still the need to finger prick?

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bev

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Hi all,
Just getting all my information ready for tomorrow about using a pump. This is a really silly question - but - do you have to finger prick for BG levels? From what i can make out on the childrens forum - some children have sensors which presumably alert a hypo - so is that instead of finger pricking? thanks for any advice. 🙂 Bev
 
Well, I don't actually know, but I'm sure I read somewhere here (possibly Adrienne) that even with sensors you still have to fingerprick. I think the sensors are more like CGM (continuous glucose monitors) that you gather data with rather than using them to determine basal/bolus.

I could be entierly wrong, of course!🙂
 
Hi Bev, you have to finger poke minimum of 4 times/day but it's better to do 8 times.
Sensors have to be calirbrated with finger pokes too.
The NHS does not provide sensors unless there is a very good reason. IE hypo unawareness.
Sue
 
Hi Bev

Yes you do still finger test. With a pump it is a lot more than 4 times a day. If you ask on the other site you will get the general idea that generally it is around 8 to 10 tests a day for everyone with MDI and pumps. As an idea this is what I do with Jessica :

8 am - test and insulin with breakfast

10 am - test (because it is two hours after insulin and you can correct now and not before, this is the rule of pumping)

12 noon - lunch time at school (but insulin is given after eating in case she leaves anything so at about 12.45 pm)

2.45 pm - test (because it is two hours after insulin and you can correct and not before)

5.00 pm test because tea time and insulin

7 pm - test (because it is two hours after insulin and you can correct and not before)

9 pm - test - two hours after the last time

10.30 pm - test

midnight - test

2.30 am - test


This is just a general idea. Sometimes it can be more but not generally less. It is more if there are hypos or hypers. With a hyper on pump rules you have to test one hour later to make sure the correction has brought it down a bit. You can never correct within a 1 1/2 hour period (2 hour period in Jessica's case).

Sensors are funded by the PCT's. They are additional to the pump consumables (the canulas and reservoirs), it is not as hard as it used to be to get the sensor funding as there is more proof at how much they actually help with levels. For example so long as the day has been relatively normal for my daughter, then from midnight to morning generally I can just look at the sensor readings and know they are ok rather than more finger pricking. One of our mutual friends on the email group does do less finger tests because the sensor is so accurate for her child but she can't stop completely.

Hope that helps.
 
Yes that helps a lot thanks Adrienne!

I was going to ask why you test after a meal because surely the novorapid is still in the system for up to 4 hours - but its because your drip feeding the insulin in isnt it? Bev
 
Think idea is generally that the main novorapid push (which happens as well on a pump, yes, but is more adjustable?) still peaks around 2 hours, so that's the measurement to see how effective the dosing is...? Anytime before and food is still being digested?

Have you not been advised to test after a meal anyway bev? We find it hugely useful on MDI: 2-2.5 hours after eating to see how the meal was dosed (should be below 10mmols). And then of course before meals will give an indication of the levermir, esp if splitting (is Alex splitting now?).

Re sensors: we just found out yesterday at the JDRF open day that the Freestyle Navigator set up claims to be able to dose from its readings -- the first to claim so. But all sensors and CGMs need callibrating so certainly several fingerpricks a day...

Re PCTs providing them: we have recently found out that our team are providing CGMs with all their pumps! So they have leapt in with asking for both pump and sensor at all times. So apparently we'll get a sensor too in time. You may be able to use this as a precedent for your GP?
 
Hi Patricia, no we havent been told to test 2 hours afterwards! We only normally test pre-meal.
Great news about the cgm and pumps! Your team sound brilliant - much better than ours. I will certainly keep this in mind when speaking to them tomorrow at clinic. Thanks. Bev
 
We were originally advised only to test *after* meals! And the whole thing just made no sense whatsoever...When we went to addenbrooke's they advised us to test before and then when we were looking seriously at ratios (when needed adjusting or whatever) to also test after meals, to see if the bolus is right (should be as I say less than 10mmol, so that it can settle back to the pre-meal level by the next meal. In theory!). We've just found that E tests loads now anyway, though not so much at school: upon waking/breakfast, then usually three hours after (break, and because this is a typical hypo time for him); then pre-lunch; then two hours after lunch, then pre-dinner, then two hours after bed and/or before bed. At the moment we are testing him at 3am as well, and if we've had to give a bedtime correction (several times in last two weeks) we get up and test at that two hour point too.

Adrienne: why so many finger pricks? Is your daughter's metabolism particularly unpredictable? I think our average school days is six or seven; when things are rough it's up to ten, certainly.
 
Patricia said:
Adrienne: why so many finger pricks? Is your daughter's metabolism particularly unpredictable? I think our average school days is six or seven; when things are rough it's up to ten, certainly.
Click to expand...

The other parents on the email list all do pretty much do the same. It is what we've worked out to get the best control we can, just it is tight management but it generally works. I do seem to test more in the evening than others but that is because I believe I nearly lost her to a hypo in Feb last year at 11 pm and had to use the glucagon but it was only pure chance I went upstairs with the ironing that I looked in on her, I wasn't due to test till midnight!!!! I learnt how to use glucagon within seconds!!!! I now test alot in the evening but can't help it and she is asleep anyway.


My daughter is different though and her aborption of insulin is not quite the same as your usual suspect. She has no pancreas so no digestive enzymes so has to take supplements, if the supplements are not right then that affects the levels as well.

