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Re: [IP] Child Pumper Crisis: Sneaking Food

Hi Kevin,
I have a 14 year old daughter on the pump who snacks constantly and sometimes 
forgets to bolus, so I somewhat understand what you are going through.  I 
also realize you are diabetic yourself and know a lot of everything already.  
This sounds like a parenting issue involving a five year old!  I just read 
the postings of Charlotte, Blake and Karen, and I agree with them.  First 
step, relax about the cheating.  She's gonna cheat; especially since she is 
only 5 and since you told her she could eat more freely on the pump.  Second, 
you can eventually "set" basels in spite of constant snacking IF you know 
about the snacks and record the boluses.  So offer her rewards for everytime 
she comes to you and informs you of a snack.  Then together you can figure 
out the bolus.  You know, positive reinforcement.  Negative punishments with 
little kids hardly ever works, plus it wears down their self esteem.  We 
never went through that fasting thing with our older daughter because it was 
too miserable to stick to it.  Just try to limit the food to healthy, low 
carb stuff and try to space out snacks as much as possible.  As you know, 
basels are never really permanently "set" anyway.  If she is constantly 
running high, up the basels a little.  If that doesn't work, up them again or 
increase the boluses.  If she goes low too easily, then reduce basels or 
boluses.  Do this yourselves, and don't necessarily wait for the medical team 
to make these decisions.  We pretty much do what we want.  This is going to 
take months to figure out.  Be patient.  Play with the numbers.  It is not a 
science with a child or teenager.  The most meticulous pumpers are, of 
course, the adults.  And only those adults who want to get exact about it.  
Not everybody does, and they aren't necessarily doomed to early 
complications.  There are some people who suffer complications in spite of 
good control.  This luck factor is one of the cruelest things about diabetes; 
it is not all about control.  My sister and brother in laws went off their 
diets all the time as kids, and 30 years later, one has huge complications 
and the other has only a few.  Third, do not live in fear of your endo 
pulling the plug on your pump.  You paid for it.  Change endos if she isn't 
understanding and patient.  Not to mention knowledgeable about the long 
learning curve of the pump.  If you don't trust her, don't work with her. She 
isn't doing you a favor by "allowing" your kid to be on a pump!  The way it 
has ended up with our daughter is that her A1Cs are the same or higher (low 
7s) on the pump, but her and our family's lifestyle is improved.  To us, that 
is real added value.  We don't have the seizures and middle of the night 
lows, or the forced snacks and awful schedule we never successfully adhered 
to anyway.  The pump isn't just for improved control, it is for a better life 
while you are diabetic.  In the beginning, I hated the pump and how it 
stressed out everybody in our family.  Nine months later, it is a major 
improvement in our lives.  I know your family will eventually get the hang of 
this thing.  It's hard.  Keep at it.     
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