Age of kids bolusing with MM pump bolus wizard

Hi we are getting the minimed VEO pump later this month for our son who will be 6 next week. We are having issue with the school being able to supervise his shots or the pump (we are in canada so no 504 plan, no school nurses. right now i am leaving work to go to the school everytime he eats which is defenatly not ideal). I know the bolus wizard is relatively easy, but at what age are your children able to bolus on their own, unsupervised?

We have a Minimed Revel as we live in the US. My daughter is 12 and does all her bolusing at school without supervision. We have only had diabetes since November 2009. The only thing that you need to make sure is that there is an adult that can supervise the number of carbs that he enters into the pump. The bolus wizard will calculate everything needed. Also, if there is any doubt about the carbs, he can always test 2 hours later and do a correction bolus if needed.

My daughter is 7 and we let her operate her own pump, but always have an adult to supervise her by telling her the carbs and double checking the amounts she puts in before she activates the last step. Luckily, she has a nurse in her school most of the time who assists and a teacher, who is willing to supervise as well. Our daughter’s Dr. requires her to have supervision and it is written in her medical request forms. In our school system, all students taking any medication, including insulin, must do all glucose checks and insulin doses in the nurses office. Jaylin is not even supposed to get an insulin dose in school without a nurse present. That is always not possible, but is supposed to be the way it works.
I’m sure it is terribly hard for you to have to be present for your son to do insulin doses. It might be possible for his teacher to assist since she is with him. Most teachers are willing to help and want to be empowered to help their students. It would be better peace of mind for you and her also, if she knows how to help take care of his needs. Good luck!

while it might be possible as far as the teacher is concerned, it is the school (and the superintendant) that is saying no. at least not without official training by our DER which happens to be 644kms away. which means maybe in a few months they will have someone trained and then if that person is ever away we are screwed for that day. plus i am suppossed to travel to neighbouring communities for my job 1-2 days per week.
I was wondering about the possibility of totaling his lunch carbs and snack carbs (and packing them separately) and putting the total carbs on a piece of paper and have him match the numbers, but I don’t think i am comfortable with that without someone double checking. So I thought I would find out if other children his age have been capable of this.

My son is on the omnipod, so I go every day to give him insulin bolus. He’s 6. I have to go everyday for a different reason though. The cafeteria is such a huge distraction that I can’t trust Will to eat everything. When I have bolused and left, I’ve found his entire sandwich left in his lunch box because he “ran out of time”. The days I can’t go and my husband or mom goes for me, I just write the carb grams on all of his baggies. It’s a pain to go everyday, but I do it so I have the piece of mind he’ll eat everything I bolus him for. Maybe your teacher could just double check like you said on the days your out of town. She could text you so you know. My sons teacher does his blood sugar and we text often to communicate. (Her husband and daughter are both Type 1). I don’t think it’s unreasonable to ask your son’s teacher just to verify that he puts in the correct amt. Your son would be giving himself the insulin if that’s the problem she’ll just double check the #. My daughter is 9 and she is able to bolus for my son, but Will isn’t handling the pump yet except to push the button to connect his pod.

his teacher is not actually with him during lunch. there are 3 EAs in a room which I am guessing has 4 or 5 classrooms of children in it. I am hoping the school can secure funding for an EA just for him.
also, does your son have snacks at school? My son’s class also has 2 snack times and while our plan was to just have free stuff it only took 2 days for him to complain about that:P

My daughter is 10, which is a lot older than 6, I know. I write her carbs on a piece of tape in her lunchbox, and she calls me everyday at lunch to tell me what her sugar was, remind me how many carbs she’s eating (she will eat all her lunch), and to tell me what the pump has calculated. Another T1 at our school follows the same procedure, except that she texts instead of calling. I think 6 is young.

As for snack, she only eats free snacks. Lots and lots of nuts - and about every kind there is, beef jerky, and sometimes veggies.

I’m frustrated for you by your school. My daughers go to private school with no nurse and no one trained except by me. I train them to understand what D is, the symptoms (might help another child), about food in general, and recognizing / responding to hyper and hypo. They don’t know how to calculate a carb or operate the pump. Really, you’re in the same boat, but my school does everything possible to accommodate Clara and I, and your school…not so much.

Will doesn’t generally have a snack until after school, but I do keep and “emergency box” with snacks around 15 grams each and the glucose tabs and juice if he needed one. He quit eating a snack after getting th pump.

normally Ezekiel doesn’t have snacks either since switching to lantus (though occassionally will ask), but since his whole class is sitting eating a snack together at the same time, he naturally wants to eat with them too. the problem with free snacks is that he is too smart for his own good and knows they are free snacks which makes him feel like he is being jipped somehow.

just to clarify, the school is working on helping us and I did not plan to have him bolusing unsupervised. I guess since we are planning to use the bolus wizard and it is very easy, I was trying to find out how much/little supervision children his age generally have with it. Right now I am going to the school whenever he eats carbs (which right now is lunch and one of the two snacks- which was our comprimise from both snacks being free to neither being free) to add the carbs and dial his pen for him (he does his own shots). The problem is they need someone trained by ‘real’ professionals but since we for sure will be pumping by october 5, I told them to skip trying to train someone with the pens and just go right to the pump training.

