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[IP] On pump for 24 hours

This is really my opinion to several threads going right now.  When you
start pumping, it's a different ballgame, and a different kind of thinking.
I really did feel like we were "starting over" with learning diabetes.
During the first 24 hours, there's still some long acting insulin hanging
around, whatever you were using before, and the basal rates are just
"guestimates."  So, lows can happen, highs can happen, and you might even
get a target range sugar in there just for grins.  The different thinking,
for us, was realizing that a high sugar isn't going to drift down on its
own, as with MDI, which was often just 'cause the food peaked before the NPH
did.  So, you have to treat the highs.  And with lows, we always figured
that 15 grams was needed to bring up the low, plus something to keep it up,
'cause, again, the low was often from NPH peaking.  With the pump, the low
is just a low, there's no insulin peaking, so you need a lot less carb to
get a low up.

As far as keeping a detailed food diary - I think it's good practice, 'cause
after 14 months of pumping, we're still learning about how different foods
affect Jenna's sugars.  It's not just carbs - we've learned that steak bumps
up sugars, pizza is a nightmare, chinese is predictable, birthday cake needs
less insulin than the book says.  Believe it or not, after 14 months, if
Jen's sugars are anything but stable (and how long does THAT last in a 10
year old?) I still keep diet diaries - and I still learn a lot from looking
back at them.  So, the diary may feel like a hoop to jump through, but doing
it may help your learning curve on pumping a bunch.  Now, all of you who
don't log a thing may throw the tomatos at me.

Nancy Morgan, Jenna's mom

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