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Re: [IPp] omnipodquestion



We do occasionally get wild readings, but have generally found that the
problem came from contaminants on my son's testing site of fingers.  An
extra-thorough cleaning and retesting has generally solved it.  We have not
had the kind of problem you describe.  I hope the new PDM sorts your problem
out for you.

Chris

On Mon, May 16, 2011 at 3:21 PM, Didem Inanoglu <email @ redacted> wrote:

> Thank you Chris. I have contacted them and they are replacing our PDM for
> the
> second time..
>
> However, this has happened before and we ended up replacing our PDM  but
> are
> still having similar problems.
>  So , you  have not had any false readings using Omnipod PDM and Freestyle
> old
> regular strips?
>
>
>
>
> ________________________________
> From: "Brostrup-Jensen, C. Christian" <email @ redacted>
> To: email @ redacted
> Sent: Mon, May 16, 2011 2:00:42 PM
> Subject: Re: [IPp] omnipodquestion
>
> Hi Didem,
>
> We have been using the Omnipod for several years now and have not
> experienced that kind of high variability.  It sounds to me like you might
> have a faulty meter in your PDM.  I would strongly suggest that you contact
> Insulet immediately, describe the problem to them and see what they
> suggest.  They have always been very helpful and responsive to our
> technical
> issues over the years.  That situation is neither "normal" nor acceptable.
> Hopefully they can help you out quickly.
>
> Best wishes,
> Chris Brostrup-Jensen
>
> On Sat, May 14, 2011 at 10:44 AM, Didem Inanoglu <email @ redacted
> >wrote:
>
> > Anybody using Omnipod?
> > We are having a recurrent problem with Omnipod . Testing BS with PDM and
> > Freestyle teststrips, we find a huge discrepancy between multiple tests
> and
> > also
> > readings are a lot higher than what we get from Ultratouch mini lifetime
> > glucometer. For example this morning our reading was 354 with omnipod PDM
> ,
> > repeated it immediately second time was 204, checked it with Ultratouch
> > right
> > away it was 149.
> >
> > Anybody else having similar problems?
> >
> > Any input would be appreciated.Thanks
> >
> > Didem ( Mother of Demre dx 4/2009
> >
> >
> >
> > ________________________________
> > From: "email @ redacted" <email @ redacted>
> > To: email @ redacted
> > Sent: Sat, May 14, 2011 4:31:30 AM
> > Subject: [dfwfotod] Digest Number 232
> >
> >
> > DFW FOTOD
> > Messages In This Digest (12 Messages)
> > 1a.
> > Dosing question and weirdness from CDE From: mwedding
> > 1b.
> > Re: Dosing question and weirdness from CDE From: suzannehunter123
> > 1c.
> > Re: Dosing question and weirdness from CDE From: Angel
> > 1d.
> > Re: Dosing question and weirdness from CDE From: suzannehunter123
> > 1e.
> > Re: Dosing question and weirdness from CDE From: Angel
> > 1f.
> > Re: Dosing question and weirdness from CDE From: cmlady1972
> > 1g.
> > Re: Dosing question and weirdness from CDE From: Melinda Wedding
> > 1h.
> > Re: Dosing question and weirdness from CDE From: suzannehunter123
> > 2a.
> > Pediatric Endos in the area? From: cmlady1972
> > 2b.
> > Re: Pediatric Endos in the area? From: Lisa Coleman
> > 2c.
> > Re: Pediatric Endos in the area? From: suzannehunter123
> > 3.
> > New to Group From: email @ redacted View All Topics | Create
> New
> > Topic
> > Messages
> >
> > 1a.
> > Dosing question and weirdness from CDE
> > Posted by: "mwedding" email @ redacted  mwedding
> > Fri May 13, 2011 6:03 am (PDT)
> >
> >
> > Good morning!
> >
> > Carson is still on MDI. We've been getting the hang of things, just three
> > months
> > in.
> >
> > We've noticed she shoots high after breakfast and needs a correction at
> > lunch.
> > I
> > sent her log to the CDE yesterday, and here's what she recommended:
> >
> > "Carson does seem to be running high at lunch time, so I would recommend
> > increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> grams
> > of
> > carbohydrates. "
> >
> > That's fine, except I have no clue what it means. Our endo shared with us
> > that
> > we can add insulin at 1 unit: 20 carbs when she wants to eat more than
> her
> > recommended carb allowance at a meal.
> >
> > Presently, we give her 3 units in the morning and she eats around 35-40
> > carbs
> > at
> > 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30. We've
> > seen
> > numbers over 250 (and even higher some days) at lunchtime.
