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worried about first night

Discussion in 'Insulin Pump Forum' started by ams162, Jan 31, 2011.

  1. Slinger

    Slinger · Well-Known Member

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    dont forget when you play around with the basal setting, you have to leave it 3 days for everything to settle down and get the true readings from the new settings
     
  2. donnellysdogs

    donnellysdogs Type 1 · Master

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    Anna Marie

    If Dylan is going low at 8pm, what time is he eating and having his bolus before that low?

    You can probably see by now that although he was 4.2 at 10pm his levels went quite significantly upward. If this occurs again, personally I would hold off 30 minutes and do another test before giving another quick acting food.

    You need a night without any high's or low's at least 5 hours before hand to really establish what is happening with Dylan.

    I have a feeling that possibly his carb ratio needs tweaking at tea time, and his basals may well need to be raised a little during the night.

    Saying this, don't forget that if Dylan is high or low at any point due to his basals-it is 3-4 hours before hand that you need to alter the rates for, right up to the hour where the high or low is occuring.

    It is so much easier to sort out high's than low's initally if they are high's due to actual bloods and pump. If the high's are due to rebounds from hypo's you don't really get to see the true picture of what is going on.

    You are so early in to the change over, and it is such a hugely different regime, you have to congratulate yourself that you are so confident and adept at handling the pump so quickly.

    Also, I was reading John Walsh's book last night, and the amount of quick acting to get a person out of hypo, according to him can be scaled by body weight. It may be that Dylan being so young and small compared to us adults that he actually doesn't need the standard gamount of glucose (jelly babies, M&M's etc) to raise him up....

    You are doing best keeping Dylan out of hypo land, but until you can alleviate the low's 5 hours before going to bed, I think it will be slightly difficult to find out truly what is happening at night. It would be better to cure the low's before bed to ascertain what is happening during the night.

    Best wishes...Sharon
     
  3. donnellysdogs

    donnellysdogs Type 1 · Master

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    Slinger,

    I didn't realise that you have to let it go about 3 days before you get true readings from altering basals..... I know that was always the way on MDI, but I thought that was part of the point of having a pump, that it was all quick acting insulin that is in and out of our bodies within 5 hours, and no background working. I may have learnt something new, as with me, I can honestly say that I can raise or lower my basals, and the affect the next time I hit those new basal rates are immediate....
     
  4. ams162

    ams162 Type 1 · Well-Known Member

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    i didnt realise about the 3 day thing on a pump either they didnt say that, i know u need to let the amounts settle abit to get the true picture tho.

    he has tea at 5 with bolus given just before i was thinking its possibly the ratios as he is on the same ratios he was on with MDI and i believe with MDI u always lose some on the skin and end of needle this way u dont so i assume hes getting slightly more insulin in his body because of it small amonts i know but he isnt on alot

    i realise we dont have a true picture yet i want to get rid of these lows to be able to see what is happening hence why i lowered a few things yesterday will wait a few days and see what happens now and go from there i think yesterday and monday he had exercise after tea too so be good tonight to see a picture without exercise

    thanks for everyones help i really do appreciate it :D :D

    anna marie
     
  5. donnellysdogs

    donnellysdogs Type 1 · Master

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    Anna Marie

    If Dylan is eating at 5pm and hypo by 8pm then you do need to adjust his carb ratio. If for example he was on 1unit to 10cho, then you would need to adjust it to 1 to 11 or even 1 to 12. Just make sure you do it in the right direction!!!!

    Low's 2-3 hours after eating can normally be attributed to the bolus ratio's....and personally, I don't think we do have to wait 3 days for levels to sort out either, on MDI yes, but not on pumps.....you should see an immediate effect when you alter the levels of anything with the pumps the nest time you do the bolus or the next time you hit the new basal rate time....
     
  6. ams162

    ams162 Type 1 · Well-Known Member

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    i altered his bolus for tea time after last nights low so will see what difference that has made tonight i guess. everything is so trial and error and can see how good the pump will be tho when its up and running with correct amounts and its lovely to be free of those injections.

    we will get there im determined to work hard writting down every detail i possibly can there have already been some good numbers in amongst it which is great as dylan had a habit of being in the 20s on MDI so to see some in the good range makes me smile :)

    anna marie
     
  7. donnellysdogs

    donnellysdogs Type 1 · Master

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    Just fantastic Anna Marie. Your determination is just enormous, the smiles just shine through from you. Well done.... I'm sure that altering the carb ratio will fend off the low's, the ratio may need a couple fo days to tweak, especially if Dylan is doing different things afterwards.

