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Having the worst trouble with my sons #s starting this past summer... We've been pumping for over 4 years... He's up he's down, he is all over.... He is turning 11 Oct 10... we pump with medtronic mini med. I can't come up with much of a pattern but I'm noticing his #'s are just higher in general and he is higher in the morning. I recently changed his 3:30 am basil up from .55 to .65 and sensitivity to 90 from 100... and insulin on board from 4 hours to 3... he has gone as high as almost 600 a few weeks ago... to as low as 44 today!! Ok any suggestions would be greatly appriciated.. ps .... Camren missed over 30 days of school last year not counting latenesses or picked up early... this year he has missed 3 half days and 2 full days already for being high sick or pump malfunctioning.
Responses
Gary Scheiner says
It would be inappropriate for me (or any clinician) to give specific advice without knowing the full details of your son's diabetes care. So forgive me if I speak in generalities. A few things to consider:
1. In children your son's age, basal insulin needs tend to be highest in the early part of the night, not in the morning. That said, I always prefer to conduct a series of short fasting basal tests to get the doses set correctly.
2. Using the same I:C ratio at each meal rarely works. Almost everyone needs different settings at different meals. Most people need higher doses to cover their breakfast.
3. Your son's insulin sensitivity seems abnormally high given the amount of insulin he is using.
4. Excessive highs and lows are usually due to miscounted carbs, uncovered snacks, infusion site issues, and over-aggressive correction bolusing.
If you're interested in a "tune up", please give my office a call (877-735-3648). We work with families like yours via phone and the internet all the time. We may not be able to achieve perfect control, but we should be able to improve things considerably.
Alicia H. McAuliffe-Fogarty says
This is a situation that you need to meet and discuss with your diabetes team about...and if they are not helpful it maybe time to shop for one that you can work with because your child is entering the age of puberty, a time notorious for crazy BGs. You and your family need some support from your medical experts because your child's education is very important to his long term well being also.
