cannula priming

Hi Harry

Cannula priming:- I was also told 0.7 by DSN and read differently in training book. Accuchek helpline DSN also said 0.7 units, which suprised me. I used to do 1.0 but then I wondered if the extra 0.3 of insulin had gone in to me, so I reverted back to 0.7. I don't know why there is a conflict between HCP's and Accuchek reps and literature. No HCP or rep or even the manual states anything about length of cannula affecting the prime, so I don't think the length is a factor....the rapid d' sets that I am now using don't have to be primed in the same way, users have to prime them before putting them in to the skin, so never any worries over priming them now.

Your 2nd question regarding high levels. There may be conflicting advice on this. For me personally I wouldn't have done a multiwave...but you did do it over a short period of time, so shouldn't have made that much difference. What was Lilly's levels before eating?
Have other levels been ok after previous evening meals, or have they jumped more than 3.0?
Depending on what your answers are, it will give more idea whether the carb ratio is wrong or the evening basals. My ratio's are now 1 to 10 for breakfast and lunch, but 1 to 8 for my tea, as I generally sit down in the evenings.

When my levels went that high on my 2 practice christmas eating days, I also gave myself 250% tbr as well as correction bolus's to bring my levels down quicker. Once I saw my levels dropping to 8 I switched the TBR off, as I knew it was going in to my system for the next few hours and would still be working. I would only do this when my high's were in the morning, as I wouldn't want to be worried of going low during the night.

It is still very early days yet, so don't get panic'd.....by the time Lilly eats that food again you will know what to do......all trial and error initially, but I would be interested in knowing what the reading were before tea? and whether her levels normally raise more than 3 in 3 hours after eating....

Bye for now
Sharon

Harry

I would change the set asap, and then start again. Check the cannula when you take it out to see if it has any blood or if it is bent.... I think the carb ratio's may not be quite right though. Has Lily ate the same foods/choc before?
Make sure you write down in the log book exactly what foods and bolus was done, and if she eats the same again, do a larger bolus.

I'm not great on dealing with chocolate bars and how they affects levels, and whether it may be an idea to do a TBR of say 200% for an hour when having a choc bar, now if it was drambuie I could have definitely given an answer for that....I only ever get to eat my mini mars or mini milkyways from lidls when I am hypo, and I know they will only raise me by a maximum of 3.

And I got to ask, are you a 100% sure that Lily hasn't sneaked anything extra----that only stems from thoughts of my own childhood!!! Not at all blaming Lily....just know what I was like!!!!

These unexplained high's - have they been after you have changed a set rather, than after you have changed the whole tube and set? Have you started a new box of sets?

So many things to think of............Sharon

If you check the booklet that comes in everybox of canulars it will tell you how much insulin to prime that particular canular, I was told by the rep to prime my canulars with 0.5u which but should have been 0.7 for the ones I use!

This could explain the reasons why an high after a set chance, some people find leaving the old set in for an hour or so after they've changed to the new one stops the high after a change...

You might have a combination of things going on that increased her levels, the rebound high after the change, as already said she might have sneak more sweats after you bolused (normal practice for a diabetic child) also you may have miscounted her carbs and the carb effect at that level!

Personally I would discourage foods such as crunchie one hell of a wack of carbs difficult to work out the asorbtion rate with the combination of the honeycombe middle which is basically pure sugar and the high fat chocolate content.. Much better to guide her to sweets, such as mikly ways, snickers as slightly lower carb value but just has nice as a treat, the fun size one are far easier to curtail the carb count, and gives the notion she had a tad more than she really has..

Truefully speaking even though insulin pumps give us a very high degree of control and flexiabilty opening up our regimes and foods... It doesn't enable free eating of carbs in reality, we still fair better and find it easier to control our levels when we stick to eating moderate amounts of carbs...

I wouldn't have done the multiwave to cover the Crunchie. even if you did a standard bolus for a crunchie I think it would be hard for the insulin to work and peak a quickly as as the sugar in the chocolate bar. Maybe do multiwave for the meal and then bolus separately for desert. I think if if she came down to a normal level then you add doing fantastic with ratios, it's hard to make injectable insulin to work as good as a human body would and if our insulin works anything unto 4-5 hours then sugary treats may cause spikes.