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[IPp] Saline Start



 I have to say that I disagree with the comment that a saline start is a waste
of time for an 8 year old. My daughter is 8 and we just started on the pump in
September. We, too, did a saline start. There were several helpful aspects:

 1. Even though we had the pump in our possession for two months, having my
daughter wear the pump and enter all blood sugar information into the pump and
also bolusing whever appropriate helped her and I learn to manipulate the pump
much better than we had been able to prior to the saline start. This experience
gave both of us quite a bit more confidence in our ability to utilize the pump
prior to the actual pump start. This confidence was invaluable.

 2. During the saline start, we were put on a rigid meal plan that was based on
my daughter's normal eating habits. Since we were entering all blood sugar
information into the pump - and bolusing (correction and otherwise) with saline
as well - CDE/pump trainer - was able to down load this information (both blood
sugar and insulin usage) and use it to help set basal and insulin to carb
ratios. I think this information helped give Jennifer a very smooth pump start.

 3. I think there is a 3rd reason the saline start is important. When kids pump
- they enter all snacks...even a 2 gram snack...into the pump. That is a big
difference from having several 15 gram freebie snacks on lantus. The saline
start helped get Jennifer used to entering the grams into the pump prior to
eating a meal or snack. I have read that one of the reasons some children have
higher a1c readings post pumping is that they periodically forget to bolus for a
snack or meal. I believe the saline start helped get us into the routine of
bolusing even for snacks.

This is just my opinion - so take it for what it's worth. 
 
 Also, Jennifer never once complained about the saline stinging. She has,
however, said that the insulin stings when the bolus is too big. We have
adjusted her bolus time to help alleviate this. Would adjusting the bolus time
help reduce any feeling of stinging someone may experience with saline?

Beth Kealey
 Mother to Jennifer (8 yr old) - diagnosed 12/16/03. Pumping Cosmo since
9/13/03.



My opinion is that a saline trial for an 8yo is a waste of time. There is 
no positive feedback for the work involved and saline "stings".   
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