> >
> >
> > Remember, we're new at this and not fully trained on ratios yet, so any
> > advice
> > you give has to be pretty basic. :)
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 1b.
> > Re: Dosing question and weirdness from CDE
> > Posted by: "suzannehunter123" email @ redacted  suzannehunter123
> > Fri May 13, 2011 7:08 am (PDT)
> >
> >
> > Here's an example of ratio's assuming that Carson has 40g carbs for
> > breakfast:
> >
> > If ratio is 1/20 (1 unit for every 20g carbs), then:
> > 40 divided by 20 = 2, so that would be 2 units.
> > If ratio is 1/18, then 40 divided by 18 = 2.2 units.
> > Now, since you are MDI you can't really dose for the .2, so assuming you
> > would
> > round down to 2 units. Which means that 1/18 really doesn't work much
> > better
> > for
> > you.
> >
> > You could consider lowering the ratio to 1/15, then that would be 2.5
> > units,
> > which means that she is getting more insulin.
> >
> >
> > However, you say she has a snack around 9.30 - is this uncovered, or is
> she
> > dosed for it? If it's uncovered then you may want to consider lowering
> the
> > carbs
> > on that snack which will then lower her lunch-time number.
> >
> > If you are dosing for the snack, then the elevated number at lunch time
> is
> > probably OK - remember that insulin duration is around 4 hours, so she
> will
> > still have active insulin on board, and you probably don't need to
> correct
> > the
> > high as she could run the risk of going low later.
> >
> > Another option to consider is pre-bolusing her breakfast insulin.
> Cereal's
> > are
> > notorius for giving wacky numbers, but if you can pre-bolus by 10-15
> > minutes
> > before she eats (assuming she's not low to start with) then the insulin
> > will
> > be
> > starting to work by the time she eats which will give you a jump-start on
> > the
> > high numbers.
> >
> > But, I have just re-read your post and you say that you give her 3 units
> > for
> > the
> > 35-40g carbs she has - this doesn't match up to the 1/20 ratio, it is
> more
> > like
> > a 1/13 ratio which may mean you may want to switch lower her ratio even
> > more.
> >
> > --- In email @ redacted s.com, "mwedding" <email @ redacted .> wrote:
> > >
> > > Good morning!
> > >
> > > Carson is still on MDI. We've been getting the hang of things, just
> three
> > >months in.
> > >
> > > We've noticed she shoots high after breakfast and needs a correction at
> > lunch.
> > >I sent her log to the CDE yesterday, and here's what she recommended:
> > >
> > > "Carson does seem to be running high at lunch time, so I would
> recommend
> > >increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> > grams
> > of
> > >carbohydrates. "
> > >
> > > That's fine, except I have no clue what it means. Our endo shared with
> us
> > that
> > >we can add insulin at 1 unit: 20 carbs when she wants to eat more than
> her
> > >recommended carb allowance at a meal.
> > >
> > > Presently, we give her 3 units in the morning and she eats around 35-40
> > carbs
> > >at 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30.
> > We've
> > seen
> > >numbers over 250 (and even higher some days) at lunchtime.
> > >
> > >
> > > Remember, we're new at this and not fully trained on ratios yet, so any
> > advice
> > >you give has to be pretty basic. :)
> > >
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 1c.
> > Re: Dosing question and weirdness from CDE
> > Posted by: "Angel" email @ redacted
> > Fri May 13, 2011 7:09 am (PDT)
> >
> >
> > Hello!! I hope this may help, a little!! :)
> > My son is also on injections. And basically ratios can be an number, no
> > matter
> > how odd the number. And they ALWAYs change. It makes it very frustrating.
> >
> > Like as of now my sons ratios are 1/22 for breakfast, 1/35 for lunch and
> > 1/40
> > for dinner. However we are in the process of adjusting them once again.
> One
> > of
> > the most important things about injections ( which is why the pump is so
> > nice)
> > that the insulin should be in the child's system for approximately 4
> hours.
> > Their BG should peek at about 2 hours after the shot. However that's not
> > always
> > true, that's when you get into the types of food that is consumed. But if
> > you
> > give your child a shot at 730am, they will be high at 930. Because they
> > have
> > insulin in their system. I try my hardest not to over lap shots. Try your
> > hardest to give an injection when your fast acting insulin is not in
> their
> > system. You said you gave your child a 15 c snack, I assume that's with
> > injection? If so you are I relaying insulin shots that's why they are
> high
> > at
> > lunch. If you wait a full 4 hours, they should be down to a normal BG.
