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[IP] Re: insulin-pumpers-digest V5 #318

In a message dated 7/28/01 4:17:26 PM !!!First Boot!!!, 
email @ redacted writes:

> My 6 yr old son Andrew  was dx @ 14 mo. and has been pumping almost 2 yrs
> with the Disetronic and Rapid 6 sets. 
> We have always had difficulties in the morning. Our situation seems a bit
> different than most though so I'd love to hear from anyone that has the
> same thing happen. He will wake up with great #'s (love that pump!) and
> will stay level (even for a couple of hours) until he eats. Regardless of
> what time he wakes up or eats, his first meal always requires twice as
> much insulin as he takes the rest of the day. It usually takes about 2
> hrs and then I have to watch for the drop. Higher protein in the mix does
> seem to help (and cereal is always brutal, even the low glycemic)  but
> after 5 yrs we've just come to accept that he'll wake up @ 100, eat
> breakfast and hit a 300 before he's back to 100 within 3 hrs. Does that
> make sense? Any one else?
> We have also found that his numbers are more difficult to control when
> he's overly tired....usually Fri nites. (Very noticable when started
> Kindergarten last yr and no longer takes a nap.)
> Hope this helps.
> Cari Ecklund (Tacoma, WA)


This sounds a lot my son, Paul. We saw drastic jumps in numbers while on MDI. 
He would wake up within range and climb to 300 in the middle of the morning 
and then be back within range at lunchtime. If we increased the breakfast H, 
he would bottom out by lunchtime.

With the pump, it has been much, much better but not perfect. We still will 
see some high numbers 90 minutes after breakfast but many times he IS within 
range. Until very recently, his breakfast ratio was 17:1 and his ratio for 
everything else was 25:1.

This is unrelated but I'll continue Paul's story.  We just recently had to 
make more adjustments as we watched his numbers skyrocket. He's now 12:1 for 
breakfast; 20:1 between breakfast and dinner and 15:1 for bedtime snack. We 
also had to jack up his basals drastically. Since going on the pump one year 
ago this month, his ratios had been .2 between 7 a.m. and 7 p.m. and .3 
between 7 a.m. and 7 p.m. This worked like a charm. But this summer, as I 
mentioned, his numbers skyrockete. We not only had to hike the bolus formula 
but we had to increase basals. He's now at .6 from 7 p.m. to 8 a.m., .2 
between 8 a.m. and 7 p.m. We'll still tinkering but we're almost there. 
Anyone else see such a drastic increase in insulin usage in just a few weeks' 

Janice, proud mom of Paul, DX at 18 months, now 7 and a half and pumping 
since July 2000.
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