# Daughter 7 moved on to solo pump



## Harpersmum (Dec 9, 2020)

Hi my daughter was diagnosed earlier in the year. In November she has started the solo pump using novorapid insulin.  When doing pump change every 3 days do people stick to the same time? I.e. Friday pump change before breakfast would you then do next change Monday before breakfast?
She seems to run so high after pump change blood sugars over 15mmol. Currently having problems with continuous hypos also. It’s deflating some days when you just think you’ve cracked it and then it all goes and messes up!! I feel so selfish for getting stressed about it when it’s my baby suffering not myself.


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## MrDaibetes (Dec 9, 2020)

I don't stick to a set routine, I used to do it first thing, but now I just do it when I have the time. With the highs after the pump change does she get anxious/stressed when inserting?


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## Sally71 (Dec 9, 2020)

We just do it whenever it's empty (unless going out for the day of course, if there isn’t enough in to last the day then do it before we go).  It doesn’t really matter what time of day, advice is to do it before food though, so that the food bolus will flush it all through and you’ll find out much more quickly if something isn’t working properly.


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## helli (Dec 9, 2020)

It depends on the pump. 
My pump (Medtrum) has an 8 hour grace period. Therefore, if I change my pump at 8am on Monday, I have until 4pm on Thursday. I usually change it when I get up so that I can remove it in the shower (I find the water reduces the soreness) but not always. 
I very rarely change it in the evening in case there is a problem with the new set which could cause problems overnight when I am asleep. 

Regarding the highs your daughter experiences what changing the pump, I do not know the Solo but are you priming the pump and ensuring you have removed all the air from it.
And regarding the lows, is there any pattern to them such as a certain time of the day or after exercise or after eating? If they always happen at a similar time of the day, you can change the basal patter to reduce the basal at that time, If they occur during or after exercise should be able to set a temporary basal before exercise. If it is after eating you may want to review the insulin to carb ratio; I found I needed less insulin when I moved to a pump.


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## Harpersmum (Dec 9, 2020)

Thanks for the replies. There is no rule of pattern as yet which is what is driving me crazy. She can run at 7 through out the night and then on an occasion for 2am check she’s down to low 3’s and then the next day she can run low after breakfast etc. I have just started the delayed insulin option which seems to be working better. She is no longer needing a 10carb snack after treating a hypo now it was sending her sky high and then needing corrections putting her back in a hypo she seemed to be all over the shop at first but I’m sure we will get used to it as we did with her new diagnosis.


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## nonethewiser (Dec 9, 2020)

Harpersmum said:


> Thanks for the replies. There is no rule of pattern as yet which is what is driving me crazy. She can run at 7 through out the night and then on an occasion for 2am check she’s down to low 3’s and then the next day she can run low after breakfast etc



Is odd low during night linked to early evening activity, this can happen when your active hours before.

In early months bg control can be hectic, pancreas producing own insulin sporadically, typical action of honeymoon period.


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## Harpersmum (Dec 9, 2020)

No, but exercise and heat make a massive impact on her she has to have snacks before pe and is a keen athletic but the club hasn’t been running since her diagnosis due to pandemic, this is something she can’t wait to return to which I am pleased about. How often is a normal amount of hypos in one week. I’m learning everyday. She was getting a bit fed up of jelly beans so we moved on to apple juice and that is a big no no for her just didn’t work. We use dextrose but haven’t tried any other type of sweets. Do you recommend any natural fruits for hypo treatment?


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## nonethewiser (Dec 9, 2020)

Couldn't answer question about normal amount of hypo's, less better.  Pumps can take while to adjust insulin delivery, once you get there hypo's will reduce significantly.

Own hypo treatment is glucotabs coke or anything sweet & fast acting


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## Paulbreen (Dec 9, 2020)

Any sort of jelly based sweet is good, I also use the mini cans of coke150ml I think they are, if I’m dropping fast into a hypo, seems to be about the right amount of carb.
As nonethewiser mentioned her pesky pancreas could be still spluttering some insulin, my friends little boy had issues with it for a couple of years


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## Harpersmum (Dec 9, 2020)

I suppose it was silly question to ask no amount of hypos are normal ‍♀️ She just seems to be hypoing quite a lot but hopefully it will calm when her body adjusts. We have gone through different profiles for basal rate and still changing carb ratio. She is different from being at school during the week to being at home at the weekend! Its a very odd and choosy disease!


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## nonethewiser (Dec 9, 2020)

On pump myself, remember well trying to get basal rates right, time & patience a must.


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## Harpersmum (Dec 9, 2020)

Paulbreen said:


> Any sort of jelly based sweet is good, I also use the mini cans of coke150ml I think they are, if I’m dropping fast into a hypo, seems to be about the right amount of carb.
> As nonethewiser mentioned her pesky pancreas could be still spluttering some insulin, my friends little boy had issues with it for a couple of years


Her DN advised this and said it can go on for some time. Just some weeks she must produce more than another. I came across a article about a boy who is trialling a drug to keep producing insulin. I must admit I had such ignorance to t1 as I didn’t need to know but being in this world is now becoming our normal and a massive thanks to you all for the support.


