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[IP] zero to DKA in nothin' flat?

Ruth wrote: (clipped)
>  Pumps require continuous thoughtful and well thought out calculation.

They also require very sensitive support from family or significant
or whomever it is close to you.  That means that as a parent you have to

walk an additional balance beam -- not only the diabetes one.  That is,
must be able to implement careful and always changing calculations while

handing them over slowly (as she gets older) to your child without ever
dropping out while always being unobtrusive -- tough act!  Many families
this brilliantly -- Renee and Michael seem to have amazing senses of
proportion (a fantastically difficult thing!) and great technical
and lots of financial and emotional resources.  Lily and Melissa seem to
handling this all very well.  If for one moment though, you imagine that
pump can be used to make things easier, it doesn't -- just better

Ruth, thank you for your input, it was very thought provoking! Thanks to
all the others who responded as well!  I have to say though, that the
regimen we are on with MDI, certainly requires much in the way of
careful calculations, as well as one eye on the clock at all times!
Every morning after Stephs bg test, I "calculate" how much insulin to
give based on what she is having for breakfast, also making any
adjustments for a high reading.  I pack her lunch with a 15 gram carb.
snack for 10:00 am, and 60 grams for her 12:00 lunch (she knows she must
eat every bite of food because the NPH "says so").  When she gets home,
she immediately has her 30 gram limit of snack (she wishes it were much
more, but not enough to take another shot).  On days she has piano
pratice, she has 10 minutes to woof down her snack before she must be at
her lesson (on days her carpool runs late, she eats in the car on the
way to the instructors house).  At dinner, it's the same routine all
over again.  Test,  calculate dose based on what she will be eating,
adjust for any highs, etc..  Most nights she eats alone as my husband
can't predict what time he will get home (we have a family lumber mill
business), and her brother may have sports practice, etc. At 8:30, she
tests, has snack based on the bg, if high, she gets nothing (even though
she might "want" something).  Again, she could take some humalog, but
doesn't want another shot.  She goes to bed at 9:00, and I go in at 10
or 10:30 to give the NPH (she has a strong dawn phenomenon, so they
don't want her to get the NPH until later).  I guess I could give her
any extra humalog at that time so she could have the option of a bigger
snack on some nights, but then I am chasing after the carbs 1 1/2 hrs.
later.... So, I DO think that the pump would make life "easier", at
least as far as our schedule goes.

I also think that the "balance beam" of gradually handing over control
is much the same with MDI.  As she has gotten older, she has taken over
her care a little at a time as she feels comfortable.   We also have had
the same "always changing calculations" with MDI.  Her doses are
changing constantly!!  I always feel we are one step behind.  Just when
we get the dose fine tuned (as much as is possible), it changes again.

The most important thing to us is what Stephanie wants.  She knows that
there is no pressure to make a decision right now and that we will be
behind her 100%.

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