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Re: [IPk] 4 year old child new to insulin pump

Hi John-
Well done on getting Andrew pumping.  You asked about CGMS while  pumping and 
action time of insulin.  Justine's had two sessions of CGMS  since she 
started pumping 4 months ago and it was a real eye-opener.  Even  when she was 
in-range before a meal, her BG would soar to the 20's  within 15-20 minutes of 
 eating. THe insulin would catch up about 60 minutes later, and have her back in
range for the next BG reading.  We  smoothed things out by increasing her 
 basal rates an hour before meal times, and bolusing before she ate rather than
after.  That one's a little tricky  though, as you can never be sure how much 
they're going to eat.  We make a  guesstimate, then top her up at the end when 
we see exactly how much was  eaten. 
These changes alone were responsible for an HbA1c improvement of 1.5 points  
in 5 weeks, and it was very satisfying to see smooth lines around meals on the 
 second CGMS.  If Andrew is starting meals high, you might need to tweak  
your basals.  Instead of skipping meals, try delaying them.
Good luck,
Alexandria, mum to Justine 5 (dx 11-01) and Elliott  4
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