Re: [IPk] Sasha's pump now postponed or cancelled!
"I feel so upset today. The diabetes nurse from Gloucester Hospital has
phoned us having said that the results of Sasha's CGMS were "interesting".
They are suggesting that our carb counting and insulin ratios are all wrong
and they need to think about a pump again because we need some months of
accurate carb counting under our belts before we can even think about
pumping. It sounded rather like they were having doubts about giving Sasha
a pump full stop!"
I am sure they will accept her for the pump. As you say the results you are
getting are the exact reason for going on the pump and I am sure you are
doing the ratios correctly and they will soon realise this too. the
Professionals have no idea what it is like to be diabetic.
"On the first evening after the monitor was fitted Sasha was OK for the
first few hours, good BG levels, then I gave Novorapid with her evening
meal. But as I pulled the needle the injection site bled immediately. I
thought to myself, I hope all the Novorapid hadn't come out with the
bleeding. As you can't tell whether it has or not I had to assume it was ok
and just check later. However the BG level rose and by 11.30 pm her BG
level 18 mmol!! So we gave 2.5 units to correct the high. Apparently that
was a BAD thing to do as at the Gloucester Hospital they would never correct
a high level at night time. But we have always been told to give 2 units
for BG levels over 15 mmols. The nurse said that they leave high levels to
come down overnight on their own."
They shouldn't knock you like this. It is only with experience that all
parties will learn the correct thing to do for Sash at various times of the
day. We have all gone through this and know that the pump basals may need
to be changed alsost hourly and may need to be changed but until you see the
patters this cannot be sorted out.
"However because have Sasha's insulatard set at the very minimum possible
amount due to nigh time hypos, her BG levels never come
down without extra insulin. Also we use a different carb to insulin rate
for breakfast, lunch and evening meal. However when I talked to the
dietician at Glos earlier last month she didn't think that was correct and
seemed to imply that the insulin to carb rate is constant throughout the
day. I don't know if that's what the
consultant thinks as well and maybe the diabetes nurses."
I used to think this but I had criticism just after Christmas and have
since introduced this and things are getting better. It seems to me that if
you keep your ratio constant, the basal rate has to be too high at certain
times of the day to compensate and then it is not possible to move the times
of meals and other things without going hypo. It is simply a mathematical
problem when you study it.
"There were also three hypos below 3.8 that showed up on our meter but no
hypos shown on their download of the CGMS. We have these recorded on the
The conference and my web reading haveexplained this to me too. The levels
are different in different parts of the body. Only the fingertips give the
correct readings and the others can be 20 minutes out.
"ne night Sasha had dropped to 4.8 at 2.30 am and we were worried it might
drop futher so gave her just half a small cup of milk which only amounted to
5 carbs. In the morning at 7.30 she was 13 mmols. I did think maybe it was
a rebound high, but apparently there was no hypo and they are questioning
why we gave food in the night and think we gave too much, but we didn't and
in the past no way would 5 grams of carbs shoot her up to 13 mmols. So this
was very unusual."
All days are unusual and different from others. Even the stress of wearing
the monitor would I think affect the readings. I think this is so in the
same way that putting in a new set can cause a high for some hours as I
think the body knows this is an 'attack' .
"I had thought that the CGMS reading would be a help to get us a pump but
now it seems to have had the opposite effect. "
Try to relax. I am sure everything will work out with time. It is awful
for you to have to sort out your daughter. It is bad enouth when we do it
" We have to attend carb counting classes on Friday and then wait and see
the consultant in the afternoon because she is now doubtful about Sasha
having a pump because of the crazy GB levels."
I hope all goes well. Keep calm to show them you know it all and are
willing to learn more as time goes on.
" When we removed the sensor it wasn't straight but curled over in quite a
bend. Does anyone know if this would have caused the reading from the CGMS
monitor to be wrong? We still have it as Sasha wanted it as a souvenir."
I think this will have caused problems. I also find that varying digestion
problems affect the control and I see Sasha is a celiaac (sp). I have just
deleted the word!
I have gone through changing my basals and insulin/carb ratios for a month
and am exhausted. I think I am getting there. I was controlled before when
I had them with the basals going high at mealtimes and I will get there
eventually. I know you will get this sorted out. I know I am not a child
but just had to write to you as your story touched me.
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