    It is a totally different regime to get used to, so just thinking you are sooooooo good :D Sharon
     
  8. ams162

    ams162 Type 1 · Well-Known Member

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    when u think u have to fight so hard to get a pump and wait a year in our case u have to be determined to make it work otherwise what was the point in fighting to get it :lol:

    thanks for ur continued support sharon i really do appreciate it

    anna marie
     
  9. Hazza

    Hazza · Well-Known Member

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    Hey Anna Marie, well done on holding off on the biscuit :) .
    I also think that the changes take effect straight away (next time the clock turns round), but we have been told to let things settle for a day or 2 and then evaluate the readings.
    I mentioned in a previous post that Lily's bolus ratio has changed since being on the pump and you could be right about the small drop on the skin accounting for this. Personally I think that it is because her basals are more acurate rather than having a flat background insulin over 24 hours.
    When we started pumping Lily would have her tea at 5ish and then nothing more untill breakfast. This way we could start checking her basal rate from 10 oclock, if the levels were within range or slightly high we left her but if they dropped below 4 then we treated the hypo. This way we could see if the basal was too much, too little or about right.
    You are doing great so far, keep it up.

    Harry
     
  10. ams162

    ams162 Type 1 · Well-Known Member

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    thanx harry

    just got back from school and he was 2.2 so that wasnt great but let him have 15g of fast acting then he sat down to eat his school dinner so hopefully be ok for the afternoon now. we will see what he is on coming home and see if the afternoon was any better looking forward to the weekend when i can monitor properly what is happening. i guess in some ways its easier to do a pump start in a school holiday so u can get things sorted before they return>

    anna marie
     
  11. Hazza

    Hazza · Well-Known Member

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    It would be easier when off school but Lily had her pump fitted and running by 10.30 and then went to school in the afternoon (Monday) But as I said she was only on .15 basal so she ran a bit high untill we brought it down. We didn't experience the lows that you have. Possibly because of her low start up rate. We didn't have to correct the lows with fast acting carbs so the only thing to do was bring her basal rate up untill it levelled out, this was really easy compared to correcting for both high and low. We gave corrections when she was high to bring her into range and then tested her at regular intervals to check her background.
    Hope that makes sense.

    Harry
     
  12. ams162

    ams162 Type 1 · Well-Known Member

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    yes it does make sense harry lol, we will get there be good to get a proper handle on it the weekend. will speak to DSN again later see what she thinks we do from here dont want to lower too quick as feels like ur playing catch up else.

    does feel like we are yoyoing at the min between highs and lows but its still early days so to be expected was never going to be perfect straight out :lol:

    anna marie
     
  13. ams162

    ams162 Type 1 · Well-Known Member

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    really pleased hes come home from school today and bloods are 6.2 how chuffed am i lol result :lol: :lol:

    anna marie
     
  14. SophiaW

    SophiaW Type 1 · Well-Known Member

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    Great result Anna Marie :) It's hard work with lots of testing initially but will be so worthwhile once you have it sorted. I've found for Jess that a 4g carb glucose sweet is enough to raise her BG by 2 to 3 mmol so maybe keep an eye that the 15g you're giving Dylan isn't too much and pushing him the other way. At night when Jess has been slightly low (e.g. 3.8 ) I suspend the basal for half an hour and that brings her readings back up to the 4s or 5s which is so much nicer than waking her to eat something.
     
  15. ams162

    ams162 Type 1 · Well-Known Member

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    thanx sophia, i think the next time i do treat i might try that give one gluco tab and see where he goes its good to know for reference anyway, the suspend is interesting i thought they said dont use suspend to treat a hypo but i guess if it works for u then thats great :D

    was so nice seeing that blood result in target its funny how a good number can improve ur mood so much :lol:

    anna marie
     
  16. SophiaW

    SophiaW Type 1 · Well-Known Member

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    I only use the temp basal (-100%) if she's only very slightly low and there's no active bolus on board. And always test again to make sure the hypo has been corrected. If there was active bolus on board then she'd need to be treated with a glucose as the reading would be falling a bit quicker.
     
  17. donnellysdogs

    donnellysdogs Type 1 · Master

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    Brilliant Anna Marie to come home to 6.2 what a result..

    Think from Sophia's message below she is agreeing with what John Walsh book says about the weight of people and qty of quick acting grammes needed for correcting hypo's. You may not need the standard 15 g that DSN's say to give. Sounds like what you did at lunchtime worked well.

    Look forward to reading your posts later to see how Dylans tea and night time goes.....keeping my fingers crossed for you that you will find a difference with changing the bolus raio.

    Well done Anna Marie and little Dylan....
     
  18. ams162

    ams162 Type 1 · Well-Known Member

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    oh i see makes sense i suppose when u say it like that its all little tricks that get us the good numbers isnt it :lol: :lol:

    anna marie
     
  19. Hazza

    Hazza · Well-Known Member

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    WoooHooo! looking good. You must be doing something right so keep doing it. :D

    Harry
     
  20. ams162

    ams162 Type 1 · Well-Known Member

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    well i thought so harry lol but then an hour later he was 3.1 so did what sophia suggested and gave one gluco tab (4g) and waited to see what he was 15 mins later he was then 7.4 so think ur right about the amount.

    we have just eaten tea so will wait an hour or so and test again :D

    anna marie
     
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