> You
> > can't
> > get an accurate BG if the shots are overlapped so it's harder or
> impossible
> > to
> > get a right correction. I'm not the best at explaining things in emails,
> :(
> > I'm
> > sorry if this didn't make since. You are more then welcome to call me and
> > ask
> > away!!
> >
> > My son is 4 and was diagnosed at 2! Still on injections but in the
> process
> > of
> > a
> > pump!! :)
> >
> > My number is  940-435-8187  940-435-8187
> > Have a great day!! :)
> > Angel
> > Ryan DXd Jan 2010, age 4
> >
> > Sent from my iPhone
> >
> > On May 13, 2011, at 8:03 AM, "mwedding" <email @ redacted com> wrote:
> >
> > > Good morning!
> > >
> > > Carson is still on MDI. We've been getting the hang of things, just
> three
> > >months in.
> > >
> > > We've noticed she shoots high after breakfast and needs a correction at
> > lunch.
> > >I sent her log to the CDE yesterday, and here's what she recommended:
> > >
> > > "Carson does seem to be running high at lunch time, so I would
> recommend
> > >increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> > grams
> > of
> > >carbohydrates. "
> > >
> > > That's fine, except I have no clue what it means. Our endo shared with
> us
> > that
> > >we can add insulin at 1 unit: 20 carbs when she wants to eat more than
> her
> > >recommended carb allowance at a meal.
> > >
> > > Presently, we give her 3 units in the morning and she eats around 35-40
> > carbs
> > >at 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30.
> > We've
> > seen
> > >numbers over 250 (and even higher some days) at lunchtime.
> > >
> > >
> > > Remember, we're new at this and not fully trained on ratios yet, so any
> > advice
> > >you give has to be pretty basic. :)
> > >
> > >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 1d.
> > Re: Dosing question and weirdness from CDE
> > Posted by: "suzannehunter123" email @ redacted  suzannehunter123
> > Fri May 13, 2011 7:13 am (PDT)
> >
> >
> > I wanted to add that making these kind of ratio changes can be trial and
> > error.
> > It is best to make the change, monitor it for 2-3 days and see how it
> works
> > out
> > and then adjust again if needed. You will also probably want to test her
> > more
> > frequently during the morning to make sure you catch any lows.
> >
> > We've all been where you are, and I remember how totally confusing I
> found
> > it
> > all in those first months, so don't worry. You'll soon get the hang of it
> > and
> > be
> > changing ratio's in your sleep!!!
> >
> > --- In email @ redacted s.com, "suzannehunter123" <email @ redacted >
> wrote:
> > >
> > > Here's an example of ratio's assuming that Carson has 40g carbs for
> > breakfast:
> > >
> > > If ratio is 1/20 (1 unit for every 20g carbs), then:
> > > 40 divided by 20 = 2, so that would be 2 units.
> > > If ratio is 1/18, then 40 divided by 18 = 2.2 units.
> > > Now, since you are MDI you can't really dose for the .2, so assuming
> you
> > would
> > >round down to 2 units. Which means that 1/18 really doesn't work much
> > better
> > for
> > >you.
> > >
> > > You could consider lowering the ratio to 1/15, then that would be 2.5
> > units,
> > >which means that she is getting more insulin.
> > >
> > >
> > > However, you say she has a snack around 9.30 - is this uncovered, or is
> > she
> > >dosed for it? If it's uncovered then you may want to consider lowering
> the
> > carbs
> > >on that snack which will then lower her lunch-time number.
> > >
> > > If you are dosing for the snack, then the elevated number at lunch time
> > is
> > >probably OK - remember that insulin duration is around 4 hours, so she
> > will
> > >still have active insulin on board, and you probably don't need to
> correct
> > the
> > >high as she could run the risk of going low later.
> > >
> > > Another option to consider is pre-bolusing her breakfast insulin.
> > Cereal's
> > are
> > >notorius for giving wacky numbers, but if you can pre-bolus by 10-15
> > minutes
> > >before she eats (assuming she's not low to start with) then the insulin
> > will
> > be
> > >starting to work by the time she eats which will give you a jump-start
> on
> > the
> > >high numbers.
> > >
> > > But, I have just re-read your post and you say that you give her 3
> units
> > for
> > >the 35-40g carbs she has - this doesn't match up to the 1/20 ratio, it
> is
> > more
> > >like a 1/13 ratio which may mean you may want to switch lower her ratio
> > even
> > >more.
> > >
> > >
> > > --- In email @ redacted s.com, "mwedding" <mwedding@> wrote:
> > > >
> > > > Good morning!
> > > >
> > > > Carson is still on MDI. We've been getting the hang of things, just
> > three
> > >months in.
