Hi. Our 7-year-old was diagnosed last July and here is how we operate (based on Doctor’s directions):
– <50 Never been there yet but if the child is still conscious, go “rule of 15”: 15g of simple sugar such as glucose gels or Cake Mate cake icing squirted into the mounth (I have had to do this while sleeping and my son kinda licks his chops and goes back to sleep) Recheck in 15 minutes and repeat as needed to get BG back above 90-100+. Glucagon is for when they are not conscious, seizuring or unresponsive/unable to swallow.
– With pumps (we are new too) we have treated less severe lows (say, 80s) with temp basals of 30% reduced. He comes back up pretty quickly, say, within 45 minutes. I’d ask a doctor or nurse what a good reduced rate would be.
–Treating lows: I do not reduce basal rate permanently… I either treat with food OR reduce basal temporarily. I have been working on our basal rate, which is changing!, and what I am hearing is you have to find the right rate and then meal boluses and everything works better. Otherwise you are always chasing.
– Treating highs: If a high like 350 two hours after a meal, we correct for that and use the insulin on board feature of his Ping pump so that we do not overcorrect. If consistently running high because of a cold or such, we do temp higher basal or set a sick basal setting to run that when he is sick… say .1 or .05 higher, depending on how high he is runnig. Still check every two hours and check ketones if staying high.,
–That said on finding and sticking with a basal rate, we: set basal rate lower after 2pm at school (.05 unit/hour less ; he’s on .5 an hour) when is is most active, and for snacks that he might get a bolus for we do an I:C ratio of 1:20 vs 1:15. I had been also running a lower basal rate than during the day at night and it was working well, but now he has been running high on that. One last deal: We reduce his basal rate at bedtime by .05 for three hours after a very active afternoon or sport – we’re told the latent affect of exercise kicks in.
Bottom line is separate basal from corrections (up or down), unless sick or stressed – when you use a temp higher or lower basal. So, find the basal that keeps your little one in range while at rest and then treat/correct two hours after meal/bolus as needed. Get ready to have to adjust your basal rate as your child changes.
I am ready to be corrected by a diabetes educator I am a parent who is still learning. It is best to run these questions and any changes by your diabetes team.
I have not yet found a sweet spot for the pump that gets us in range for more than a few days at a time. It’s been furstrating. We were having better luck on injections. But we are thinking it is coincidence with growth spurts, or (remote possibility) infusion site issues. Any advice for a new pumper with a rough start? Anyone?