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Re: [IP] Nedd some basic ideas for pizza bolus with D pump

Does the D pump have a temp basal?  I met a CDE (saw her a few times when I had a
short term Kaiser policy) who said that she finds most people have a max dose and
anything beyond that has to get split up.  She wears a pump herself and I was
pleased and surprised to learn that I am not the only person who crashes after 3-4
units no matter what I have eaten.  So, what I might do is to see if your patient
can figure out the max bolus that doesn't cause him to crash (I suspect it varies
a whole lot from individual to individual so I won't even give a stab at #s).
Then, if the total carbs is 2 x or less the max bolus, give the max bolus with the
pizza and break the rest up with a temp basal or with 1/2 hourly bolus doses.  If
it is more than 2x, my experience is that I have to extend the amount of time I
distribute the rest of the bolus over.  Pizza lasts a long time for me -- I often
keep seeing elevated bgs for 12 or more hours.  I think other people may have
quicker time frames so maybe their sense of how long a big pizza meal lasts may
help you develop a starting point.  Since 19 year olds probably do the pizza thing
often, this seems like a smart one to model the testing process and to come up
with a basic formula for!

Good luck!

email @ redacted wrote:

> I have a new pumper on H insulin with a Didetronic pump. Last night, he
> decided to eat 5 slices of pizza (I don't know the size of it) and drank 16
> oz. of milk with it. Basal rate is at 1.3. Bolus rate at 1:8. BG was at 196 at
> start of meal. He corrected for the high BG (target at 120/20).  He gave 19
> units of H. Exactly 1 1/2 hours later, BG was 55. Not unsual fo a slow
> absorbing pizza. I had warned him about this. Since he is a teenager (19), and
> could use a few more pounds, I am not trying to limit his intake. He would
> probably have been OK, if he had not corrected the high BG. Anyway, how would
> most of the D users here have handled the meal. He did treat the low with a
> tube of glucose gel since he had some numbness around his lips, and raised the
> BG to 78. He was not happy with that number, so ate raisins, cookiesand juice,
> Needless to say, he was up to 300 by 4 hours after the pizza.
>      I went to the HOW TO section of the main web site, but info was not
> really helpful. I suppose he could have split the bolus up to deliver a
> portion over 2 to 3 hours. Do you all think I am on track here, or am I all
> wet?????
> Thanks, sorry this is so long. Anyone choosing to answer,send to my email
> address.
> Barbara B.
> ----------------------------------------------------------
> Insulin Pumpers website http://www.insulin-pumpers.org/
> for mail subscription assistance, contact: HELP@insulin-pumpers.org

Insulin Pumpers website http://www.insulin-pumpers.org/
for mail subscription assistance, contact: HELP@insulin-pumpers.org