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Re: [IPk] Charlie Dalton

In message <004701c264ae$cc39eab0$email @ redacted>, Barbara Dalton
<email @ redacted> writes
>from Barbara, mother of Charlie aged 10 who has been recommended a pump by his
>consultant at Kings' College Hospital.
>I avidly read all your messages daily to get more info on what we are about to
>embark. However, I am beginning to feel rather scared - so many of your
>messages seem to be about problems with equipment, support and the uninformed
>views of so called professionals. Having received so much positive personal
>encouragement form members of the site, I am now wondering if we are embarking
>on the right track. Charlie boards at school and the two nurses and Head are
>wholly supportive of  Charlie's decision to try a pump. He knows he will be
>healthier and not end up in A&E so often and is feeling very positive about
>the whole thing. It's just me panicking!!

Please don't panic: the team at Kings have a very good reputation, so
you won't have a problem there.  Yes, the pump does malfunction
occasionally, but as I keep saying: a malfunctioning pump is miles
better than mdi!  

>Another thing, Charlie seems unable to keep stable BMs. He is usually anything
>between 18 and 30 during the day but has frequent night hypos despite eating
>cereal etc on going to bed. Any advice? His diet is good, he loves food and
>the school monitor how much he eats every day. No problems there. But despite
>changing insulin's, amounts etc we are unable to keep to a happy medium. Is
>this very unusual? Could it be the stress of a 'high-profile' chorister life
>that affects everything? I feel so ignorant.

It sounds as if his long-term insulin is simply not matching his basal
needs.  With a pump, you can set it so that he gets NO insulin during
the night, and LOADS during the day. No long-term insulin, in any dose,
can cope with wildly different needs at different times of the day.  The
best they can deal with are people who need nearly the same amount all
the time.  

A predictable, but wrong pattern of bgs is the easiest thing to solve
with a pump.  Unpredictable is harder to solve (if you said 'he often
goes hypo in the night, and some days he's hypo, others over 30', for
example, it would be more of a challenge than the pattern you describe).  

The 18 - 30 swings may, in part, be due to the different absorption of
insulin at different bg levels.  So a meal eaten with a bg of 8, might
result in a rise of 4 over 4 hours, but eaten with a bg of 18, might
result in a rise of 12 over 4 hours. 

You say the school monitors what he eats ... do they monitor what he
injects, and make sure that he changes the amount, according to the
amount he eats, and the bg he has before he eats?

Best wishes,

(dm 30+, 508 1+)
Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
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