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RE: [IP] Sliding Scale Insulin Dose



Ted is right on target.........education is the key....and it's never too late to learn.
RHonda
type 1...33 years
pumping 23 months....

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 email @ redacted wrote:
> 
> Once again I am writing for advice.  My daughters Endo and our Pediatrician
> both say they do not believe in doing "sliding scale" for insulin dosages.

Oh, they think they're practicing medicine in the '50s when I was diagnosed?
Sorry, they're being stupid, assuming that a child can't control it well is
antique thinking.

> They say we are just trading highs for lows and it is NEVER recommended for
> pediatric treatment of Type 1 Diabetes.   

They never talked to my endo who recommended (and still does) as good a control
as I could achieve, regardless of age. Think he got it right, the kind of
doctor that predicted I wouldn't live past '78 (something like your doctors
stance?) have been proven wrong by events.

They say what is below the peaks is
> what counts and not the occasional peaks.  

OK so it's fine with them if she happens to peak at 3000 mg/dl? Wrong again.

Whatever her readings are they
> want me to give the same amount of insulin each day.  (this makes no sense to
> me - why would you give the same amount of insulin for a 300 reading as you
> would for a 90?)

They're proving how stupid doctors can be. Sounds like it's time to set them
straight, they are the ADVISORS (not dictators) for your daughter's treatment of
diabetes, and she, NOT THEY, will suffer any and all consequences of their 
outdated methods. If they can't allow you and her to treat her condition 
more agressively they need to seek another victim, and you need to seek a 
real endo that knows up from down!

> Also, as a mother I struggle with not giving her Humalog to bring down an
> occasional high.  This doesn't happen frequently but on occasion it does.  I
> realize if this are happens frequently and we see a trend it is time to change
> the insulin dosage.   To not treat the high bothers me greatly.  When I give
> the extra Humalog I am careful to not do it in conjunction with the NPH peak
> (so far I have never sent her crashing).   Currently she is on a 2 shot/day
> regimin - before breakfast and dinner.

You're right, and if they push just ask them to compare what happens to
children followng THEIR methods, as opposed to yours?

> If we have the technology available to bring quickly bring down highs then why
> not?  I don't want to be going against our doctors but I am sense there may be
> two schools of thought on this.   Any input will be greatly welcome.  Also if
> I am completely off base please set me straight!

You are totally on base. I wouldn't suggest that she try to run things as
tightly as the adults can, childhood does have some variability I've 
outgrown, but it CAN and SHOULD be treated to reach a somewhat higher
target zone with no major problems.

Ted Quick
Type 1 for 41+ years, MiniMed 506 pump user for 4.1+, use Humalog


Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/

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