> > > >
> > > > We've noticed she shoots high after breakfast and needs a correction
> at
> > >lunch. I sent her log to the CDE yesterday, and here's what she
> > recommended:
> > > >
> > > > "Carson does seem to be running high at lunch time, so I would
> > recommend
> > >increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> > grams
> > of
> > >carbohydrates. "
> > > >
> > > > That's fine, except I have no clue what it means. Our endo shared
> with
> > us
> > >that we can add insulin at 1 unit: 20 carbs when she wants to eat more
> > than
> > her
> > >recommended carb allowance at a meal.
> > > >
> > > > Presently, we give her 3 units in the morning and she eats around
> 35-40
> > carbs
> > >at 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30.
> > We've
> > seen
> > >numbers over 250 (and even higher some days) at lunchtime.
> > >
> > > >
> > > > Remember, we're new at this and not fully trained on ratios yet, so
> any
> > >advice you give has to be pretty basic. :)
> > > >
> > >
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 1e.
> > Re: Dosing question and weirdness from CDE
> > Posted by: "Angel" email @ redacted
> > Fri May 13, 2011 7:14 am (PDT)
> >
> >
> > Hi again!! Suzzane was MUCH better at explaining lol!! However one think
> I
> > thought of, is if you do want to stay with the 1:18 ratio, you can always
> > add
> > a
> > few carbs to even it out. I did that when Ryan was first diagnosed. I had
> > little
> > things that were 1g each. If I wanted the number even on the ratios I did
> > that.
> > Now I attempt to do a .2 or so on. It's hard on a syringe though.
> >
> >
> > Sent from my iPhone
> >
> > On May 13, 2011, at 9:08 AM, "suzannehunter123" <email @ redacted com>
> > wrote:
> >
> > > Here's an example of ratio's assuming that Carson has 40g carbs for
> > breakfast:
> > >
> > > If ratio is 1/20 (1 unit for every 20g carbs), then:
> > > 40 divided by 20 = 2, so that would be 2 units.
> > > If ratio is 1/18, then 40 divided by 18 = 2.2 units.
> > > Now, since you are MDI you can't really dose for the .2, so assuming
> you
> > would
> > >round down to 2 units. Which means that 1/18 really doesn't work much
> > better
> > for
> > >you.
> > >
> > > You could consider lowering the ratio to 1/15, then that would be 2.5
> > units,
> > >which means that she is getting more insulin.
> > >
> > >
> > > However, you say she has a snack around 9.30 - is this uncovered, or is
> > she
> > >dosed for it? If it's uncovered then you may want to consider lowering
> the
> > carbs
> > >on that snack which will then lower her lunch-time number.
> > >
> > > If you are dosing for the snack, then the elevated number at lunch time
> > is
> > >probably OK - remember that insulin duration is around 4 hours, so she
> > will
> > >still have active insulin on board, and you probably don't need to
> correct
> > the
> > >high as she could run the risk of going low later.
> > >
> > > Another option to consider is pre-bolusing her breakfast insulin.
> > Cereal's
> > are
> > >notorius for giving wacky numbers, but if you can pre-bolus by 10-15
> > minutes
> > >before she eats (assuming she's not low to start with) then the insulin
> > will
> > be
> > >starting to work by the time she eats which will give you a jump-start
> on
> > the
> > >high numbers.
> > >
> > > But, I have just re-read your post and you say that you give her 3
> units
> > for
> > >the 35-40g carbs she has - this doesn't match up to the 1/20 ratio, it
> is
> > more
> > >like a 1/13 ratio which may mean you may want to switch lower her ratio
> > even
> > >more.
> > >
> > > --- In email @ redacted s.com, "mwedding" <email @ redacted .> wrote:
> > > >
> > > > Good morning!
> > > >
> > > > Carson is still on MDI. We've been getting the hang of things, just
> > three
> > >months in.
> > > >
> > > > We've noticed she shoots high after breakfast and needs a correction
> at
> > >lunch. I sent her log to the CDE yesterday, and here's what she
> > recommended:
> > > >
> > > > "Carson does seem to be running high at lunch time, so I would
> > recommend
> > >increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> > grams
> > of
> > >carbohydrates. "
> > > >
> > > > That's fine, except I have no clue what it means. Our endo shared
> with
> > us
> > >that we can add insulin at 1 unit: 20 carbs when she wants to eat more
> > than
> > her
> > >recommended carb allowance at a meal.
> > > >
> > > > Presently, we give her 3 units in the morning and she eats around
> 35-40
> > carbs
> > >at 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30.
> > We've
> > seen
> > >numbers over 250 (and even higher some days) at lunchtime.
