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[IP] HELP! Pumping and control (not yet)

Now that David (9years old) is using the pump (MM508 since 13 March 01), I'm
not seeing the improvement in BGs I thought I would. His diet is still carb
counting and we seem to have the boluses right (at least breakfast and
lunch).  His numbers are mostly stable during the day, but at bedtime he
drops low.  We feed him 1g per 5 pt we want his BG to rise targetting 150.
Then his BG spikes high at 3am (rebound?) and any correction sends him
crashing by 7am!!!!  YUCK!!!!!  I know it must be a basal rate problem but
it just doesn't make sense.  Do basal rates fluctuate a lot more at night?
In children?

I'm using the 500 Rule to set his Insulin to carb Ratio.  We have his basal
rate set at 50% of TDD (0.5u/h X 24 hours).  We are using the 1800 Rule for
Insulin Sensitivity Factor.

Supper is at 6pm, bedtime is at 8:30pm.  He tends to crash sometime between
7pm and 11pm.  Is it from the PE class once every 4th school day
(9:30am-10:30am), the Volleyball practice every Mon and Wed (3-4:30pm), the
Outside play that he does now instead of watching TV in the afternoons
(4:45pm-6pm)? It seems I've got him on a temp basal more often than a normal
basal rate.  And I'm just GUESSING at the temp rate.  I never seem to get
the right rate or duration to avoid the low at bedtime or the next morning.

To do a basal rate test "Pumping Insulin" says to wait until 3.5 hours after
the last bolus and when your bedtime BG is between 100 and 150. This is just
not happening for us!!!  Should I be serving supper at 5pm?

Pumping Insulin also says "Don't try this test following a day in which
you've had a major insulin reaction, major emotional stress, or unusually
strenuous exercise."  He's having insulin reactions every day (before
breakfast and/or after supper) and unusually strenuous exercise all the
time.  (He just can't seem to get enough "play" now.  He has the energy so
he uses it!)

What do I do?  Stop the activity and get a "couch potato" basal rate?  What
good would that do David?

Marie Matthews

Mother of David Jr 9 (dx 9/99) MM508 3/13/01

Daughter of Donna 59 (dx in 1945)
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