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[IPp] re:Cutting back on basals - for Field Day

<<<Sarah wrote:
<My five yr old son has been pumping for about a month now and he has an 
upcoming Field Day at school.  I have been told by the school nurse and phys. 
ed teacher that there will be a lot of running that day and a lot of physical 
activity. I am so nervous.  I have heard you mention to others that you cut 
back on your basal rates by 0.2.....how does that work with a child who is on 
0.1 to 0.2 thru out a day?  I imagine that I will need to suspend his pump 
for Field Day, and check his blood sugars every hour.  Now, if his blood 
sugar checks out fine...then what?  Do I bolus him for the missed basal while 
being suspended?  Or do I leave it alone and do nothing?  I know what to do 
if his blood sugars are high, I would just give him a correction...and if he 
is low I would give him a snack and not bolus for it. 
How do you guys deal with days at the beach or a park...or days where your 
kids are really playing hard?>>>>>>

My son Luke, 7, runs on a 0.1u/hr basal rate during the day.  If he's super
super active like on Field Day (Sports Day, etc.), we just put him on a temp
basal or disconnect altogether for a while and then check him every hour off
the pump - or if he "feels bad" (which is what he says when he feels low). 
Same as what we do for swimming/beach stuff.  If he's in range, we just leave
him alone as long as he's active - if he's <100, we usually give him a few
glucose tabs or a couple of crackers so he'll have enough carb to burn.  If
he's low, we treat the low & stay off the pump - no bolus.  If he's hungry, we
reconnect & bolus (the joy of the pump), and if he's high, we reconnect, bolus
a correction & then disconnect again - if we're at the beach.  If we're at a
park or something, we leave him connected if high.

Luke can burn sugar from about 250 down to 50 in less than 1 hour so I
understand your concern for Matthew.  If you have him check at the beginning of
the day, you'll also have a better feel for how he is - read the chapter on
Exercise Carbs in "Pumping Insulin" by John Walsh & Ruth Roberts to get a
better idea of how to keep feeding Matthew throughout all the exercise to keep
him stable.    

Unfortunately, we've found that on a regular basis Luke cannot
have a zero basal rate unless he's super active & starts at a reasonable level
(<200).  His honeymoon phase has long been over, and if he's remotely sedentary
with no basal going, his blood sugar hits 300-500 within an hour.  Because of
this, his minimum rate is usually 0.1u/hr & that's enough to keep him from
going too high.  We've found that out from trying, and I certainly recommend
that you try a zero basal as needed on Matthew to keep him from running low all
the time.

Good luck & have fun on Field Day!
Shelly V, mom to Luke, 7, dx'd 10/99, pumping 3/01

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