> > >
> > > >
> > > > Remember, we're new at this and not fully trained on ratios yet, so
> any
> > >advice you give has to be pretty basic. :)
> > > >
> > >
> > >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 1f.
> > Re: Dosing question and weirdness from CDE
> > Posted by: "cmlady1972" email @ redacted  cmlady1972
> > Fri May 13, 2011 8:03 am (PDT)
> >
> >
> > How incredibly confusing for you! I have never been where you're at
> > personally
> > because we were given carb ratios from day one of diagnosis, but I still
> > understand your confusion.
> >
> > Currently Carson is on a 1:13 ratio if you are giving insulin for the
> > morning
> > snack, 1:18 ratio if you're not. The other message with the math explains
> > that
> > so no sense explaining again. Therefore, the CDE's recommendation to
> lower
> > to
> > 1:18 is doing nothing for Carson, especially since you haven't been
> > thoroughly
> > trained in carb ratios. My son's doctors have over the years made 1 unit
> > carb
> > changes and told us to report his BG numbers in a couple of days, meaning
> > lowering to a 1:12 or 1:17 ratio from where you're at now. If that didn't
> > work,
> > they would lower it again. For example, using your numbers for breakfast
> > 35/12
> > would be 3 units at breakfast. 15/12 would be one unit for morning snack.
> > If
> > you
> > are not currently bolusing for the snack, that could be one of the
> reasons
> > she
> > is running high at lunch.
> >
> >
> > If it were me, I would call the CDE back and make them get you in for
> > training
> > on carb ratios. They are not helping you at all and that is what they are
> > there
> > for. They need to know the confusion they are causing.
> >
> >
> > Cheri
> > (Christopher, age 14, DX 2/16/07)
> >
> > --- In email @ redacted s.com, "mwedding" <email @ redacted .> wrote:
> > >
> > > Good morning!
> > >
> > > Carson is still on MDI. We've been getting the hang of things, just
> three
> > >months in.
> > >
> > > We've noticed she shoots high after breakfast and needs a correction at
> > lunch.
> > >I sent her log to the CDE yesterday, and here's what she recommended:
> > >
> > > "Carson does seem to be running high at lunch time, so I would
> recommend
> > >increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> > grams
> > of
> > >carbohydrates. "
> > >
> > > That's fine, except I have no clue what it means. Our endo shared with
> us
> > that
> > >we can add insulin at 1 unit: 20 carbs when she wants to eat more than
> her
> > >recommended carb allowance at a meal.
> > >
> > > Presently, we give her 3 units in the morning and she eats around 35-40
> > carbs
> > >at 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30.
> > We've
> > seen
> > >numbers over 250 (and even higher some days) at lunchtime.
> > >
> > >
> > > Remember, we're new at this and not fully trained on ratios yet, so any
> > advice
> > >you give has to be pretty basic. :)
> > >
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 1g.
> > Re: Dosing question and weirdness from CDE
> > Posted by: "Melinda Wedding" email @ redacted  mwedding
> > Fri May 13, 2011 9:48 am (PDT)
> >
> >
> > Thanks for the input, all.
> >
> > We are following the DMP they gave us at the hospital. It looks like
> this:
> >
> > Breakfast: 35-40 carbs, 3 units
> > Snack: 15 carbs, no insulin
> > Lunch: 45-50 carbs, 2 units
> > Snack: 15 carbs, no insulin
> > Dinner: 45-50 carbs, no insulin
> > Bedtime: 15 carbs + lantus
> >
> > This has evolved over time as I've sent in logs. They'd review and send
> > feedback. I know that we've been spoon-fed that info, but it sure seems
> > abrupt
> > that she'd assume I'd be able to switch ratios on the fly if we've never
> > been
> > taught at all!
> >
> > Anyway, I gave her 4 units this morning and her lunch number was 105.
> >
> > Thank you, thank you, thank you for your help!
> >
> > ____________ _________ _________ __
> > From: cmlady1972 <email @ redacted com>
> > To: email @ redacted s.com
> > Sent: Fri, May 13, 2011 10:03:06 AM
> > Subject: [dfwfotod] Re: Dosing question and weirdness from CDE
> >
> > How incredibly confusing for you! I have never been where you're at
> > personally
> > because we were given carb ratios from day one of diagnosis, but I still
> > understand your confusion.
