Hello all my name is Mike, and I'm the father of a 13 year old boy who was diagnosed with type 1 in March of this past year. I have been visiting this group for a few months reading and trying to learn as much as possible for obvious reasons.
Every time I come on here, it just makes me realize how much I don't know and that this will be a life long learning experience for our whole family. The first question I would like to ask the group is can anyone provide their opinions on my son being on Novolog 70/30. At first I thought it would be good for him, only two shots a day, but now after almost a year, I'm having serious reservations. For one thing, just when we think we have his ratio nailed down, we're thrown for a loop with a BG reading. His A1c two months ago was 7.0, but I was expecting it to be better. I've been looking at and reading about a pump for him, it seems everything I read, and everyone I know and run into that has one, has nothing but good things to say about them.
Hello there, this is a great site for information and support, interesting him being on the 70/30 are you all from the US? most newly diagnosed kids are put on lantus and novolog at meals. the biggest question is, is your son ready for a pump. with his A1c at 7 i'd say you are doing well but will need to intensify his therapy at some point, it is an adjustment moving on to a pump i would speak with your endo but probably doing the lantus and novolog with meals and snacks if needed accounting for carbs, correcting bs's and all that would be the next step. if you have any other questions feel free to ask, my son is 13 also diag. at 10 and started the omnipod 8 months ago, it has been nice not doing shots and having the other features but there are also some new worries. hang in there you have found a good site for infomation from people that have been there not just an endo that you see for 15 minutes! best wishes amy
First of all, a 7.0 is a darn good A1C. Keep in mind that he is going through puberty, and this makes control REALLY hard. Growth and sex hormones all cause insulin resistance, and this means he will have more high BGs that are generally harder to correct. Once puberty is over this will settle down.
One thing to keep in mind is that kids can generally tolerate high BGs better than adults can. Lots of lows will make it really hard for him to concentrate and can hinder brain development, something that is still occuring at his age.
What you really should be looking at is his standard deviation (SD). Is he achieving a 7.0 A1C by having extreme highs and lows, or he generally more steady (like hovering consistently between 120 and 200)? I can tell you from experience that those huge jumps make you feel lousy. You feel a lot better when your SD is smaller.
Pumps are awesome. I've never heard of a T1 kid being put on novolog mix before so can't help you there. While fewer shots sounds enticing, it usually doesn't work out to meaning better control.
If you want my personal opinion (and if this were my kid and I had the financial resources to do so), I'd be working to get him on pump. Pumps provide A LOT of flexibility. There is a learning curve, but with a pump you can easily adjust for all those little things in life (snacks, physical activity, etc). I use the Minimed Revel and love it. My personal recommendation would be to go a with a tubed pump (Revel or Ping), but that's just me.
If you have any specific questions, you're more than welcome to private message me.
yes, we are from the U.S.From what I've been reading and other parents I have talked to, I'm also starting to think it is strange he's on the 70/30. I do think he could make a smooth transition to a pump, he's very techno savy and mechanicaly enclined. Luckily we've met two area children about his age who just got their first pumps about six months ago. I haven't yet spoken to them since because I wanted them to experience them first before I started asking questions. I hope to contact them this week.
In my opinion, he has at times had a large SD. Some times before lunch he can be in the 60's or 50's but then at dinner he'll be over 200. We are trying to adjust, but just when I think I have a good grasp of balancing his snacks with the amount of 70/30 something goes haywire. That's probably the biggest reason I'm looking at a pump for him, I want better control, even with my lack of knowledge, common sense says that type of a swing can not be good long term. Also, I feel a pump can give a person much more freedom of choice and flexibility.
I work in health care and I am really surprised to he is on 70/30 starting off. I've had Dr's tell me 70/30 is usually given to people who have a hard time figuring out how to dose for carbs they eat, or if health insurance is an issue because 70/30 is a MUCH cheaper insulin to be on versus Humalog and Lantus or one of those combinations.
My honest opinion of it, I was on it for years, but its really not the best insulin at all to be on, it can cause some wicked lows if your not careful. You really have to be on top of when you need to eat, not a lot of flexibility with it, and just really doesnt give you very good control I think your son would do much better on something like humalog/novalog and lantus/levemir.
And I think too def a pump can give you even more flexibilty and control. But it is a lot of work to keep on top of it. Probably more so than injections. I think sometimes people have the notion its a very easy fix. I think as long as your son keeps that in mind, that he really has to be even more diligent about checking bs and staying on top of that, than definately a pump is a very good option.
