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[IP] Re: Gabe pumping

email @ redacted stated:
Now, I need help with this; I spoke to the doctor on call and he said to call
the CDE tomorrow.
4p.m.     b.g.     98    1 hour off the pump for shower and site change
5p.m.     b.g.    176    bolused .5 to replace missing basal as I calculated
6:30 pm b.g.     246   bolus 2.5 (this is what I would use with syringe)
7:15 pm b.g.     246
The bolus of .5 did not work and the bolus of 2.5  did not bring b.g. down at
all for 45 minutes.  Lunch was at 2 p.m. and was not high fat or high
protein.  At that point (7:15)  I gave him dinner as he was very hungry.  He
bolused and rose to 269 and then 297 at one hour after dinner and the finally
at 8:30 p.m. dropped to 239.

Hi Marion,

The possibilities that I see are:

1.  Gabe's basal requirements are higher in the afternoon - evening. 
The 98 at 4:00 p.m. is being affected by his 2:00 p.m. bolus, so 
don't know what the number would have been fasting.  At 6:30 p.m., 
Gabe's bg's are still climbing, even with the replaced basal.  And a 
correction of 2.5 didn't lower his bg in 45 min. time from 6:30 - 
7:15 p.m.

2.  His 2:00 p.m. bolus for lunch was too much and he rebounded. 
Unlikely, but possible.

3.  Something happened with the site change since his bg's started 
climbing after that.  In the beginning, it would be easy to miss a 
step until it becomes second nature.  Reservoir plunger rotation up 
and down and both directions, drawing up insulin and removing bubbles 
and air pockets, manually priming the tubing, priming after reservoir 
is placed in pump, another prime after site is placed, etc.

4.  I know some people experience highs after a site change if they 
don't leave their old site in with their new site for a while.  Noah 
has never needed to do this so I can't comment on that as a 

It will be frustrating until you get Gabe's basal rates figured out. 
At least with Noah that was the most difficult but made the 
difference between bg's making sense and then figuring out bolus 

You've already made a lot of progress.  I'm sure in time, you'll get 
it all figured out (as best anyone can with this disease)!

Cindy, mom to 15 y/o pumping Noah (dx age 9), and Micah, age 11, wife to Steve
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