> >
> > Currently Carson is on a 1:13 ratio if you are giving insulin for the
> > morning
> > snack, 1:18 ratio if you're not. The other message with the math explains
> > that
> > so no sense explaining again. Therefore, the CDE's recommendation to
> lower
> > to
> > 1:18 is doing nothing for Carson, especially since you haven't been
> > thoroughly
> > trained in carb ratios. My son's doctors have over the years made 1 unit
> > carb
> > changes and told us to report his BG numbers in a couple of days, meaning
> > lowering to a 1:12 or 1:17 ratio from where you're at now. If that didn't
> > work,
> > they would lower it again. For example, using your numbers for breakfast
> > 35/12
> > would be 3 units at breakfast. 15/12 would be one unit for morning snack.
> > If
> > you are not currently bolusing for the snack, that could be one of the
> > reasons
> > she is running high at lunch.
> >
> > If it were me, I would call the CDE back and make them get you in for
> > training
> > on carb ratios. They are not helping you at all and that is what they are
> > there
> > for. They need to know the confusion they are causing.
> >
> > Cheri
> > (Christopher, age 14, DX 2/16/07)
> >
> > --- In email @ redacted s.com, "mwedding" <email @ redacted .> wrote:
> > >
> > > Good morning!
> > >
> > > Carson is still on MDI. We've been getting the hang of things, just
> three
> > >months in.
> > >
> > > We've noticed she shoots high after breakfast and needs a correction at
> > lunch.
> >
> > >I sent her log to the CDE yesterday, and here's what she recommended:
> > >
> > > "Carson does seem to be running high at lunch time, so I would
> recommend
> > >increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> > grams
> > of
> > >carbohydrates. "
> > >
> > > That's fine, except I have no clue what it means. Our endo shared with
> us
> > that
> >
> > >we can add insulin at 1 unit: 20 carbs when she wants to eat more than
> her
> > >recommended carb allowance at a meal.
> > >
> > > Presently, we give her 3 units in the morning and she eats around 35-40
> > carbs
> > >at 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30.
> > We've
> > seen
> > >
> > >numbers over 250 (and even higher some days) at lunchtime.
> > >
> > >
> > > Remember, we're new at this and not fully trained on ratios yet, so any
> > advice
> >
> > >you give has to be pretty basic. :)
> > >
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 1h.
> > Re: Dosing question and weirdness from CDE
> > Posted by: "suzannehunter123" email @ redacted  suzannehunter123
> > Fri May 13, 2011 11:58 am (PDT)
> >
> >
> > Yay! What an awesome number!
> >
> > I'm assuming you go to Children's not Cooks? We were told to use ratio's
> > from
> > day one so don't know any other way. Maybe this particular nurse assumed
> > you
> > knew about them already? Looks like your well on your way to not even
> > needing
> > their training!
> >
> > Personally, I would say given her routine below you have two choices - up
> > her
> > ratio's, or decrease her uncovered snacks. Ideally long-term (especially
> if
> > you
> > are thinking ultimately of a pump) you will get to the point where there
> > are
> > pretty much no free/uncovered foods. She would then have a slightly
> higher
> > meal
> > ratio, and insulin to cover the snack. But for now, if she's happy to
> keep
> > having the snacks then there's no harm - just be extra careful if she
> > doesn't
> > have it one day, as you'll see her numbers drop considerably by lunch
> time
> > (her
> > 15g snack is basically 1 unit).
> >
> > --- In email @ redacted s.com, Melinda Wedding <email @ redacted .> wrote:
> > >
> > > Thanks for the input, all.
> > >
> > > We are following the DMP they gave us at the hospital. It looks like
> > this:
> > >
> > > Breakfast: 35-40 carbs, 3 units
> > > Snack: 15 carbs, no insulin
> > > Lunch: 45-50 carbs, 2 units
> > > Snack: 15 carbs, no insulin
> > > Dinner: 45-50 carbs, no insulin
> > > Bedtime: 15 carbs + lantus
> > >
> > > This has evolved over time as I've sent in logs. They'd review and send
> > > feedback. I know that we've been spoon-fed that info, but it sure seems
> > abrupt
> >
> > > that she'd assume I'd be able to switch ratios on the fly if we've
> never
> > been
> > > taught at all!
> > >
> > >
> > > Anyway, I gave her 4 units this morning and her lunch number was 105.
> > >
> > > Thank you, thank you, thank you for your help!
> > >
> > >
> > >
> > >
> > > ____________ _________ _________ __
> > > From: cmlady1972 <cjwarren39@ ...>
> > > To: email @ redacted s.com
> > > Sent: Fri, May 13, 2011 10:03:06 AM
> > > Subject: [dfwfotod] Re: Dosing question and weirdness from CDE
> > >
> > >
> > > How incredibly confusing for you! I have never been where you're at
> > personally
> >
> > > because we were given carb ratios from day one of diagnosis, but I
> still
> > > understand your confusion.
