Idiots guide so he might try again tomorrow morning. Failing that, we will wait to see the DSN on Monday and maybe he needs to adjust his basal too.

    Hope there is someone out there who can help

    Cheers
     
  2. iHs

    iHs · Well-Known Member

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    Hi Stoney

    Ive not used multiwave myself very much as usually when I do, my bg levels usually go up much higher than I'd like as I dont get the balance correct so usually I stick to standard and that is more or less ok for me.

    Jopar did some msgs on the forum a while back about using the wave http://www.diabetes.co.uk/forum/threads/eating-pulses.24751/
    and
    http://www.diabetes.co.uk/forum/threads/accu-chek-combo-multiwave-bolus.21981/

    There is also this one which is quite good
    http://5childrentype1diabetescoelia...1/07/meals-bolus-types-for-insulin-pumps.html

    and this

    http://www.uclh.org/PandV/PIL/Patient information leaflets/Advanced Bolus Options.pdf


    Might be better for James to use standard to deal with the carb in the bread and then possible use one of the waves to deal with the porridge. Better still..... skip the porridge and just eat the bread lol
     
  3. jodysd6

    jodysd6 · Well-Known Member

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    I use multiwave with some success but mostly for things that are causing highs at the 3-4 hour mark where in this case it sounds like at the point there is a drop. What insulin is he using and how long before he eats is he blousing? With the high before 2 hours then a drop sounds like insulin is not having enough time to be working before the carbs cause the rise, maybe try blousing a bit sooner, depending on the amount it drops later then he may actually need less insulin but just tweaking it so it is peaking at the right time?
     
  4. mrman

    mrman Type 1 · Well-Known Member

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    Hhmm, may work but multiwave would generally mean having an initial percentage dose of suggested dose, followed by the rest of it over the course of an hour. If using same ratios and bolus amounts will result in a much higher 2 hour reading. If going into the teens and normal before next meal a multiwave would not help. Multiwave is mainly used to prevent lows 2 hours post meal not highs. when having a large carb/fat meal it often results in a delayed reaction of absorbtion of the carbs followed by a high after 2~4 hours. Things like pizza,lasagne good examples. When these are bolused for in full often results in a 2 hour low followed by a high. Multiwave allows a portion of insulin initially to prevent the 2 hour low, followed by another smaller wave of insulin to prevent the high after the 2 hour mark


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  5. stoney

    stoney Parent · Well-Known Member

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    Thanks for your replies. IHs thanks for the info, very informative. James has decided he is not confident enough now to change anything at the moment and is going to wait til he goes to clinic on Monday.

    Thanks for your support.
     
  6. mrman

    mrman Type 1 · Well-Known Member

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    Porridge and toast is alot of carbs for breakfast, with little fat. This means carbs are converted to sugar very quickly, with not much left to absorb after 2 hours,resulting in a post meal high,followed by a normal pre meal next reading.
    However, this may happen even with reduced carbs at breakfast as many people are more insulin resistant in mornings or, their body is raising sugar levels naturally.
    Could be he needs slightly less bolus for breakfast but an increased basal rate an hour before breakfast and an hour after breakfast. By increasing basal there would be more insulin working before meal is eaten.

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  7. stoney

    stoney Parent · Well-Known Member

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  8. stoney

    stoney Parent · Well-Known Member

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    Thanks Brett, his DSN did say she may need to adjust his basal rate for the morning. He does like to have a good breakfast as he does not get much time to have anything else to eat until 1ish and he is a growing lad, more up than out though which his consultant is happy about , saying keep him lean, keep him lean!!!
     
  9. mrman

    mrman Type 1 · Well-Known Member

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    I'm the same lol but done all my growing.

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  10. ElyDave

    ElyDave Type 1 · Well-Known Member

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    No problem with that at all, but does it need to be so high carb?

    I have porridge routinely, but bulk it up with nuts and seeds to add protein and fat as well, tends to keep me fuller for longer as well as lowering overall GI.

    Or you could go with porridge followed by eggs for the extra calories perhaps?
     
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