Pump user

Firstly from your son's DSN ( diabetes nurse) and consultant. Keeping detailed records about blood sugar and diet helps a lot.

I also found the book Pumping Insulin helpful too, and I like Think Like A Pancreas because it was very readable and had good advice on controlling diabetes

Agree with @azure, the best people who can advise on fine-tuning his insulin doses are his pump DSN/Consultant, do get in touch with them if your unsure about anything.

arno said:

My son is using the Medtronic minimed insulin pump and we are struggling to fine tune the settings between the carb ratios, sensitivity an total daily insulin in order to get better sugar readings. Where can we get guidance on how to make the correct ajustments?

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Pumping insulin as already mentioned plus no1 priority is to sort the basal out first.

Yes, DSN, plus Pumping Insulin. And don't expect it to be right in a couple of days. There are too many variables, basically. It is going to take a few weeks to be able to isolate all the effects of all the variables.

arno said:

My son is using the Medtronic minimed insulin pump and we are struggling to fine tune the settings between the carb ratios, sensitivity an total daily insulin in order to get better sugar readings. Where can we get guidance on how to make the correct ajustments?

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I am quite shocked you have asked this question as you should have all the manuals and guidance documents as part of receiving the pump........

you should definitely get the diabetic team to provide you with the correct reading material but also physical training on the pump......

how old is your son?

if he is young I can see how this has happened as carb counting/dose adjustment training seems to be a bit harder to come by if your a young child........;(

Have a look at this site:
http://www.inputdiabetes.org.uk/alt-insulin-pumps/kids-pumps/

There is a link to a workbook for children on pumps that might help to.

Arno, I live in Turkey and I use the Medtronic Minimed Paradigm 715, so it's not the latest model. I got some training from my endo, and the Medtronic representative, but I got the most useful information from reading this forum and buying the book, Pumping Insulin by John Walsh. It is not specifically aimed at children, but it covers absolutely everything about basal rates, correction factors, insulin to carb ratios, reductions in boluses and basal for exercise, etc. etc. I used it as my guide, and basically worked on improving one thing per week. You can't really adjust everything at the same time (as I discovered!). You have to make a change, let it ride for a few days and see how is works out. You may want to undo it, or make a smaller or bigger change in the same thing after a few days observation. Then make the next change. It allowed me to get balanced very quickly, and also taught me the principles about how to react to changes in my insulin needs or my activities. The other book that was very useful to me was Think Like a Pancreas by Gary Scheiner. But I think you will find Pumping Insulin covers everything you need to know right now.

@arno

Children are harder than adults on a pump.
I have a very dear friend (from this website) that has a daughter on a pump... (4 years using a pump).

I say it is more difficult with a child because they are not always with you...

As an adult we are responsible for our pumps and we realise (in time) what we should be doing- even if a set is the wrong type for us.. Or uf it doesn't feel right we can move it etc.

Children are out of parental care at nursery etc, at school, with friends etc... No matter what age they are you have not got 100% total care like an adult has over their pump...
An adult can basal test if needed but a child going without food for 10 hours is hard..... Even boiled eggs can have an effect on blood levels...

The first point to consider with a child is if they are going high or low 2-3 hours after a meal...
Even without basal testing you can get better post meal times readings by analysing this snd adjysting doses of bolus accordingly.

Night times... You need to get up and test... To see patterns and have the confidence to change doses accordingly.

Being a child and a parent with a pump is very much different to an adult managing their own pump because of external factors....

Set yourself up at soing the basics again...test for each meal.. 2 hours after and during the night....read the book and see if you can gain confidence... Your child will learn from you not nurses etc... So it is you that will ensble them for the future....

You know there's a also section on this site specifically for parents looking after children with diabetes. I am sure you can get some good info there. Also, as someone who was diagnosed as a child (I was 5), I can say that a pump is much, much better for a child for two main reasons. The first is the exactitude of hourly basal rates, and the second is the flexibility of the Temporary Basal Rate. I would have been spared many a trip to hospital in an ambulance if pumps had been around forty-odd years ago! So, good luck, and I advise you to stick with it.