Here goes!
1. What kind on insulin management mode do you use?
Isabel and Bob both use the Medtronic Paradigm pump (Isabel's on the 522, Bob is on the 722), with NovoRapid. Bob uses the QuickSet sites and Isabel now uses Silhouettes, which are MUCH easier :)
2. How often do you inject/change pump sites?
We change sites every 3 days, or sooner if the site falls off or gets kinked. This rarely happens for Bob so he does his every 3 days. It used to happen a lot for Isabel when she was using the QuickSet sites but is less of a problem now with the Silhouettes. We don't refill at the same time as the site change unless the pump happens to have run out.
3. What type (s) of insulin do you use?
NovoRapid for both of them.
NovoRapid for both of them.
4. What are your basal settings ?
Isabel has lots!
00:00 = 0.2
06:00 = 0.3
08:00 = 0.1
12:00 = 0.2
14:00 = 0.3
16:00 = 0.2
19:00 = 0.35
Bob only has two - one for the day and one for the night....and I have no idea what they are (neither would he, I think, without looking at the pump!)
5. What are your correction factors ?
Bear in mind this is mmol/l (1.0 mmol/l = 18)
Isabel only has one - it's 1:10 but I think that is too high. According to the maths she should be on about 1:7 but that is far too high. I'm thinking of changing it to 1:12 or even 1:13 as I often give her less than what the pump says. Sometimes, though, it's spot on. Usually instinct kicks in and tells me when to reduce the correction dose. Amazing how we Mums just know, isn't it. I don't know what Bob's correction factor is!!!
6. What are your meal ratios ?
Again, in mmol/l.
Isabel has lots, again! Here are hers....
00:00 = 1:27
06:00 = 1:15 (for breakfast)
08:30 = 1:27
16:30 = 1:20 (for dinner)
19:00 = 1:27
Again, I don't know about Bob's - I think he just has one, and it seems to work OK!
7. What do you do for activity and/or PE?
Isabel doesn't really do PE at school - they have outdoor play from 10:30-11:00 after her snack, and this usually brings her down just a little bit. She leaves the pump connected for that, unless they are doing water play. Swimming always brings her down unless she is over 15 or so to begin with, in which case she needs a bolus. Today, for example, she started her swimming lesson at 10.5 and finished it at 7.0. We disconnect for swimming and ballet classes but not for ad hoc activity like walking, playground time, riding her bike, etc. But we do disconnect for playing on the beach - can't have the pump getting full of sand! And usually she is in and out of the sea, paddling, so it's safer to disconnect. Next year when she starts "big school" and does swimming lessons and PE there, we will have to work out how to manage it. Bob disconnects for swimming but leaves the pump connected for his morning walks. He doesn't normally find that activity brings him down a lot - just a little bit, sometimes.
8. How do you manage Pizza, Macaroni and Cheese, or any other "difficult to manage" foods?
For Isabel, we do a dual wave bolus for as long a period as possible. At dinnertime (5pm) the maximum I can give in terms of the time is over 1.5 hours - she needs to be in the bath at 6.30pm so I can get her in bed at 7pm. At lunchtime, we do it over two hours, perhaps. But a lot of the time it's guesswork. High-fat and high-protein foods don't always send her up if she has been very active. Pizza at lunchtime before an afternoon on the beach, for example, doesn't need a long dual wave as the activity keeps her down even if the pump is disconnected.
Bob does normal boluses for everything and never counts his carbs - he is too used to the old jab habit and guessing his insulin doses based on the size of the whole meal, so he sticks with that. It seems to work for him - his BG has been more stable since going on the pump, so he takes the approach "if it ain't broke, don't fix it"!
9. How do you prefer to manage your logs/data?
I keep a notebook, for Isabel. I write EVERYTHING down! We have the option to download the data from the meter and the pump into nice software packages but to be honest they are more hassle than they are worth. I have a small notebook and use a double page spread per day; on the left side I have 4 columns, for Time, BG, Carbs and Bolus; on the right side, reading across, are relevant comments for that particular measurement or the food that goes with the bolus, etc. Night time readings go on the bottom of the previous day; each day's page starts with her pre-breakfast reading.
Needless to say, Bob writes nothing down - you'll be getting the idea by now....diabetes management for him is a case of muddling along and forgetting about it, most of the time, but it seems to work for him so why not?! I hope one day we can get to that point with Isabel - it doesn't impinge on his life or our family life at all really, and I love that.
I am a bit anal about this for Isabel, I must say - but it works for me! It was the same when the kids were babies. For each of them I had a large notebook - left side was feeds (time, length of time, number of fl oz, right or left side for the 6wks I breastfed them, whether or not they fed well, etc.). Right side was naps (time, length of time, good sleep, whether they went down OK, etc.). I still have both notebooks....saving them for when we have baby no. 3 so I know what to do :)
Well, there it is - my contribution to Naked Pancreas blog day. Better get back to work now!
Kerry xxx
Soooooooo, when my daughter finally gets on a pump; I can come to you to help me figure it all out? ;)
ReplyDeleteNice site! Can't wait to here more from you. Thanks for stopping by my corner of the world.
Thanks Amy! Yes indeed, do stop by - although we are no experts :-/ It's our lovely endo who does the maths :)
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