My daughter is 7 yrs old and is using the Mini Med pump. She has been on the pump for 2 weeks now. When suspending the pump when your blood sugar low, how long should you suspend the pump before retesting, and what is the best food or drink to give her. Her doctor just changed her basal rate yesterday, because she was going to low in the afternoon and was to high in the morning. Any thoughts on this???
Thanks!
Marie
Personally I never suspend the pump unless I go low AND still have a ton of insulin on board or have had a combo bolus going (then I cancel the combo bolus and will stop the pump for its duration). Stopping insulin delivery won’t have any noticeable effect for an hour or two, so there’s not much point for treating a low unless you think there will be more in the future. I also find it very easy to accidentally end up really high a few hours later if I stop the pump or do a temporarily lowered basal rate.
For treating lows I use Skittles. If I’m really low and don’t feel like chewing I will have a small juice box, but I feel like that takes longer to kick in than the Skittles do.
Agree with what Jen says. Suspending the pump is not a standard treatment for lows — takes too long. Keep the basal delivery going (perhaps assess whether or not the rate needs changing — if lows are occurring regularly at the same time of day) and treat the low with fast-acting sugar. I use “Dex 4” glucotabs.
Nope, I don’t suspend either. I do dial the basal down to about 50% during & after exercise or vigorous house/yardwork.
Rather than “suspend” the pump, I will adjust it to like 50-80% if I’m doing something and don’t want to be bothered eating and it’s drifting down, sort of not quite low but on the way? I agree that it’s better to treat lows w/ some carbs than worry about shutting the pump down or off. A lot of times when I get crazy and do stuff like that, the rebound is inevitable.
If it’s low at pretty regular times most days, then the basal rate needs tweaking. Stopping/starting the basal has about a 1 hr delay, so won’t really help short term and might mess things up long term. I like skittles too - 1 carb each 
I agree. Suspending the pump won’t make an impact on BG for 1-2 hours or so. If you stillw ant to suspend the pump, I will do a temp basal of 0% for the time you want, otherwise you may forget to restart the pump later.
Don’t suspend! (unless of course your endo tells you otherwise). Suspending will result in a bad rebound high if you’re not careful. Better to treat the low and use the bolus wizard to calculate your daughter’s correction dose based on low blood sugar and carbs consumed. You can decrease the basal rate; I generally decrease mine about 50% if I feel I’m going low or am doing something that I know will make me go low (hard exercise, cleaning the house, etc).
The other thing you have to be careful of is causing a clog in the tubing when you suspend the pump. I was told by my trainer that if you must stop insulin delivery for some reason, it’s better to just unhook the pump. When you suspend the pump, the insulin can crystalize and cause a clog, which would then result in a high blood sugar later.
The only time I suspend is if I’m low (or going low) and have a lot of insulin still on board from a past bolus. Or I’m getting close to low and have been or will be exercising.
Otherwise, I treat the low with fast-acting carbs. It’s an easier, faster, and more reliable way to treat a low.
Just one more vote on the “don’t suspend” list. Now I treat with glucose tabs although when I was starting out, I used those cute little juice boxes which might be more appealing to your daughter.
Maurie
Dex 4 glucose tabs are the fastest for me. I sometimes use 1/2 cup skim milk if I am home. I also agree with not suspending, and will set a temporary basal (75-80%) for a few hours if I know I will be exercising a lot (and recently for 90 degree plus heat). Since you are so new to the pump and your daughter is so young, I would not make changes without your MD’s guidance. I am a RN and still waited 2 years to make changes on my own. I realize others may consider that to be very cautious, but I everyone has their own comfort level.
I never suspend my pump because then you have to remember to restart it. However, there are times that I will use a temporary basal of zero for a period of time. I do not use it as my primary method of treating a low because as others said, it takes too long for reduction of insulin to take effect.
If it is bedtime and I am at a normal BG and have some insulin on board, I’ll often use a temp basal of zero for thirty minutes or an hour and let the active insulin that I don’t need act as my basal. Other times, if I am low and involved in something active, I’ll treat the low with glucose tabs and use a temp basal of zero for thirty minutes just to reduce insulin a bit.
My basals are quite low, usually about .3 or .35 and I have a long insulin action. So 30 minutes of no basal is not a big deal when I’m on the low side.
As others said, I don’t think that it’s ever good to suspend your pump. But temporary basals do the same thing with a time limitation.
I never suspend. Just correct to cover the IOB and how much you want you BG raised. If the drift is less than 2-2.5 hours after the bolus I use peanut butter. After 2.5 I use peppermints or gummy bears.
I agree with what others have said. I wouldn’t bother suspending, but just treat the low. I personally find glucose tabs the most predictable and the quickest to raise blood sugar. For me I take 2 tablets if I’m in the 50s and 3 if I’m lower but everyone has to find out what amount works for them. I know some parents use things like juice boxes which kids are more agreeable to.
I also suggest you keep good records of her blood sugars and when you see patterns of lows (or highs) at the same time of day, tweak the basal for the period a couple hours before the low points. I found the smallest possible tweaks actually can iron out those wrinkles. I have 6 different basal “time zones” and I think our bodies really do vary which is one of the very best uses of the pump.
When I take a bath, I just disconnect at the site and don’t worry about the short period of time without basal.
I use a cgm to I have a little bit more information. If I am at 90 and going down slightly, I will use a temporary basal of about 80% or 60% if more active. If I get to about 75 and only slightly down, I will suspend for about 20 minutes. Only if it gets to about 60 will I treat with Juice or a high sugar candy. Raisins are also good about 15 G carbs. But the suspend should not be used for too long as it can lead to later highs. It really needs to be done before you are truly low.