Tuesday, August 14, 2012

Day 2 - Insulin

Just a quick note to say that we have finished day two of our pump school. One day to go. We are tired...it is hard for grown ups to think and focus on so much new information and hard for little girls to sit and play quietly, even watching fun movies on the laptop. In a room with other people...it's just not home.

Hooking Sam up this morning was fine. We un-clipped her from the pump at home so that we could fill the pump with insulin. Left her original site (sticker/canula) in. Made breakfast and lunch to take to the clinic. Once we got there and had our pump settings approved, we clipped her back in and did out first real Bolus (for the carbs she was getting for beakfast). Easy peasy.

The girls did fine without a snack this morning and we had a small bit of almonds and babybell cheese this afternoon. The start of pumping requires no snacks to help us get a clear sense of how well the basal rate has been set. It is currently set to give 0.2 units of insulin every hour. (note:this is technically NOT a lot of insulin...we are still in the honeymoon phase where her pancreas is trying to work and putting out a little of its own insulin.). It has been SO nice to be able to give her insulin for meals without a needle. Just pushing buttons. And so nice too to be able to correct any high glucose numbers.

To clarify, she pump is set to give her a basal background rate of insulin all day long. Regardless of food she gets this. For high activity, we could lower her basal rate, for example, for a one hour soccer game, to account for her body using extra glucose, but generally, the basal rate stays the same. A Bolus is a bunch of extra insulin given in 2 cases: to cover carbohydrates she is eating or to bring down a higher than desired blood sugar. Previously, we were giving her a specific dose of insulin in the morning and at dinner time and feeding her the amount of food needed to use up this insulin (no more, no less!). And until recently, we were not doing anything insulin-wise to bring down high blood sugars. The pump is great for food flexibility and better blood glucose control. Today Sam's BG (blood glucose) was a little high since the insulin amounts programmed in her pump were based on normal daily activity and sitting all morning is not normal for her. Bu it was fixable by giving a bolus for high blood glucose (when we test her) and felt good doing so.

I can't member if I mentioned yesterday but for the next two weeks we eat as we have been, with specific carb amounts and then after that, once any necessary changes to the basal rate have been made, we can start exploring flexibility...eating what we want whenever we want it. (obviously, we are still interested in making healthy choices for the most part, and as enjoying a comfortable daily routine, as we did before diabetes too, but in a much less rigid, more normal way.)

Today we learned about calculating Insulin to Carb ratios and calculating Insulin Sensitivity Factor...two things that help you figure out how much insulin to give for a Bolus. Good to know, but happy that the blood glucose meter/pump remote does the calculating automatically for us too. Tomorrow we learn more about activity and calculating Insulin On Board (how much insulin is still working in your body from the last time you bolused). Then we are on our own!

Good night!

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