Back to the syringe, for the moment

Well, not entirely. We’re using Lantus again for Eric’s basal rate, primarily because I can no longer deal with night after sleepless night of him shooting the moon and showing ketones at 1, 2, or 3 a.m. I’m not sure exactly how he does it but he’s developed a true gift for crimping his pump site overnight, and I will wake to find him fussy in the wee hours of the morning. BG check shows him well over 300, usually, and then a check of his blood ketones will have him anywhere from 0.3 to 1.0 – and that means an automatic site change plus some Humalog via syringe. I’ve had 5 nights in a row of interrupted sleep because of this and I’m done with it - the clinic agreed, I had to make the move back to Lantus for my own well being. Sleep deprivation does bad things to me mentally. Here’s to tonight’s rest!

Sorry to hear that! Why did his sugars get so terrible at night?!

I would never second guess the treatment choices of any diabetic, but as I struggle with my own pump management I often wonder why an endro would ever put a very young child on pump treatment. We brought my father-in-law home on a feeding tube many years ago, which required 17 daily hours of infusion. Infusion sites fell out, air bubbles would form in the infusion line, Pop would roll over on the lines…the machine was constantly making alarms. There were 10 of us supporting this home care and we were all exhausted. You are not a human version of CGM. Eric is safe at night and that’s the number one priority. Sleep tight, he will have a lot of energy and a much happier Mommy to play with tomorrow.

Good plan! Hope you both get needed sleep.

Just FYI. Like many others, I had better results when I switched to Levemir.

@Rebi, lately Eric has been pulling out or crimping his pump sites. Just in the past week, I’ve been changing them almost daily (usually in the wee hours of the night) because I’ll find him sky-high with ketones after a site becomes crimped. This has been happening more and more often in the past few months and I think it’s just that he’s 3, he’s active, he’s curious, and bouncy little boys who yank at their pump sites tend to have more site failures.

@nopucksnosticks, the reason is very simple: a small child uses such tiny amounts of insulin, only a pump can deliver them with any accuracy. We used syringes for the first 10 months because of insurance issues, and we had nothing even approaching decent control because we had to dilute the insulin 1:9 just to be able to measure the doses! When a kid eats 20 carbs and needs only 0.3 units of insulin to cover it, well… that’s impossible to measure in a syringe at full strength, so you HAVE to dilute it with saline. But the problem with diluted insulin is, you’re never able to be certain that he’s getting the full 0.3 U of insulin in the 3 units of solution you draw up, so your BG control is awful. We were happy any time his numbers were below 300, much of the time. That’s how bad it was. But this is a good compromise - the pump can measure out the bolus and correction doses with much greater accuracy than we can, but the Lantus spares us from having to deal with middle-of-the-night set changes.

@Gerri - got six hours last night, and it was bliss!

Thanks, did not even consider teeny amounts of insulin, and 20 carbs, oh my. Happy for Eric and the rest of the family a new approach was possible.

Happy for your sleep!

How were Eric’s morning numbers?

@nopucksnosticks, unless you’ve been-there-done-that, you had no way of knowing. He was still a baby when Dx’d. But even now, he can eat a huge meal of 50 carbs or so and still take less than 2 U.

@Gerri, so far, morning numbers have been low, low, low - 60s, 70s, not where I want them. Lantus does have its drawbacks - with the pump I can adjust the basal rate downward through the very early a.m., and I can’t do that with Lantus. But, he hasn’t lost a pump site in the week since we put him on the Lantus and started taking the pump off him at night. So that’s a pretty telling clue that the problem came from him being irritated by the pump itself and tugging or scratching at the site.