If he can operate an iPhone or comparable smartphone, he's more than qualified to operate an insulin pump. The only thing you want to make sure of is that he has a decent handle on doing MDI. A pump is great, but it's a gadget and can fail/break. Most of us have experienced a pump failure/disaster at some point and have had to go back MDI while we wait for the new pump to arrive. Always good to be familiar with your back-up plan. I would recommend going ahead and starting the process. You may run into some snags with insurance, but less so than what we used to go through getting a pump.
I need to agree with the other responses and say that 70/30 does not seem like a good choice to me, unless it was used just to stabilize your son right after diagnosis. 70/30 is a pre-defined mix of NPH and Regular insulins, both of which I took when diagnosed over 30 years ago, but hardly used today in Type 1's. NPH has all sorts of peaks and valleys in terms of effectiveness, and regular is slow-acting as compared to today's more modern insulins. With a mix like that, you find yourself "feeding the insulin"... eating to accommodate the insulin you've injected, rather than adjusting the amount of insulin to accommodate the food you're eating. And 70/30, which is a common ratio, does not leave much flexibility for tweaking dosages.
Is your son seeing an endocrinologist who specializes in diabetes? You really would need someone whose career revolves around diabetes, not a general doctor who sees many patients with varying conditions.
As far as advice, I'd suggest finding a pediatric endo in your area. If you live in Boston, as your profile icon suggests, I know that's a very good part of the country as far as medical expertise (and research!) goes. I'd also suggest asking about switching to Lantus (for long-term basal coverage) and Novolog or Humalog (for mealtime coverage). Unfortunately, diabetes isn't about going with the fewest number of shots.... the shots are the easy part. It's about finding the balance between insulin, food, and blood sugars. You and your son will find that balance a lot easier with Lantus and Novolog/Humalog.
I wish you guys the best of luck, and I hope you'll hang around this site a lot and learn how to help your son care for himself as best as he possibly can...
Thank you to everyone who responded since I was last on, I can't come on often so please forgive me if I respond late or not at all. We're in the begining stages of searching for a pump, and as days go on, I'm convinced it is the right thing to do. I've read some old posts, and there was some discussuion on a "Solo" pump. Has this been released yet, or is Omnipod still the only unteathered one out there.
Scott and Christy, I think your comments regarding the 70/30 have hit the 'nail on the head" with what my observations are telling me. Scott, I was thinking exactly that (feeding the insulin) tonight after my son's BG was low after us going up on insulin two days ago because he was trending high at the same time of day. We have a Dr.s appt. in two weeks and I will be making lots of inquiries as to the 70/30 being the best plan.
Scott, Yes we are B's fans, always said I wanted to see them win it before any other Boston team, but better late than never. We have been spoiled here since the early 2000's. Who is your team, I'm to lazy to look it up?
My daughter is 15 & just got her pump in August 2011--she was diagnosed Nov 2010. She went from Novolog & Lantus pens to her Animas pump. It seems doctors like the kids to go with shots for a while?? So they learn how to do the basics, because they might need it in case of a pump malfunction. Plus, they're learning how to count carbs, etc. The pump is yet another learning experience. Samantha's A1C has been hovering around 7 for an entire year, but she definitely bounces all over the place with her blood sugars & I've been surprised sometimes that it turns up with 7 instead of something higher, because it seems like we're a little out of control. But I've definitely seen some numbers that we have no influence on due to teenage hormones, so I'm thinking 7 is ok, although I'd rather see a 6. So -- just my experience as a newbie with a teenager -- I don't know anything about 70/30.
Scruff, you've got a great attitude about this! As far as I know, the Omnipod is the only commercially available untethered pump right now, but there are lots of people who prefer the tethered ones, Some are disgusted by problems they've had with the Omnipod, yet others absolutely love it and swear by it, My point is this: look at all the +'s and -'s about each pump before deciding, don't let tubing be your only criteria. I still think it's a bit too soon to look into that, though. Try Lantus/Levimir + Humalog/Novolog injections first, It'll make the learning curve a bit easier, and figuring out starting doses easier as well.
By the way, I'm a Devils fan. Not sure yet if I should be proud of that fact this year! Leading the league in shorthanded goals FOR and shorthanded goals AGAINST really confuses a fan like me,
