Thursday, 18 October 2012

Tweak, tweak

Last week I wrote about the problem we were having with Dyl constantly running slightly high (Trends Don't Lie). As a result, we upped a couple of basal rates in the hopes that it would at least curb the 2 daily spikes he was experiencing. And we were right, it did combat the spikes. However, it still left him elevated throughout the day, all day.

Fast forward to today, when we were back at the diabetes education center for a check-up. In addition to doing Dyl's quarterly A1c, weighing and measuring him, and talking about changes and updates in diet and exercise routine, the endocrinologist took a really hard look at Dyl's pump data and decided to make some pretty substantial changes. In fact, she increased every single basal rate. Background note: Dylan has six different basal rates which vary considerably at different times of day. For example, because he is prone to hypoglycemic seizures in his sleep, he takes less insulin at night. For some reason, which we really have no idea, he requires more than twice the amount of insulin between 2:30pm and 6:00pm than he does at any other time of day. The other 4 rates fall somewhere in between. (This ability to vary insulin delivery over a 24 hour period is one of the MANY reasons I love pumping over MDI.)

I've said this before, and I'll say it again and again: I love our endo and I trust her explicitly. So when she says increase all the basal rates, I do it. And I did, but not without fear. This is, by far, the most drastically we have ever altered Dylan's settings, and a couple of the settings were increased by as much as 0.2 units per hour. In an MDI user that injects insulin two or three times a day, 0.2 units may not seem like much, but in an 11 year old pumper, who boluses additional insulin for food, it's a lot. Fingers crossed that these changes get his bg levels back into ideal range, at least most of the time.

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