Re: [IPp] more new pumper questions!!
Many people have a insulin resistance at night. My daughter does as well.
We try to have dinner between 6pm and 7pm, so that I can test and correct if
needed by 9pm the latest. (We test two hours after the dinner bolus.) We
don't give her a snack after dinner and her sleep time is around 8-8:30pm.
If the 9pm bg is good, we are good the rest of the night and the morning
number will usually be 70-110. However, if not good after the correction at
the 11pm check, she will not be in range, the insulin just seems to not
work, until after 3am. (So, continued testing and correction in vein till
that time.) Our endo said it was that during time hormones including growth
hormones are released causing insulin resistance.
What I have discovered, and works for us, (ymmv), if at 11pm check the bg is
still out of range, we set a temp basal, (for half and hour to an hour), and
the rate depending on how out of range the bg is, from 115% to 150% in
addition to the actual correction. This lowers the bg before the midnight
time. Also, the lowest sensitivity is set between 10P and 3A, (so the
greatest amount of insulin is given for correction).
We had similar issues as you stated while on shots. We needed our daughter
bed time bg to be near 200 to wake up at 70-110, not good for her a1C. Just
by looking at your numbers from last night, I suggest doing some basal
testing. It seems that more insulin may be needed at night and less in the
pre-dawn hours.
On Dec 6, 2007 1:41 PM, jackie shanahan <email @ redacted> wrote:
>
> I apologize to Sammi because this is getting off the new pumpers
> questions
> issue, but Lorraine, you mentioned that your child had highs at night but
> woke
> up in range before pumping and that the pump corrected that. We have had
> that
> same problem with my son sinice diagnosis. When he was on NPH and then
> Levemir,
> he would be in range at bedtime and then go to high 200's around 11PM, but
> wake
> up around 100-120. We have tried so hard to correct this problem with the
> pump.
> At first, with the help of his NP, we adjusted his basals to the point
> that he
> had 3 different basals during the night, but the problem persisted. Then
> the
> doctor suggested adjusted his nighttime snack insulin to carb ratio
> (around
> 7PM). When we did this, he would end up going low right before bed, I
> would
> treat the low and he would still be high at 11PM. It has been so
> frustrating
> trying to eliminate these nighttime highs. The other problem is that
> Brendan
> does not react to a correction as
> quickly at night as during the day. So last night for instance, he was
> 110 at
> bedtime (8:30PM), 290 at 11PM(I gave him a correction), 250 at 3AM (gave
> him a
> partial correction) then he was 60 at breakfast this morning(7:15AM). I
> keep
> going back to something one of his nurses told us after he was diagnosed
> and
> that is that some kids' livers put out glucose at night for no apparent
> reason.
> I keep wondering if that is his problem and we will never be able to
> regulate it
> quite right. What have you done for this problem?
>
> Jackie - mom to Brendan dx 8/06, pumping Animas since 6/07
>
> My 4 yo started pumping in April. Insulin requirements were also
> significantly
> higher. At first I thought "end of honeymoon", but I think it's more the
> difference bt long lasting and fast acting insulin - he just needs more of
> the
> fast acting.
>
> His target is 100 during the day, slightly higher at night.
>
> Initial settings seem to be an educated guess and you need to fine tune
> them
> once the body gets used to the new treatment. We were told that the long
> lasting
> insulin could stay in his system for a couple of days - sounded odd, but
> seemed
> accurate as his overnight numbers did seem to jump in that timeframe.
>
> Caleb's a1c dropped after starting the pump - from 7.1 to 6.7 in just a
> few
> weeks, and this shocked me because of all the highs that we were seeing
> at
> night
> when we were trying to get his settings right. But pumping allows for the
> correction to take affect so quickly that the highs are not sustained. On
> injections he was on so little insulin and so sensitive to changes that we
> were
> not able to properly measure dosing to handle some of his highs and they
> were
> sustained particularly in the beginning half of the night even though he
> always
> woke up under 100 (with only the slightest of NPH in the am). To correct
> the
> high would likely have resulted in a too low low in the morning. Pumping
> fixed
> that immediately.
>
> Good luck! I know it can be frustrating. I really thought the pump would
> keep
> him in range almost all the time and although it is fantastic and we love
> pumping, my expectation was way too high.
>
> Keep asking questions!
>
> Lorraine
>
>
> Sami Ritter
> wrote:
>
> Hey there,
> How do the Dr.s know how much one unit will bring down Quincy? And....how
> do
> they know what his sensitivity is? It is scarey to be sent home with there
> suggestions. I know it is only guidlines but Q has already dropped low
> being
> home pumping 24 hours. I am sooo nervouse!!! Another question.....they put
> in
> his pump a target range of 120, that seems so low to me being a very
> active
> busy
> 11 year old boy. What do you have your pumping kiddos target ranges at?
> And I
> am
> asking agin to all Paradigm 722 users......am I reading this right, that
> the
> pump takes into account unused insulin from say an hour ago in the body
> when we
> go to bolus for another snack or meal? It seems like he is already needing
> somuch insulin and he was on a total TTD of lantus and Novolg doing shots
> of
> 20-23 per day.
>
> Thank you,
> Sami scared pumping momma to Quincy
> 11 yrs old and dx 02/15/01
>
>
>
>
>
>
>
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