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Re: [IP] Re: diligent diets (was glycemic index)

At 12:35 AM 2/3/02 -0500, you wrote:
 >In a message dated 2/2/2002 9:26:15 PM Pacific Standard Time,
 >I honestly am struggling to see how a pump will help my son.  His HBA1Cs 
 >been 6, 6.2, 5.9 and recently 5.8.  He eats anything he wants at meals 
(and I
 >mean anything) on the condition that I weigh it, account for its glycemic
 >index and dose it.
 >We often get through the day with only 3 injections, U and H before
 >breakfast, H at lunch and U and H at dinner.  His post prandials are rarely
 >over 130.   I have found that when he eats a large meal or pizza type 
meal, I
 >can simply split the dose of insulin.  He corrects high b.g.s maybe four
 >times a week.  The dawn rise is a problem, but I am working on that by
 >gathering data on how much it is and possibly correcting it before it hits.
 >It is not consistent.  Even if he rises from 4-7 a.m., those hours of high
 >sugar still won't hurt him.

When he eats a large meal or a pizza he can split the dose without taking 
an extra injection.  And on the pump he won't go high for several hours in 
the morning.  This is very important, as having a high sugar in the morning 
is often an indication of problems (both high and low sugars) to come later 
in the day.

 >Tonight we were at the synagogue at a prayer service.  I imagined Gabe on 
 >pump and the pump starting to alarm during the silent prayers.  Or him rough
 >housing with his friends after services and messing up the insertion site.
 >And so on and so on.  I was glad he was already finished with dinner, 
 >by a shot of Ultralente and H and hopefully finished with diabetes for the

Alarms will happen so rarely that it's really not anything to worry 
about.  And if the pump should happen to alarm during prayers I'm sure the 
members of your synagogue would understand that this interference--assuming 
they would hear it at all--is necessary for Gabe's well-being.  It's not 
like a cell phone ringing; this is a life-support system.  I think people 
can understand that.

As far as roughhousing messing up the insertion site, I have to say it's 
unlikely.  Lots of kids play contact sports with the pump without any 
trouble, once they learn how to stick the sites on well.  I have two young 
kids with whom I roughhouse frequently and I've never lost a site because 
of that.

 >When the refreshments were served, he really wasn't hungry and I don't
 >encourage him to snack.  He had a few grapes and that was it; the cake and
 >cookies weren't appealing to him since he had dessert with his breakfast,
 >lunch and dinner today (usually only dinner gets dessert, but he wanted to
 >try some of the home-baked leftovers from the night before).
 >So what in the world would he have done with a pump today?  I simply need to
 >convince myself; he is going to give it a trial one way or another, but I am
 >not on the bandwagon yet.  I have heard that the pump gives people a 
 >to eat".  Gabe is only 12.5; no license yet.

No injections.  No dawn rise.  If he had wanted to snack he could have with 
no problem.

Forgive me, Marion, but I don't know the details of your situation.  From 
your post it seems that you're very comfortable with taking care of Gabe on 
MDI. It sounds to me like it's Gabe who wants to go on the pump. That tells 
me that he's not happy about the current state of affairs. And very soon 
he'll be taking care of himself.  My feeling is the sooner you can teach 
him how to do it in a way that makes him happy the better.

If he wants to try the pump I think you ought to give it a fair shot.  As 
he's doing so well on MDI the transition to the pump should be fairly 
simple.  Once you've both given it a fair shot Gabe can decide which 
treatment he prefers.  This is, after all, his disease.

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