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Re: [IPp] 4 year old pumper with night time lows



Katie,

Thank you for all of the information.  I am in agreement with you and I am
going to start with changing the basal earlier and seeing what happens.

thanks julie
----- Original Message -----
From: <email @ redacted>
To: <email @ redacted>
Cc: <email @ redacted>
Sent: Thursday, February 28, 2002 1:50 PM
Subject: [IPp] 4 year old pumper with night time lows


> In a message dated 2/25/2002 6:29:58 PM Mountain Standard Time,
> email @ redacted writes:
>
> > Her basal rate is set at .3 but the pump is
> >  off from 3:00 pm to 5:00 pm.  For some reason she gets low during this
time
> >  frame.
> >
> >  We have not been able to get the night time down yet.  We still test
her 2
> >  to 3 times during the night and often have to give her a drink box in
the
> >  middle of the night because she is getting low on us.  at night her
basal
> is
> >  changed at 12:00 am. to .2 and then again at 3:00 am. to 5:00 am the
pump
> is
> >  off again.  But we still have lows throughout the night.  Which is my
> >  biggest fear of when she will go low.
>
> I don't know which kind of pump you have, but even if it's not an Animas
pump
> you should be able to set basal rates as low as .1 units per hour (as well
as
> 0.0 units per hour), which is why I'm curious as to why you have higher
basal
> rates (.3 and .2) and then just turn the pump off -- a zero basal).  Here
are
> some thoughts I had:
>
> First of all, if you want to prevent lows through adjusting basal rates,
you
> need to look at adjusting the basal rates that are happening 1-3 hours
BEFORE
> the time period when the lows are occuring.  So if your daughter tends to
go
> low between 3 and 5 pm, you'd probably want to be lowering the insulin
that's
> being pumping into her from at least 1 to 3 pm . . .
>
> Second, I would look at lowering basal rates to the lowest possible level
> (probably .1) instead of having them higher at some periods of time and
then
> "shutting off"  the basals completely at other times.  If this isn't
enough,
> you can try alternating periods of the lowest basal rate your pump allows
> (either .1 or .05) with a zero basal rate (either alternating hours or
blocks
> of two hours depending on how many basal rates your pump allows you to set
> up).
>
> There should be no reason that you have to check her 2-3 times per night
> because she's frequently running low and you're needing to give her juice
at
> night.  If her night time basals are set right, she should wake up with
her
> BG level being somewhat higher (maybe 30-50 points higher for a young one
> like her) than what she went to bed at.  If she's dropping, and having
lows
> at night, the most basic rule of diabetes management says she's getting
more
> insulin than she needs.  That means you need to to make some significant
> reductions in her night time basals (probably starting at 8 or 9 pm), do
some
>  several night time checks for 2-3 days, and if she's still dropping or
only
> rising a little, then that tells you that you need to reduce them further.
> If you don't feel comfortable with making these kind of adjustments on
your
> own, by all means, discuss it with your CDE or endo, but you should know
that
> there is no reason that a child on the pump should be having night time
lows
> like this -- it's a VERY fixable problem.
>
> I hope this helps give some idea of what some of your options are.  Feel
free
> to come back with more questions -- and be sure to keep us posted on how
> things go!
>
> Happy pumping!
>
> Lyndy
> Pumpmama to Katie (11, email @ redacted)  happily pumping with her Animas pump "Elvis"
> since 6-1-01
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