How do you.....

[Adrienne]

Bev

I would post about the CGMS on the email group as well. Some of them have a lot of knowledge and experience about that and what you should get and helpful things to say as well.

Are BUPA saying they will fund a normal CGMS or a Guardian RT and is it a once off use or permanent. There is a difference. If one off use to see what is happening then a CGMS is a good idea as you can't see on a screen until you download the data. If it is a permanent thing for the forseeable future then a Guardian RT is a good idea as you can see the readings on a screen on the machine and you can tweak accordingly (obviously following the rules).

 

[sofaraway]

I just think it is important that somebody interprets the data for you. What you don't want to happen is Bupa will do it then give you the results and your consultant won't go through them with you because they weren't done by the hospital. Hopefully that wouldn't happen though.
I wonder if his team have any reasons why they don't think he will benefit at the moment or any other reason why he is unsutible, or if it's just that they don't have access to one.
If they will fund it once then you will need to think carefully if this once is now that you want to use that chance.

 

[bev]

Well i dont know who would interpret the data - but his consultant is on BUPA'S list - so it might even be her doing it! Obviously i wouldnt go ahead with it until i knew who would look at the data afterwards. His team told me at first that they didnt have access to one - then they told me that the only one they had was broken and anyway its not for us in paeds - i think its for teens. I suspect it boils down to the funding of it and whether they think Alex's situation warrants it or not. In my view it does , but then i am bound to say that as his mum arent i! Bev

 

[diagonall]

Bev to test a basal no food of any sort should be eaten.
Protiens and fats do effect blood sugar levels.

Here is the basal test that people use be it on MDI or pump same principle aplies.
But do double check it's ok with DSN to do it.
http://www.diatribe.us/issues/13/learning-curve.php

 

[Adrienne]

I totally agree Sofaraway. You do need someone looking at the data for you and telling you what happened and what you can do to tweak things and it needs to be someone who deals with them and knows what they are looking at. The only way to make a Guardian RT work for you is if you have proper training on how to work it and have someone you can call to ask questions of as and when needed.

 

[Adrienne]

Bev to test a basal no food of any sort should be eaten.
Protiens and fats do effect blood sugar levels.

Here is the basal test that people use be it on MDI or pump same principle aplies.
But do double check it's ok with DSN to do it.
http://www.diatribe.us/issues/13/learning-curve.php

That is totally right and they do affect the levels, especially fat.

With children, especially young ones they say that they can eat a no carb meal as children can get very stressed with no food and that too affects levels. I can't ever say about adults because I just don't know.

I did read Admin's message re mine being wrong advice and I'm checking it out now. I only ever speak from personal experience and wouldn't say things that we haven't been through ourselves. I would be horrified with myself if that was totally wrong. I was only told this very thing last week by one of the leading hospitals for paediatric diabetes but as I say my daughter is pumping which is why I am now querying myself.

 

[diagonall]

That is totally right and they do affect the levels, especially fat.

With children, especially young ones they say that they can eat a no carb meal as children can get very stressed with no food and that too affects levels. I can't ever say about adults because I just don't know.

I did read Admin's message re mine being wrong advice and I'm checking it out now. I only ever speak from personal experience and wouldn't say things that we haven't been through ourselves. I would be horrified with myself if that was totally wrong. I was only told this very thing last week by one of the leading hospitals for paediatric diabetes but as I say my daughter is pumping which is why I am now querying myself.

How about eating a SF jelly then? 🙂 I bet that would go down well for breakfast

 

[Adrienne]

He he he I know my daughter would love that

 

[Adrienne]

Hi

Just to clarify, it seems to be the general consensus (Bev has no doubt seen all the emails flying backwards and forwards about this) that for a child when testing a basal the child can eat a non carb meal. We all know that protein and fats (especially) can affect levels but it is hard to make children miss their breakfast or whatever meal. So you obviously have to take that into account and the levels need to be good beforehand.

