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Re: [IP] How do Pump Mamas handle this fact?

In a message dated 4/23/2002 12:15:45 PM Mountain Daylight Time, 
email @ redacted writes:

> I am wondering how Pump Mamas handle the fact that (toddlers
>  through teens) do not have an exact time to eat - and the quantities
>  change also. Who, how, when the bolus for each meal is determined?

When Katie was on shots, she did exact times to eat (she was using H+NPH for 
breakfast & dinner time, with occasional corrective injections of H). She 
often HAD to eat a certain amount at a certain time (whether she was hungry 
at the time or not) -- especially lunch + morning and afternoon snacks 
because theey were covered by the NPH -- which peaked very unpredicatbly for 
her.  It was really stressful having to make sure that meals and snack were 
available right on time (30 minutes could make the difference between being 
fine and a nasty low). It sucked!  BTW, Lantus wasn't available at the time . 
. . 

On the pump, it's A LOT easier and food is now pretty non-issue around our 
house (I hated having to make her eat sometimes!).  When she's not hungry, 
she doesn't eat (and her basals keep her BGs pretty level).  When she's 
hungry, we count carbs and bolus according to her carb ratio -- the first 
food she eats for the day  ("breakfast"  -- but that could be as late as noon 
if she sleeps in on a weekend) is bolused at a 1:12 ratio.  Everything else 
is bolused at 1:20.  Our endo & dietician worked with us on the initial carb 
ratios (based on her carb ratio while on shots) and then we adjusted them in 
the first month or so on the pump (not having any long acting insulin acting 
at unpredictable times made for some big differences in her carb ratio, as we 
soon discovered).

Basically, we tested the carb ratios by checking her BG before she ate and 
then 1.5-2 hours after eating -- and we made sure to very carefully count 
carbs for those meals (weighing and measuring portions, etc.).  The endo 
calls a carb ratio good if the post-meal number is within 30 points of the 
pre-meal BG. 

Pumpmama to Katie
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