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Re: [IPp] Remember to bolus

Here is a snip from my latest book:

Friend to Friend

*For the Forgetful Pumper

Parents of very young children with diabetes are often advised to bolus for
a meal after it is eaten. Sometimes this is recommended even for adults,
especially when eating a high-fat meal, or for those suffering from
gastroparesis (delayed stomach emptying). The problem that often arises in
such cases is that people forget to administer the bolus. This can have
dangerous consequences, especially if it occurs a bit too frequently. Even
if there wasnt such a large dose of missed insulin, many people will need
an even greater bolus to make up for the missed amount. It seems that when
insulin is administered in anticipation of a BG rise, it is more affective
than when taken later, when blood sugars are already high. (To quote the
well-known wisdom, An ounce of prevention is worth a pound of cure.) If
you find that you or your child is forgetting to bolus after eating, try the

~Remove your pump from your pocket, belt, etc., and leave it on the table as
long as you are eating. Having the pump in front of your eyes throughout the
meal will surely serve as a reminder to administer the necessary insulin.

~Alternatively, you can try keeping your log book or even an
attractive-looking notebook on the table while you eat. Dont put it away
until you have jotted down your meal, its carb content, and the amount of
coverage it requires. This trick is also useful for the forgetful BG logger!

~ There are several watches available with multiple alarms that can be
preset to sound at the times you usually eat a meal. Some computerized
watches can even be programmed to read BOLUS. One example is the Ironman
watch by Timex that can be bought at major department stores for under $50.

~If you have eaten a meal with an unusually high fat or protein content, you
may require additional insulin several hours after eating. (Or, you can use
a square wave bolus. See Extending your Bolus below.) You can use your
pump as an alarm clock to remind you to bolus. All the pumps have an
auto-off feature, meaning that the pump shuts off after a preset amount of
time during which no buttons are pressed. The pump will alarm at that time.
So, if you will want to take additional insulin two hours after eating a
meal, you can program the auto-off to beep after two hours, as a reminder to
bolus. Keep in mind, however, that if this alarm is not turned off in time,
the pump will go into suspend and you will be missing not just boluses, but
basal rates too.

~If you dont like any of the above ideas, theres still hope! The new Cozmo
pump by Deltec which is now in the making features alarms to remind pumpers
to bolus.

Rabbi Hirsch Meisels
Jewish Friends With Diabetes
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