I would be very nervous about having a six year old bolus without supervision. Is there any way an aide or another adult could supervise that he is keying in the right numbers. You could give him a cell phone, they could call, you go over the numbers put in the pump, the carbs; they can read off the amount of insulin pump recommends and you will then know it is correct. They would wait for your confirmation before confirming bolus on pump. It helps to give the same amount of carbs every day for lunch and Minimed pump more helpful as once the pump recommends the insulin bolus, you do not have to dial in the bolus like the Animas. I think this will eliminate error. If you speak to the school, ensuring them you will make all decisions over the phone, you just need an adult to double-check with you, I hope the school will agree. There is no other way; he has to eat. P.S. Treats in the class, teacher could call you on cell, you can look up carbs in calorie king and teacher could supervise bolus. What is the school’s solution? That he not eat at all the eight hours he is in school???

My daughter is 10, 9 when she started on the pump. We have stuck to a 40g carb lunch to keep things simple. She eats everything but any ‘free’ foods that are optional. For the first 2 years of her D, I went to the school everyday at lunch and she just didn’t get to eat carb snacks. Last year (grade 4), she started on the pump and I had her call me at lunch with her BG and plug in the 40g to her pump and tell me the amount of the bolus. At the end of last school year she felt she could do this without calling me every day so we tested it out and for the most part this has worked. She forgot to bolus a few times which resulted in her having to call her lunch BG numbers in again for awhile. She is very ‘good’ about dealing with her D but still makes mistakes, forgets to bolus, doesn’t eat something she should have. I would say 6 is too young to do this on his own. My recommendations would be:
-keep the lunch carb amount the same every day - your bolus wizard could read “School Lunch”
-have an adult supervise him entering anything into his pump and call you with the resulting bolus amount or, it this isn’t possible, have your son call you and check the numbers with him - the bolus amount being the key thing to check and for you to confirm before he presses go. Can you two Skype at lunch?
-have an adult check and make sure that he has eaten all his carb food
-have some ‘free’ options that he can choose not to eat something if he wants to get outside sooner or just wants some choice.
-same with the snacks - it really would be best if a supervisor could check that he did in fact enter the right ‘snack’ or carb amount into this pump and then have him confirm that he has eaten it all
Best of luck with this, I know it’s difficult.

again, I would not have him doing it unsupervised (though I did toy with the idea of getting him a cell phone but I still wouldn’t be able to see the number). The school is willing but the problem is they won’t double check the number even until someone can be officially trained by real trainers on the pump. which also means if the trained person is away they will have no one. their solution? I can just drive over to the school everytime he eats (which is what I am doing right now) or I could just move him back to NPH (like the other type 1 students before him who never needed insulin at lunch. in a way it was good they had these other students as it gave them some knowledge, but on the other hand they had a set way of dealing with things and we aren’t fitting into that mold:) I have really good communication with his teacher and I think she would be open to snack bolusing (if the school would allow it), but she isn’t there at noon hour. They are also in the process of trying to get funding for him to have his own TA since I informed them that other children his age are getting this funding (which they didn’t seem to think he fit any criteria, but now are looking into it) which would help also.

right now my son’s lunches vary a lot. he gets way more angry over food restrictions than needles. The first 2 days of school he had only free snacks. the 3rd i came to the school for both then we strted to do one free, one carb snack, which puts me at the school twice a day, but the last 3 days he hasn’t eaten his free snack and it has been wasted (since it has been perishable). i never thought of skype, but i don’t know a lot about it. something to look into.

I could not see where you are located, if in the U.S.? What they are doing is against the law. But since they are in the process of accommodating you and they are working with you to get him an aide or train personnel on the pump, I would just bide my time, come in to the school to bolus as you have been doing. I would stress they are legally responsible for doing this sooner, rather than later. They are leaving you with no other options. I don’t understand why they won’t allow an adult to look at the numbers on the pump and read them off to you at each stage of the bolus while you are on the phone with them. Does not have to be a cell phone. When your son reads off the numbers you can have calculator in hand to see if everything is correct. Too risky for him to do it himself. Kids are careless, can fly through the pump and push the buttons quickly. I would be afraid he would make a mistake at some point.

we are in Canada. it is not a law that they have to accomodate. I guess partly i thought if i threaten to have him do it solo the thought of him making a mistake and going low at school might be more scary to them then having someone assist him, but I just wouldn’t be able to follow through with that threat-lol.

Skype is a brilliant idea! Don’t use it myself so don’t know how long it takes to set up.

Takes only a few minutes to set up Skype.That would be great, as you could see his pump # for yourself with careful positioning of a webcam.

I put a post-it in my son’s PDM case every day with the amount of his lunch carbs. He is doing his own bolus now that he is 9, but up until last year, he would just have an adult watch over his shoulder to be sure he put the right amount of carbs into the entry screen. Other than that, we allow the PDM to determine the bolus amount, as it is quite accurate. Any adult can do this. You could even have a buddy do it, for that matter.

Hi there!

I’m in Canada as well.

My son is 6 and in 1st grade. He sometimes boluses himself at home under my supervision but an attendant does it for him at school. He’s getting the hang of it, but I don’t plan on pushing him to do it before grade 2 (mind you, we have the luxury of a full-time health care person at school).

What helps us: The basal program is configured to cover 2 snacks of 15-grams of carbs each.The basal rate is increased about 15-30 minutes before snack time and it seems to work out well. So no bolus necessary for snacks. Lunch at school is always 50 grams of carbs. Easier for the attendant, no notes necessary. I presume it will also make things easier when my son does his own bolusing. It’s a pain to prepare lunches in the morning to arrive at exactly 50 grams of carbs, but worth it.

Good luck and congratulations on getting the pump!