I think what I missed from my original post which was said to be wrong advice was the word children. I apologise for misleading anyone with that. Obviously for adults and teens testing basals is no food but not necessarily so for children.

However I have had advice from a professional source tonight about this as well and amongst other things has said that on MDI it is hard to distinguish between basal and bolus effect. To start with check the TDD (which someone suggested) again weight (of child), make sure the basal/bolus is roughly 50/50 (same person suggested - sorry can't remember who whilst writing this) and only if this is right you can start thinking about ratios even. But you must be prepared for hypos if you miss meals on basal bolus (MDI) and obviously you can't alter the basal insulin according to hourly requirements anyway.


Hope that clears anything up. 🙂

 

[bev]

Thanks Adrienne and everyone else,
Very thorough advice indeed Adrienne! It seems that it is quite a tricky thing to do - so as always i will check with Alex's DSN when we go to clinic in a couple of weeks.
I just wanted to say thanks to everyone as i didnt know about the 50/50 split or even that it depends on the weight of the child! I think Alex has just been put on a 'suck it and see' type regime as its still very early days for us - and also that he seems to be very insulin sensitive - so perhaps changing anything major for now may not be advisable. Thanks again all. 🙂 Bev

 

[Lizzie]

Bev to test a basal no food of any sort should be eaten.
Protiens and fats do effect blood sugar levels.

I was told on my DAFNE course that if testing basal it is OK to have carb free meals. They didn't say that we would have to starve for a day to test basal! Was I told the wrong thing?

 

[aymes]

I was told on my DAFNE course that if testing basal it is OK to have carb free meals. They didn't say that we would have to starve for a day to test basal! Was I told the wrong thing?

I test day time basal by only having a 'carb free' meal also, usually an omlette or similar, I also was told this while on DAFNE.

 

[diagonall]

I was told on my DAFNE course that if testing basal it is OK to have carb free meals. They didn't say that we would have to starve for a day to test basal! Was I told the wrong thing?

You do not basal test all day you do it in segments. So only one meal a day is missed.
If you starve all day your liver will dump glucose so again a pointless exercise.
If you eat anything at all then the test is a complete waste of time.
I know some people that need 3 units of insulin to cover scarmbled eggs so what is the point of doing a basal if the result is totally inacurate.
http://www.diatribe.us/issues/13/learning-curve.php

 

[aymes]

You do not basal test all day you do it in segments. So only one meal a day is missed.
If you starve all day your liver will dump glucose so again a pointless exercise.
If you eat anything at all then the test is a complete waste of time.
I know some people that need 3 units of insulin to cover scarmbled eggs so what is the point of doing a basal if the result is totally inacurate.
http://www.diatribe.us/issues/13/learning-curve.php

I don't agree that it is necessarily a 'complete waste of time'. For some people yes if they are affected a lot by non-carb food then yes the not eating anything approach would be best but personally I know that a small salad or an omlette will have no effect on my levels so if I'm basal testing a carb free lunch works fine for me, again that's my experience, not necessarily suitable for everyone.
The approch I use, as Lizzie said, is part of the 'dafne rules', I have found dafne has really worked for me so I'm happy with that approach.

 

[Adrienne]

Hi

I think we have discovered exactly the diversity that is 'diabetes'. We are all told different ways and whilst lots of medical teams are very poor in their advice there are obviously different good ways told to us by very good teams. DAFNE intrigues me greatly, never been on a course and when I once chatted to a lady who had been it sounds far more complicated that just normal carb counting. Again though on pump you learn different things that would not always come into it on basal/bolus (MDI).

I agree with Amnes in that when my daughter was on MDI she could not have just fruit as a snack when a proper snack was needed as it did nothing at all 'except grapes and bananas', odd but true, protein also seemed to do nothing, she would hypo after if not carbs, fat probably did but I didn't know that until pumping. However once on a pump then yes fruit did affect her levels.

Think I'm gonna look DAFNE up on the net and see what its all about.