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[IP] Setting basal rates

Hi Kathie,
Hang in there!  When my daughter Jenna got the pump, at 3 weeks I was ready
to throw it in the trash can!  Good thing I knew how much it cost, it was
the inspiration to hang in there with it.  Amazingly, within the next week,
things kind of started falling into place, and by 1 month of pumping, it was
pretty smooth.  There's always a little tweaking to do - people's bodies
change over time.  Here's a checklist that I used:

1.  Carb to insulin ratios may vary according to time of day and day of
week.  Check sugar 2-3 hours after each meal, and see if you're about the
same.  A lot of people require more insulin per carb at breakfast than the
rest of the day.  Jenna needs less insulin in her boluses on the weekends
than weekdays, and much less after vigorous exercise.  We started out
thinking that there'd be 1 carb-to-insulin ratio, when I learned otherwise,
I was a quantum leap ahead.

2.  While you're setting things, try to eat only predictable foods in normal
quantities, and do about your usual amount of exercise.  A friend whose son
recently started pumping let him eat gobs of french fries and pizza while
trying to set basal rates.  There's lots of us who haven't figured out those
foods after long times on the pump.  So, keep it simple till you adjust.

3.  Be sure to make notes about exercise and stress.  They affect your sugar
way more than anyone thinks, and while you can't eliminate them while you're
setting pump rates, you can at least start to see what their influence is
for you.

3.  Are your sites lasting?  Jenna was one of those whose sites would only
last 2 days.  So, on the 3rd day, she was high, then we'd change a site,
then the next day she'd be high because she was insulin resistant from being
high the day before, then we'd have a good day, then the cycle would repeat
itself.  At first, we solved the problem by changing sites every 2 days.
Then we tried the Velosulin / Humalog mix, which worked, despite the fact
that our endo didn't see any scientific reason that it should.

4.  Take command.  Read "Pumping Insulin" till you about have it memorized.
Then tell your team what you think you need to do, rather than ask them what
to do.  They will never understand all the subtleties of your body the way
that you will.

Nancy Morgan, mom of Jenna, 10 years old and pumping 11 months

>  From: email @ redacted
> Subject: Re: [IP] A1C results
> How long did it take you to regulate your basels, bolus etc.  I have been
> the pump for almost 2 weeks.  I am all over the place.  They have made
> changes but still all over the place.  I have never had such highs and
> They want to make slight changes and one at a time, Is this how it works?
> Kathie

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