My son is on an animas pump. usually if he has been low (say, 4.0), I give him quick sugar, check in 15 minutes and then use that bg (say, 8.5) to figure out his bolus. Is this how most people are doing it? or would you enter the first,lower reading to calculate the bolus?
I do not think that you can use an emergency recovery time as an opportunity to calculate ratios. The body could be compensating at the same time. I thought the calculations were based on many more numbers, like a day. There are books, healthcare providers and sites that would help you with that( and maybe “tu-diabeaters”).
I’ll share what we do personally. We use an Animas pump also.
If Riley goes low and gets a fast acting sugar and it is time for him to eat a snack or meal, then I always check to make sure his sugar has come up, but I use the lower number to figure out his carb bolus. This works for him because if all he got for the low was juice, that juice is going to be burned off pretty quickly, so I don’t count the rise in BG from it to calculate his bolus.
If Riley goes low and gets a fast acting carb to bring him back up into range, but does not eat a snack or meal along with it, I never bolus for that because the purpose of the fast acting carb is to bring him up and keep him up.
Like I said, this works for him. But, what works for one may not work for another. Sometimes it is just trial and error.
Right, of course I’m only talking about bolusing for a meal. I had always used the second reading, after the juice, but lately he has been running a lot lower, so in addition to lowering basals, I thought I should try to use the first reading. It has been working better.
Still using Animas here as well. We were told, after correction, never to count the higher number. In other words, if she was 60, had 15 grams of simple sugar as a correction, and her BS rose to 135, not to put 135 into the pump. We would instead use a target number. In that case I would choose a bit lower than her true target, and put in a BS number of 100 into the pump (target is 120). If the correction caused her BS to rise to 175, I would probably choose 140 as the number to put into the pump. If her number, after correction was 84, I would put 84 into the pump. I use my judgment and would be using less insulin when bolusing after a low, but not dramatically less. If, however, she has had a low earlier in the day or the night before, I would bolus even less insulin. If she has been trending high, I would put in a true BS target of 120, after correction if she was over 120. If after correction she was under 120, I would put the lower number in, i.e., 94. I hope I haven’t confused you and I hope this helps. In other words I base my decisions on how low she went, almost never correct fully the rise in BS after correction, also taking into account her pattern the past day, day and a half.
How long do you wait to bolus after a low? We were never told to do this. We wait it out, and maybe give something for the food after the emergency 15g. But without CGMS, how do you know what the trend is? like after exercise, it is hard to estimate how much s/he will drop. Sounds like a potential yo-yo or roller coaster. Maybe it is different when you have a younger child and you are seeing the intensity of exercise, and are there for every bolus.
Also what is the conversion of mg/dl and mml? Thanks.
Hi Kelly, I use this link:
If I don’t bolus him for his meals, he will be sky high, regardless of a low beforehand! We can’t afford CGMS, also it hasn’t been recommended because he is very small for his age (Sam is 5) and doesn’t have enough fat to support two infusion sites. I would love it though!
How old is your child and how long has he/she used CGMS?
17, 1 year. but does not like it because the needle is bigger, and painful. Thanks for the reference for conversion. I did a quick index and could not find anything.