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More ponderings on pumps

November 23, 2010 | 6:23 pm

We haven’t calibrated Sam’s basal rate on his pump yet, even though he’s had it for over a fortnight. Our diabetic nurse wants him to stop having low’s before we go through the process of starving him to calibrate the pump.

Which is fair enough.

But we haven’t been able to get through a day without a low. We thought we had done it yesterday. Samuel got to lunch without a low, the first time I can remember this happening. Lunch was fine, and so was the afternoon at school. But his Monday night swimming lesson caused havoc, with a low whilst he was in the pool (potentially dangerous) followed by a high of over 12.5 (225 in American money) a couple of hours later. This was probably caused by the four gloucose tablets he took, but the exercise in the pool may have contributed. (More on anerobic vs aerobic exercise another day).

So by bedtime we had to give him a correction of insulin to bring him down, something we have never done before. It makes me very nervous that he could go too low at night, if we give him insulin just before bed, without any food. I’d be interested to hear from any other Type 1 diabetics (or parents). Do you correct at night? He was down to 8.5 (153) by 10.30pm but I tested him again at midnight, whilst he was asleep and he’d dropped to 6.5 (117). Normally just about spot on, but if he followed that trend over the next few hours he’d be 2.something (below 50) before 3am.

Of course, that meant I was up in the middle of the night, and thankfully he was steady at 6.4 at 2.30am.

Which got me thinking. The direction in which blood sugars are heading is just as important as the level they are at. A continuous gloucose monitor (CGM) like this one from Dexcon would give us this information. I may explore this device some more. And I’d be interested in hearing from anyone who’s got one. What are they like? What are their advantages and disadvantages?

I don’t think our local PCT (who would decide if we get funding or not) are big fans of them, but I will do some more digging and see.

As you may have gathered already from this site, I am a big fan of using technology to help with the management of diabetes. And if a tool like a CGM can help us keep blood sugars under control, then we should be using them. The more people that do, the less complications in later life that cost the NHS so much.

And also the greater the market for the pump manufacturers, the more they will invest in technology that could take us closer to a complete closed loop of insulin pump and CGM.


Posted by Gareth

One Response to More ponderings on pumps

  1. avatar avatarAndy says:

    I’ve had a CGM for nearly a year now and love it. I have the Dexcom Seven Plus. I only do the “old fashioned” test once a day on average now. I can see my trend at any point in the day, with 288 individual results. While I don’t rely on those to be spot on, they provide the more important trend, which is perfect for the situation you describe. In that situation, I would have taken a very small amount of juice or a single glucose tab and make sure it levels out.

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