[IP] Young Pumpers

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1)  How old to most people find their children to be before they'll let
them bolus by themselves?

Bolusing by yourself and calculating a bolus are two different things.  You
can press the buttons way before you can do the math.  When a child shows
you that they can press in the numbers accurately, go for it.

(a) Have your child bring the treat home, like we do now on injections?
(b) Teach the teacher how to estimate the carbohydrates and bolus
accordingly?
(c) None of the above?

(C) Cell phones!  Jenna calls me regularly from school, tells me what treat
they are having, and I tell her what to bolus. I wouldn't even try to
explain this to her teacher - her support on letting her use the phone is
all that I ask! Now that she's in the 4th grade, if the treat happens to
come in a wrapper with the carb content on it, she does the math herself.
She also has a copy of the carb counting book that we use at home in her
backpack, and can look up some things.  She's not missed a treat at school
since going on the pump

2)  Should we try pumping straight humalog first and see how things work
out, or should we start off with the 5:1 ratio?

See how straight Humalog works first.  80% of the pumpers use straight
Humalog.  We're part of the 10% (or whatever) that mix, but only after we
found out we couldn't keep a site going for more than 2 days otherwise.
Mixing is a bit of a hassle, and even with using a 5:1 mix, there's a bit of
"tail", when the regular is peaking, that's a bit of a nuisance to
accomodate.

3)  I'm very happy with Kelly's control on shots, when we keep it
between 80-180.  Should we be aiming for tighter control on the pump?  I
know about the results of the DCCT, but how likely are complications
with an average Hba1c of 7.0?

Complications at 7.0 are minimal - the renal complications really take off
on the graphs at an A-1-C of 8, and the eye above 7.  But both of those are
most likely in the post-puberty set.  I would err on keeping a little kid
from being hypoglycemic (target 80-180), and tighten up later if you need
to.

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