I think you met some of my great friends on Saturday at the JDRF thing.
 
Oh and an aditional bit of fun not there's the frequent basal testing that needs to be done.
So adding it up bev there's one heck of a lot of finger poking to be done.
Pos anything from 250 to 300 pokes/month.
Pumping can take up a lot of time and effort and is not an easy option or a quick fix.
You need to be able to understand how the insulin works in conjunction with activity or lack of/different types of food/stress/illness etc.
You have to be able to think for yourself and have the confidence to make the desicion to act NOW and not wait an hr and then ring the dsn for guidence.
Carb counting needs to be off pat too.

Hope that helps a bit more for you.

Sue
 
Type1_Sue said:
Oh and an aditional bit of fun not there's the frequent basal testing that needs to be done.
So adding it up bev there's one heck of a lot of finger poking to be done.
Pos anything from 250 to 300 pokes/month.
Pumping can take up a lot of time and effort and is not an easy option or a quick fix.
You need to be able to understand how the insulin works in conjunction with activity or lack of/different types of food/stress/illness etc.
You have to be able to think for yourself and have the confidence to make the desicion to act NOW and not wait an hr and then ring the dsn for guidence.
Carb counting needs to be off pat too.

Hope that helps a bit more for you.

Sue
Click to expand...


Hi

Do you pump yourself Sue? You sound quite negative about it.

I don't do loads of basal testing for my daughter in the sense of skipping a meal, if that is what you meal. Its a lot easier on a pump to tell if it is the basal that is wrong or the carb ratio so you can tweak without the basal testing which is a huge bonus especially for children. 🙂
 
Adrienne said:
Hi

Do you pump yourself Sue? You sound quite negative about it.

I don't do loads of basal testing for my daughter in the sense of skipping a meal, if that is what you meal. Its a lot easier on a pump to tell if it is the basal that is wrong or the carb ratio so you can tweak without the basal testing which is a huge bonus especially for children. 🙂
Click to expand...

Hi Adrienne, Yes I pump and love it.
I'm just trying to point out to bev the pros and cons.
People seem to think that you just plug a pump in and it does all the work.
The pump only does what you tell it :D
If the basal is not correct then nothing else is. So reg basal testing is a must, so my pump trainer told me. This applies to MDI too. Basal wrong and everything else is wrong.
As we discussed before what is wrong with sugar free jelly for breakfast for the kids? :D
 
Type1_Sue said:
Hi Adrienne, Yes I pump and love it.
I'm just trying to point out to bev the pros and cons.
People seem to think that you just plug a pump in and it does all the work.
The pump only does what you tell it :D
If the basal is not correct then nothing else is. So reg basal testing is a must, so my pump trainer told me. This applies to MDI too. Basal wrong and everything else is wrong.
As we discussed before what is wrong with sugar free jelly for breakfast for the kids? :D
Click to expand...

Hi Sue

Oh good, you're lucky I was going to try and sell pumping to you 🙂

Not sure what you mean by regular basal testing though, how regular is regular and surely you would only test it if you suspect something was wrong. Some friends do basal testing but not frequently and we certainly don't. I have found with a pump that there is much less of a need to test the basal like you would for MDI, as before doing that you can do other things to test without having to miss a meal. I know this isn't a big deal for an adult but for a child missing a meal is a biggie. They use so much energy, mentally included that they can't really miss a meal which is why they are advised to have a non carb meal, I'm afraid sugar free jelly just isn't enough (although I love sugar free jelly and I would eat it for a meal but that won't help any diabetic :()

Not sure I quite agree with the last sentence 'wrong basal and everything is wrong' where pumping is concerned. As you can have so many basal that if one is out then that doesn't mean the rest of the day is out, it can do but not always. For example if my daughter's basal needs altering at say 8 pm as she spikes for some reason at 10 pm and I don't change it I can correct in the early hours so she back down to normal by morning and then she would be fine all day until the wrong basal again in the evening. So where that is concerned this is a huge bonus as opposed to injections.


I think there are pros and cons, as with like most things, with a pump there are more pros but you do have to be prepared to want to chuck it out the window maybe in the first week. Our DSN said one thing that has stuck and I think it is very important. Trust your pump. This is so true, once you trust it you are well on the way to happy pumping.

Wouldn't it be so much better if it was magic !!!!😉
 
i do!!!!!!!!!!!!!!!!!

yes i finger prick at least 5 or 6 times a day and am hoping to get a pump soon aswell, have you got msn??? if you have tell me and i'll give you my msn!i need some one to talk to!!!
 
Lozzy said:
yes i finger prick at least 5 or 6 times a day and am hoping to get a pump soon aswell, have you got msn??? if you have tell me and i'll give you my msn!i need some one to talk to!!!
Click to expand...

Hi Lozzy

I think you are new here from what I can gather. I don't really use MSN, I don't have the time. Have you chosen your pump, how far down the line are you to getting one? Does your hospital do them?:confused:
 
Adrienne, just want to say how absolutely awful it must have been to encounter such a situation with your daughter by chance...doesn't bear thinking about. It was the night pricks I was surprised about, yes... But I know what you mean: woke up at 1am last week suddenly, convinced E was having a hypo. Went to check -- he wasn't. But...
 
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