[IPk] Honeymoon Period
re the example you gave of taking 8 units for breakfast for a
breakfast of 75g carbohydrates if Jamies BG was 12 , then 5 units
would be a meal bolus and 3 units correction bolus.
The meal boluses were always presented to us as an amount for
the carbohydrates plus a correction.
If he wanted just an orange juice for breakfast, say 15g of
carbohydrates then he would bolus 1 for the meal and whatever
correction he needed for the BG. We tend to work in half units
for the correction part now, not full units as was proposed - our
The tables were given to help us plan a "balanced diet" for
Jamie, based around his weight and age. We found them very useful
in the first few weeks when we were coping with diabetes, the
pump and secondary school for the first time.
We are much more flexible than this now: Jamie rarely eats
breakfast at the weekend , he likes a long lie in and his basal
bolus works very well. (18 hours without food with a BG around
6). He often snacks in the evening/in the car if he wants to etc
(the first thing he did when leaving hospital was work out how
much insulin he needed for a twix)
The hospital Jamie goes to (diabetes section of the childrens
unit of the teaching hospital in Geneva) is very experienced with
children and pumps (all children go on pumps unless there is a
good reason not too - completely opposite to UK - there were 3
including Jamie going on the pump when he was in hospital) and we
have had 100% support. It may be their attitude is "old
fashioned" but I think it has been great for the first few months
to have them behind us and has given us great confidence.
However, from the beginning Jamie has taken a very hands-on
approach to his illness (he handles all aspects of the pump -
changing canula, programming changes, clearing the air bubbles)
and has very sensible suggestions regarding boluse, (using
delayed boluses when we eat out, increasing basals to 110% when
he had a cold and his BG's were high).
I have encouraged him in this - I want him to be independant in
his management, understanding the consequences of his
diet/lifestyle on his diabetes, but giving him the flexibility to
be a teenager like any other etc. I also want us to be really on
top of this before we move to the UK in June next year
With the honeymoon period, I wanted to see if we could work out
whether he was in it, what would be the best thing to do etc
before consulting the hospital. In the back of my mind I thought
I had heard of a link between total insulin intake per day with
weight. ie a unit per kilo measure. In my original e-mail, I
clearly didn't explain this too well.
I think rather thank honeymoon, we may have been "correcting"
too quickly sometimes for high BG and then getting in to the too
high/too low cycle. This may be where separating out the meal
bolus from the correction bolus more clearly in our minds and
when we bolus is a good idea - I will start presenting this to
Jamie in this way.
regards and thanks
Maggie (mum to Jamie 11, dx 22/09 and pumping since 26/09)
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