Son new to pump - i have a question - and need some support too :P

my son is three and started on the ping pump tuesday - so far its been a good transition i think
i am disappointed in the lack of support from his diabetic nurse and am looking for advice
i will be contacting her again today but thought people might have an idea

so he has been on the low end still through the night so at 3am he gets some juice to get him through the night
he was low this morning 3.8 and i gave him two tabs and then his breakfast
i did his bolus based on the 3.8

then when i checked him at two hours past he was 20
so now i did a correction bolus

yesterday the exact same thing happened in the morning

but then at lunch he was low again
so i am guessing thats what will happen today

any ideas

am i over treating the low?

i’m overtired right now and getting frustrated
he shouldn’t be going up and down like this

Depending on how much juice you are giving him you may be “over treating”. It doesn’t take much. Kids also love glucose tablets, you could try two or three of those. It is possible that his night time basal rate needs to be adjusted to a lower rate.
You said he was also low at lunch yesterday? Was he playing physically at all before that? Now that he is wearing a pump and has that continuous basal, lows seem to sneak up when you’re expending energy. You can temporarily lower the basal rate for any given amount of time to help that. Just something to be aware of, but never ever stop playing. I’m sure you two will get the hang of it. It took me a little time to get used to it. In the last two years since I’ve gotten me pump I have changed the settings a ton of times, all been worth it. Good luck

Hi Matilda. It sounds to me like his night time basals might be off just a bit. Typically late evening (right around bedtime) the basal rates are cut back a bit because a lot of people find this is their lowest needs of the day as far as basals. Sounds like that time period may be a bit too high. When you treat him for low sugars is usually right around the time most people’s basal rates are the highest to control for Dawn Phenomenon. It sounds like you are treating him right when this period would happen. I suspect if you did not treat him his blood sugar would climb throughout the rest of the night (although I don’t think you should not treat him). Of course this is different for everyone and when it is a kid all bets are off. I hope you can get some better sleep in the days coming. You may try to post this in the Parents of kids with Type 1 forum as they will likely have a better idea of what ‘normal’ (there is no such thing is there?) basal patterns may look like in kids.

It does take awhile to get the hang of the pump, and if the diabetic nurse is little help, you will have to work on tweaking the numbers yourself. If you don’t already have it the book Pumping Insulin by John Walsh is invaluable. A couple thoughts: For me, if I listen to the pump and lower my meal bolus based on a lowish number, I generally go high after the meal. I generally just bolus for the carbs I’m eating. Especially if you gave him two tabs and then his breakfast, you were giving more carbs and bolusing for less! (I assme you didn’t count the tabs. What I do when I’m low is either treat with glucose tabs and then wait to bolus and eat until the blood sugar comes up to normal. Or else I just go ahead and eat, bolusing either right before I eat or after I’ve started eating rather than waiting 15 minutes as I usually do.

If he is going lowish during the night and needing juice at 3AM to get through, he is taking too much basal. Most of us set our basal at different levels for various time periods as our needs differ and this is one of the great pluses of pumping. But it does take awhile to get the basal levels where you want them. John Walsh says to plan a three hour ahead, so if he is low at 3AM you would want to lower the basal for the period around midnight. Keep good records and after awhile you will see the patterns, when he goes high or low and tweak the basals accordingly.

Going up and down for awhile until the pump settings are right is pretty normal for the adjustment period.

Seriously thnk you need to get the nurse on the stick quickly. Would contact her and if she isn’t helpful go to supervisor and or contact Animas directly.

I had a similar pump start… Is he on just one basal rate? Look back at the numbers… the general rule of thumb is to raise or lower the rate about an hour to 90mins before the numbers start dropping… I was blood testing close to 20times a day when I first started… It takes a little time to get all the rates straightened out… Be sure to keep a good log book (I have major trouble with this!) for the first couple of weeks to look for patterns… As always, your mileage may vary esp since I started the pump at age 20 :slight_smile:

I totally agree here. I had replied earlier but do not see my reply. Get a better nurse to help you out. They should be avail 24/7 with a toddler. Good luck.

i really appreciate everyones responses - around lunch she did end up coming back and made all these various adjustments which seemed to me for the most part to make sense and then he crashed again in the afternoon and so then we paged her, surprise surprise, she called back
but then she went back to almost a 24hour same basal rate - which to me is frustrating because i think his basal rate between 6pm and 8pm needs to be more aggressive to treat consistent highs at that time - and she adjusted his ISF to ten from 8 - is that a huge jump … anyways
so i wanted to keep 6pm - 8pm at a more aggressive IC but didn’t - and then like i thought, he was sky high at night
so whatever
step by step i know
we’ll get there
i just need to speak my opinion more
and will do that next time we talk

My son started the pump with insulin last Monday. I can not believe how much they keep reducing the amount of insulin he needs. So many lows - after lunch, before bed and during the night. He did a dinner fast last night which did not get completed because he went low. He did a lunch fast today and again he went low. We fax logs to his doctor tomorrow morning and I expect more changes. His doctor has us faxing logs to them every two days and they are making the adjustments as they see fit. Are your doctors having you fax logs?

I have been pumping for 9years (last week!). I initially was calling and talking to my endo every day (I was one of his first pump patients so we were adjusting and following very closely). This is typical for the start-up time with the pump (also the fact that you are reducing the insulin too!).

When I go back to MDI, I have to add about 25% - 40% more insulin. This is typical for starting on the pump.