Dance - snack - IOB

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Monica

Monica

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A little bit late to worry about it now, but I just wanted to see what you think.

Yesterday afternoon Carol decided she wanted to eat a Mars bar (we still haven't got to the bottom which size, regular or snack), for which she counted 15g carbs😱. So of course, at dinner time she was 19ish. Corrected and had dinner.

Before dance 2h later, she tested and was 11ish, so she didn't have a snack as normal. After dance she was 6.5 with 1.something IOB. So I said she should have something to eat before going in the shower, but she didn't. She had a chewee bar, 15g carb, about an hour later and gave no insulin for it.
She didn't test any more during the night, but this morning she woke up 11ish again.
I know her basals are probably not right yet (not that we're testing them) and we've only just started pumping.
Was I right telling her to eat that snack?
 
I think you were just being safe to be honest..................the problem stems back to the mars bar. How many carbs were in it? If this was known then maybe doses could have been more accurate.....

But as you say, the basal rate is not right yet, and so potentially all readings during the day may not turn out as you expect.............are you planning to basal test?

That would be the first thing on my to do list................🙂
 
To be honest, you can't be sure if you were right if you have no idea what her levels were (and if it was basal related, or the snack - ie the 11 she woke up on could be that her basal is set correctly and the 15g snack took her from 6 to 11 - or she could have hypod - etc etc). In the early days of pumping it's probably a good idea to get her to check really regularly, especially as basals are going to be out.

If it was me, next time I would be checking really regularly, especially after a sport - having the pump means you could potentially dodge post-sport hypos, but she won't be able to do that if she doesn't test! 🙂
 
Well, the Mars could have been either 25g or 40g, I suspect the latter.

We were not told to basal test, nor night time test on a regular basis. I did say to the DSN outright that I expected them to say I had to test Carol at midnight and 3am for the next 2 weeks (we'll have another appointment on the 7th July), but she just said you can if you want to. Well, I did the night before, but not last night. Also, Carol only has 1 basal rate over night.
 
Wow, how do they expect you to get basals right without testing?

For lots of people the whole point of the pump is to use the varying basals...I would definitely be testing overnight to make sure the basal rate is right for the whole night (for example, my basal goes up in the early hours to counteract the rise I get in the morning).

Also with the Mars Bar, did she check the packet? The other fab thing about the pump is having such small increments of insulin, might as well put them to good use!!

I'd post on CWD. Those mums will know what to do 🙂
 
Monica said:
A little bit late to worry about it now, but I just wanted to see what you think.

Yesterday afternoon Carol decided she wanted to eat a Mars bar (we still haven't got to the bottom which size, regular or snack), for which she counted 15g carbs😱. So of course, at dinner time she was 19ish. Corrected and had dinner.
Carol needs to bolus for what she eats. If she doesn't know the carb value then doesn't eat until she finds out. Simple.
Before dance 2h later, she tested and was 11ish, so she didn't have a snack as normal. After dance she was 6.5 with 1.something IOB. So I said she should have something to eat before going in the shower, but she didn't. She had a chewee bar, 15g carb, about an hour later and gave no insulin for it.
She didn't test any more during the night, but this morning she woke up 11ish again.
Now that does suprise me, not :( Having a pump you can not eat foods for free. There is no long acting soaking up or trying to soak up some carbs.
I know her basals are probably not right yet (not that we're testing them) and we've only just started pumping.
Carol needs to start her basal testing sooner now than later and prove to everyone she is grown up enough to use and have a pump.
Was I right telling her to eat that snack?
Obviously the end blood sugar result gave you that answer. 😉
Click to expand...

There is no reason now what so ever for Carol to have to snack unless it is unexpected exercise. Things like prearranged dance etc a reduced basal can be set.
The unfortunate side affect of to much snacking on unhealthy foods is a very fat/podgey teenager at the end of the day. Hormones are not always kind to teenagers so with unhealthy unneeded snacks as well esp for girls the end result is not always a pretty sight 🙂 She will also gain a lot better control by not snacking untill she has sorted her basals out. This way there is no insulin being stacked to mess up any results.