> > >
> > > Currently Carson is on a 1:13 ratio if you are giving insulin for the
> > morning
> > > snack, 1:18 ratio if you're not. The other message with the math
> explains
> > that
> >
> > > so no sense explaining again. Therefore, the CDE's recommendation to
> > lower
> > to
> > > 1:18 is doing nothing for Carson, especially since you haven't been
> > thoroughly
> >
> > > trained in carb ratios. My son's doctors have over the years made 1
> unit
> > carb
> > > changes and told us to report his BG numbers in a couple of days,
> meaning
> > > lowering to a 1:12 or 1:17 ratio from where you're at now. If that
> didn't
> > work,
> > >
> > > they would lower it again. For example, using your numbers for
> breakfast
> > 35/12
> >
> > > would be 3 units at breakfast. 15/12 would be one unit for morning
> snack.
> > If
> > > you are not currently bolusing for the snack, that could be one of the
> > reasons
> >
> > > she is running high at lunch.
> > >
> > >
> > > If it were me, I would call the CDE back and make them get you in for
> > training
> >
> > > on carb ratios. They are not helping you at all and that is what they
> are
> > there
> > >
> > > for. They need to know the confusion they are causing.
> > >
> > >
> > > Cheri
> > > (Christopher, age 14, DX 2/16/07)
> > >
> > > --- In email @ redacted s.com, "mwedding" <mwedding@> wrote:
> > > >
> > > > Good morning!
> > > >
> > > > Carson is still on MDI. We've been getting the hang of things, just
> > three
> > > >months in.
> > > >
> > > > We've noticed she shoots high after breakfast and needs a correction
> at
> > >lunch.
> > >
> > > >I sent her log to the CDE yesterday, and here's what she recommended:
> > > >
> > > > "Carson does seem to be running high at lunch time, so I would
> > recommend
> > > >increasing breakfast insulin by decreasing her ratio to 1 unit for 18
> > grams
> > of
> > >
> > > >carbohydrates. "
> > > >
> > > > That's fine, except I have no clue what it means. Our endo shared
> with
> > us
> > >that
> > >
> > > >we can add insulin at 1 unit: 20 carbs when she wants to eat more than
> > her
> > > >recommended carb allowance at a meal.
> > > >
> > > > Presently, we give her 3 units in the morning and she eats around
> 35-40
> > carbs
> > >
> > > >at 7am. She gets a 15 carb snack around 9:30 and eats lunch at 11:30.
> > We've
> > >seen
> > >
> > > >numbers over 250 (and even higher some days) at lunchtime.
> > > >
> > > >
> > > > Remember, we're new at this and not fully trained on ratios yet, so
> any
> > >advice
> > >
> > > >you give has to be pretty basic. :)
> > > >
> > >
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (8)
> > 2a.
> > Pediatric Endos in the area?
> > Posted by: "cmlady1972" email @ redacted  cmlady1972
> > Fri May 13, 2011 8:33 am (PDT)
> >
> >
> > Good morning!
> >
> > I joined the group a couple of months ago and have been reading all of
> the
> > posts, but not contributing until today.
> >
> > My son, Christopher was diagnosed at age 9 on 2/16/07 while we were
> living
> > in
> > northwest Oklahoma. Luckily, they refer all newly diagnosed patients to
> OU
> > Children's Physicians in OKC. Even though it was a 2 1/2 hour drive every
> 3
> > months, I have been very pleased with the care we have received there.
> > Since
> > moving to Denton almost a year ago, we have continued to make the trek to
> > OKC
> > because it is the same 2 1/2 hour drive we were used to. Our local doctor
> > told
> > us that if we wanted to switch to an endo in the DFW area, he would refer
> > us
> > to
> > Cook's. So here are my questions... .
> >
> > Which clinic do you use? Are you happy with the care you receive there?
> Are
> > they
> > available between visits to make necessary changes to bolus rates?
> >
> > Thanks in advance for your help.
> >
> > Cheri
> > (Christopher, age 14, dx 2/16/07)
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (3)
> > 2b.
> > Re: Pediatric Endos in the area?
> > Posted by: "Lisa Coleman" email @ redacted  lcole721
> > Fri May 13, 2011 9:02 am (PDT)
> >
> >
> > Hi Cheri,
> >
> > Welcome to the group! We live in Corinth and there is a clinic for Cooks
> in
> > Denton. My daughter (Rebekah)  was diagnosed at age 4 and is now 11. We
> > have
> > been with them from diagnosis and they have been great to us! There are
> > several
> > Dr.s there, we see Dr. Wilcutt's but he is not accepting any new patients
> > but
> > the other dr.s are. They are there to help out with changes if you need
> > help
> > but
> >
> > I know they really encourage us to learn how to make changes on our own.
