New pump, little kid, extended honeymoon?

(Fiora) #1

Just looking for anecdotes, I think.
My daughter is 4 (today!) and started with the tslim 3 weeks ago. It’s going great.
She was diagnosed 6 months ago and her carb ratios have been steady and consistent for a while. In the last week I have had to change them all, multiple times, due to lows. I know not to try to look for whys when it comes to diabetes but I am curious if anyone else has experienced this. I’m wondering if receiving basal insulin in spurts is supporting her pancreas better than Lantus was, or if it could be a growth spurt? She’s really steady overnight and during the day so mealtime bolus is clearly the culprit. Her new dinner ratio looks like it should be 1:60 which is lower (higher?) than when she was diagnosed.

(joe) #2

Hi @Fiora welcome to TypeOneNation. It is common for newly diagnosed type 1 to start making insulin. The timing around when that starts or how long it lasts is random.

Essentially, the job is to control blood sugar. It doesn’t matter if that means using 1 unit for 5 grams carbs or 1 unit for 60. Her body needs what it needs.

The pump will make an easier job of those fractional units, so having it can make things easier. Since she’s growing and recently diagnosed, her insulin needs will change over time so keeping good notes is important.

I hope you are getting all the support you need. Many of us here have had type 1 a long time so please take advantage of that knowledge. Good luck!

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(Joel) #3

Hi @Fiora

I’m hoping that your daughter had a great birthday.

As for the honeymoon question, here’s the thing: our bodies are constantly in the process of repairing themselves. When your daughter has periods of low inflammation and/or her immune system is otherwise not attacking her beta cells, they will regenerate and she will produce insulin. I believe this is especially true in the younger years when our bodies have higher levels of stem cells and growing is at its most accelerated rate.

Also, she’s 4, and probably at one of the most physically active times of her life, so that’s going to affect her insulin needs, too. She may not need meal dosing at all for a while. Three months after diagnosis, our son was on just 4 units of Lantus daily for a week, no carb coverage needed, no high correction needed, just a little more activity.

If her tSlim doesn’t already have the Basal IQ software, I strongly recommend getting it. Either way, you’re paying attention and making adjustments for her needs, so that’s good.

Best wishes, and happy birthday to the little one!

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(Elizabeth) #4

Hi Fiora. I don’t know anything about the tslim, but I’ve had T1D since 10, (42 hrs) so I’ve been through the gammet of u explainable highs and lows and they still leave me bewildered at times. The fact that she is steady through the night is fantastic and the most important. The ups and downs of bs and carb counting for me has always the biggest challenge. If you haven’t done so already you should learn as much as you can about the many different TYPES of carbs. Also fats slow the absorption of carbs into your blood stream, which may explain why she is having lows after meals. Proteins are critical for stable blood sugars. It’s a lot to take on and learn but keep vigilant. You’ll figure it out.

(Andrea) #5

Hi there! My daughter was diagnosed just after her 4th birthday (she’s 7 now). My son was diagnosed a month ago just after his 11th birthday.

While my son is not on a pump yet, only CGM, my daughter went on a pump only a couple months after diagnosis at 4 and we experienced the same thing as you. And I’m a type A figure outer, so I am ALWAYS trying to figure out the “whys”, despite knowing it’s not always possible. Between some honeymooning and the change from Lantus and Novolog to just Novolog, it took some time to figure out the correct I:c ratio. And to be quite honest, we are STILL always changing it 3 years later. Those little bodies are always changing and growing. When my daughter was diagnosed at 4, her breakfast I:c ratio was like 1:40 and now at 7, it’s 1:13. And it has changed probably 20 times in those years. My son’s breakfast I:c ratio started at 1:20 and now that they honeymoon seems to be coming to an end, it’s more like 1:12.

I don’t need to say it cuz you obviously know…but I liken diabetes to a newborn: just when you think you have it figured out, it all changes again!

Good luck! :slight_smile:

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(Dennis J. Dacey, pwD) #6

Hi Andrea @DJAdgieB, your children’s bodies just like you own body is never static - continuously changing. Yes, your daughter’s need for breakfast increasing from 1:40 to 1:13 certainly is “drastic” - but if it is what her body needs then that is what she needs. I know that my bolus carb rations frequently need tweaking and I am comfortable making changes as needed; my pump basal rates need change too, especially at season change.

For your daughter using the pump, I suggest that you first spend as much time as it takes to get her basal adjusted and then go on to rework her bolus ratios; keep in mind that change in activity will play an important part - I use different pump “profiles” or “patterns” depending in what I expect my day’s activity will be.

The pump basal rates - use as many as needed over the course of the day - can be validated by “controlled fasting”; for instance I validate overnight by not eating anything after super until noon the next day; check BG every two hours and eat if needed if “low” or for reading higher than range calculate how much to increase the basal rate based on her insulin sensitivity factor.

You certainly impress me as a caring, knowledgable and proactive mother!!!

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(Andrea) #7

I wasn’t looking for help, but thanks. I’ve got it all under control. I was simply responding to the original post. :slight_smile:

(Fiora) #8

Hi! Yes, I’m a type A figure outer as well, as is probably evident. I was just curious if it was related to the pump as it seemed her honeymoon was over- ratios pretty consistent since about December. We definitely change them as needed but hadn’t experienced such a drastic change (1:17 for breakfast changed to 1:50 kind of blew my mind)
Of course now she’s shifted back more where she was. I do appreciate the flexibility of not being stuck to rounding to half units.
We used the exact same comparison to having a newborn, it’s so accurate. Best wishes to you and your kiddos as well!

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