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Re: [IP] HELP! can't figure the basal rate

> Her endo gets back on Monday. I obviously have to raise
> her pre-dinner rates and up, and her rate before 2:30 am 
> down. I just don't know for how much before 2:30 am I 
> should lower it, and if I raise it up before dinner and just
> after, this will also affect her 2:30am reading. I welcome 
> any suggestion from someone who is real experienced 
> with the pump and children. It is tuff being a "Newbie."

The tough part is that you must learn to accurately profile her basal 
requirements. You endo can't live with you. The day to day management 
must become your 'task' if you wish your daughter to have good 
control. Your list mates can offer suggestions and guidance, but you 
must do the work.

Re-read the sections in Pumping Insulin on how to profile basal 
requirements. Read the HOWTO's on the web site.

A quick re-cap.

It's nice if you can start by stabalizing night times. Skip dinner 
(she can eat at 3 or so)
Start by fasting 5 hours then begin measuring bg's every 2 hours 
until she goes to bed. Wake her after 2 hours and check bg's.
Let her sleep 4 hours and check again. Check in the morning.

You can continue the test if she gets a 'little' low and you can 
correct with glucose "for which you know the bg rise". Other wise, 
make a small adjustment in basals to compensate for the low and try 
again another night. If she gets high, over 180, give up for the 
evening, adjust a small amount and try again some other night.

Once you make it throught the night, repeat the procedure a couple of 
days later except wake her after 4 hours of sleep in the middle of 
the night.

You should be able to get repeatable bg rise/fall by doing the test 
sequence again on another night. Don't do them back to back or you 
will tire her out and the bg reading will not be good. Don't try to 
wake her every 2 hours for the same reason.

Don't skip 2 meals, do other periods of the day on a different day.

It may take several weeks to get it all right. Don't be in a hurry, 
it won't help. Usually, however, the adjustments needed will be small 
and obvious. All the testing can then be done in a few days.

Remember, kids have growth spurts and their insulin requirements may 
change rapidly and by a lot. It is hard to be aggressive, but watch 
for a pattern of highs or lows and make the appropriate changes to 
ratios or basal requirements based on hard data.

Michael ( dad of Lily age 16, pumping 4+ years )
email @ redacted
Insulin Pumpers website http://www.insulin-pumpers.org/
for mail subscription assistance, contact: HELP@insulin-pumpers.org