Have you purchased the book pumping insulin by john walsh? It can be found on amazon.
Carbs and calories would also be an ideal book for Carol as it's a picture book with all carb values at a glance.
Good luck with the basal testing
http://www.diatribe.us/issues/13/learning-curve.php here's the link to get you started.
 
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shiv said:
Wow, how do they expect you to get basals right without testing?

For lots of people the whole point of the pump is to use the varying basals...I would definitely be testing overnight to make sure the basal rate is right for the whole night (for example, my basal goes up in the early hours to counteract the rise I get in the morning).

Also with the Mars Bar, did she check the packet? The other fab thing about the pump is having such small increments of insulin, might as well put them to good use!!

I'd post on CWD. Those mums will know what to do 🙂
Click to expand...

I think they want to take it one step at a time, they are still "new" to this, Carol is child 34 to have the pump. Although I must admit, I know of 1 boy who had one for approx. 2 years now.

She did look on the packet, but it was one out of a multipack, so it didn't have the carbs on it😱 We told her that if she isn't sure to text me and ask (we were very good - no telling off!)

I almost posted this on CWD, but deep in my heart I DO know the answers really. Do test every night!!!!😛 I also would love to tell Carol to lay off eating new things until we have it right (well as right as poss).

Right, will go and post this on CWD anyway now. See what they say.
 
Pumper_Sue said:
There is no reason now what so ever for Carol to have to snack unless it is unexpected exercise. Things like prearranged dance etc a reduced basal can be set.
The unfortunate side affect of to much snacking on unhealthy foods is a very fat/podgey teenager at the end of the day. Hormones are not always kind to teenagers so with unhealthy unneeded snacks as well esp for girls the end result is not always a pretty sight 🙂 She will also gain a lot better control by not snacking untill she has sorted her basals out. This way there is no insulin being stacked to mess up any results.

Have you purchased the book pumping insulin by john walsh? It can be found on amazon.
Carbs and calories would also be an ideal book for Carol as it's a picture book with all carb values at a glance.
Good luck with the basal testing
http://www.diatribe.us/issues/13/learning-curve.php here's the link to get you started.
Click to expand...

We haven't learnt about temp basals yet, so in theory she should have had a snack before dance, hence the chewee bar later.
We have warned Carol that she will end up a fatty like me at this rate, but I think it might just be the novelty for now.
I haven't bought pumping insulin, as I wasn't sure about it. I'll order it now.🙂
Carol does have Carbs&Cals on her iPod touch, but she didn't have it with her yesterday.
 
Pumper_Sue said:
There is no reason now what so ever for Carol to have to snack unless it is unexpected exercise. Things like prearranged dance etc a reduced basal can be set.
Click to expand...

I'm going to politely disagree here. Sometimes I choose to have a snack instead of fiddling with basals - I don't think it's fair to say you *must* set a lower basal. It makes sense if it's for weight loss, but if you have no weight issues and exercise for fun, I don't think there's a right or wrong way to do things. Just my point of view.
 
shiv said:
I'm going to politely disagree here. Sometimes I choose to have a snack instead of fiddling with basals - I don't think it's fair to say you *must* set a lower basal. It makes sense if it's for weight loss, but if you have no weight issues and exercise for fun, I don't think there's a right or wrong way to do things. Just my point of view.
Click to expand...

Carol has no weight issue (yet😛), so I think we're staying with having a snack before exercise.
 
Hi there, gosh still really early days for you, takes time to get things right. I agree though that basals need to be worked on first and if you can start by getting the nights on the right path your days will be easier to manage. Do it in stages though, it is exhausting. I too would recommend the "pumping insulin" book by Walsh.
It is rare that we can give M a snack without a bolus unless running low, but then she is not doing scheduled exercises at 2yrs, all very random! The only thing we don't bolus is her evening milk (10g) which takes her through the night. Needs a lot of checking and correcting initially but will be worth it. I too would have given her the evening snack btw, it would be difficult at this stage to know the after effects of the dance and IOB etc Good luck 🙂
 
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