> > Please
> > let me know if you have any more questions I will be glad to help!
> >
> > Lisa (Rebekah dx 11/04)
> >
> > ____________ _________ _________ __
> > From: cmlady1972 <email @ redacted com>
> > To: email @ redacted s.com
> > Sent: Fri, May 13, 2011 10:33:27 AM
> > Subject: [dfwfotod] Pediatric Endos in the area?
> >
> >
> > Good morning!
> >
> > I joined the group a couple of months ago and have been reading all of
> the
> > posts, but not contributing until today.
> >
> > My son, Christopher was diagnosed at age 9 on 2/16/07 while we were
> living
> > in
> > northwest Oklahoma. Luckily, they refer all newly diagnosed patients to
> OU
> > Children's Physicians in OKC. Even though it was a 2 1/2 hour drive every
> 3
> > months, I have been very pleased with the care we have received there.
> > Since
> > moving to Denton almost a year ago, we have continued to make the trek to
> > OKC
> > because it is the same 2 1/2 hour drive we were used to. Our local doctor
> > told
> > us that if we wanted to switch to an endo in the DFW area, he would refer
> > us
> > to
> > Cook's. So here are my questions... .
> >
> > Which clinic do you use? Are you happy with the care you receive there?
> Are
> > they
> >
> > available between visits to make necessary changes to bolus rates?
> >
> > Thanks in advance for your help.
> >
> > Cheri
> > (Christopher, age 14, dx 2/16/07)
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (3)
> > 2c.
> > Re: Pediatric Endos in the area?
> > Posted by: "suzannehunter123" email @ redacted  suzannehunter123
> > Fri May 13, 2011 11:50 am (PDT)
> >
> >
> > Hi Cheri, and welcome!
> > We live just outside Denton off 380 near Aubrey. We go to Cooks and
> overall
> > love
> > it. They have a clinic here in Denton at Presby, which would save the
> drive
> > to
> > Ft Worth. although we still usually go to Ft Worth purely because we love
> > one
> > of
> > the nurses there - and since we see the nurses/CDEs more frequently than
> > the
> > doctor, and usually get better information from them that is what is
> > important
> > to me.
> >
> > They have always been very good at help between appointments. Any urgent
> > issues
> > are dealt with promptly by the on-call endocrine nurse and they are also
> > very
> > good with non-urgent questions. We've found that we can fax or email our
> > logs/print-outs over to them and I would say 99% of the time we'll get a
> > response that same day.
> >
> > Is it possible with your insurance to ask for a trial visit to Cooks
> before
> > actually making the switch? That way you could go and visit and meet and
> > see
> > what you think.
> >
> > --- In email @ redacted s.com, "cmlady1972" <cjwarren39@ ...> wrote:
> > >
> > > Good morning!
> > >
> > > I joined the group a couple of months ago and have been reading all of
> > the
> > >posts, but not contributing until today.
> > >
> > > My son, Christopher was diagnosed at age 9 on 2/16/07 while we were
> > living
> > in
> > >northwest Oklahoma. Luckily, they refer all newly diagnosed patients to
> OU
> > >Children's Physicians in OKC. Even though it was a 2 1/2 hour drive
> every
> > 3
> > >months, I have been very pleased with the care we have received there.
> > Since
> > >moving to Denton almost a year ago, we have continued to make the trek
> to
> > OKC
> > >because it is the same 2 1/2 hour drive we were used to. Our local
> doctor
> > told
> > >us that if we wanted to switch to an endo in the DFW area, he would
> refer
> > us
> > to
> > >Cook's. So here are my questions... .
> > >
> > > Which clinic do you use? Are you happy with the care you receive there?
> > Are
> > >they available between visits to make necessary changes to bolus rates?
> > >
> > > Thanks in advance for your help.
> > >
> > > Cheri
> > > (Christopher, age 14, dx 2/16/07)
> > >
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (3)
> > 3.
> > New to Group
> > Posted by: "email @ redacted" email @ redacted
> > email @ redacted
> >
> > Fri May 13, 2011 4:21 pm (PDT)
> >
> >
> > Hi!
> >
> > I'm new to the group, but not new to being the parent of a diabetic. My
> son
> > Hayden (just turned 5) was diagnosed Feb. of 2009.
> >
> >
> > Thank you for providing a forum for us to ask questions & respond to
> > others.
> >
> > Jennifer
> >
> >
> > Back to top Reply to sender | Reply to group | Reply via web post
> > Messages in this topic (1)
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