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## Paulbreen (Dec 9, 2020)

Before pumping I would have at least 1 per day, since I started pumping I had a few in the first coupe of weeks but then the pump settled down with some tweaks to the basal pattern and then I don’t remember my last real hypo, my pump warns me of going low and pauses delivery of the basal and gives me enough time to eat a sweet or two before I go too low


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## trophywench (Dec 9, 2020)

There's always the same reason for a hypo - too much insulin when we don't need it!

However whether we can do anything to prevent that being the case is another matter!  Let me know when you crack it, I've only been trying 49 years so far and I haven't cracked it yet.

Just get's less of a hassle is all.  Surprised they didn't tell you not to follow with a carby snack after correcting a hypo with a pump - it was absolutely one of the things I was told not to do 10 years ago when I got my first pump.

I don't understand why anyone would go high after changing stuff - it takes literally minutes so it's not like you actually miss very much insulin whatever, is it?  After jabbing for 35 years, admittedly first time I had to change everything at once it probably took 10 minutes but once I had some practice maybe 3 or 4 minutes.  What takes most time with a tubed pump is priming the tubing.  Perhaps 30 seconds.  The insulin drips out of the free end of the tubing and onlt then do you attach that end to the cannula, prime the cannula (approx 7 seconds) and away you go again.  Do you prime 'patch' pumps before attaching them to yourself, or what?


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## helli (Dec 9, 2020)

trophywench said:


> Do you prime 'patch' pumps before attaching them to yourself, or what?


Yes. 
The process is slightly different but there is still a step which primes the pump.


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## SB2015 (Dec 10, 2020)

Harpersmum said:


> She is different from being at school during the week to being at home at the weekend! Its a very odd and choosy disease


(a belated )Welcome to the forum @Harpersmum 

In my Accu Chek Combo I have three different profiles.  When I was working I had one for during the week and another for the weekend, as my insulin needs were very different.  I am not sure whether the Solo does this too.  

Or you could use temporary basal rates, especially when your daughter is doing exercise.  I use these a lot as my days are very varied such as a training session for her athletics when they start again.  Could she work on managing this whilst at home doing exercise similar to her training to see what adjustments she needs.  She will then be prepared when things start up again.  There is a lot of interesting information about these ideas on RunSweet, which addresses adaptations in T1 management for different sports.  This will take some trial and improvement but this does not need to stop her achieving whatever she wants to do.

I know that the Honeymoon Period is generally shorter for youngsters, but that does tend to confuse things in the early stages, as the remaining beta cells in the pancreas decide to chuck out some extra insulin with no warning at all.

Keep the questions coming.  We have all had to work things out and whilst we can’t advise on doses etc, we can suggest strategies.


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## SB2015 (Dec 10, 2020)

Harpersmum said:


> I must admit I had such ignorance to t1 as I didn’t need to know


I knew absolutely nothing about it when I was diagnosed.
It is a steep learning curve, but as you say it becomes our new ‘normal’.


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## Thebearcametoo (Dec 10, 2020)

My daughter’s on a tslim 

We tend to change at roughly the same time each pump change as it stays as part of the routine.
We were told there was no need for a snack after correcting for a hypo on the pump and that seems to track with your experience.
We have sometimes given a small correction dose (half a unit or so) after a pump change if she was high going into the change (she’s prepubescent and growing like a weed and lots of changes going on so it depends how on top of basal changes we are as to how in target she is to begin with).

In general we are loving the pump but it does feel like we have to babysit it a lot but the HBA1C result has been amazing with it so it’s obviously an improvement.


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## everydayupsanddowns (Dec 10, 2020)

Sorry to hear that the Diabetes Fairy has been up to her tricks again with your daughter’s levels 

I’m tagging in some of our other frequent parents of CWD @Bronco Billy @Thebearcametoo in case they have any pearls of wisdom

EDIT: Was beaten to it!


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## Harpersmum (Dec 10, 2020)

SB2015 said:


> (a belated )Welcome to the forum @Harpersmum
> 
> In my Accu Chek Combo I have three different profiles.  When I was working I had one for during the week and another for the weekend, as my insulin needs were very different.  I am not sure whether the Solo does this too.
> 
> ...


Thank you so much I will look up what you have mentioned! 
she has always been very active. I get comments sometimes by friends/family and teachers saying she looks so tired all the time. This upsets me a little. I’ll do everything I can to manage her diabetes and keep her healthy. I’ll never let it control her she controls it x


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## Bronco Billy (Dec 10, 2020)

Hi @Harpersmum, welcome to the forum.

We do pump changes for our two in the evening. It’s not so much to do with consistency of the timing, but because it means we will know if there is a problem, e.g. the cannula doesn’t insert properly, while they are with us and not at school/college. The set can take time to settle, hence the highs. What you could try is putting the new cannula in without any tubing to give it time to settle in for an hour or so, and leave the old cannula and tubing in during this time. 

It’s possible your daughter is still in the ‘honeymoon’ period given the swings. If she does go high after a hypo, try not correcting the high. It may come down on its own as the correction of a hypo can sometimes cause a temporary spike. 
Having a snack before exercise is a good idea as the carbs can be needed to compensate for the glucose the body will use during the exercise. There are other tricks for managing BGs as well, but I don’t want to overload you with information.
Diabetes likes routine. Her body will have got used to everything school related, then the weekend comes and that routine changes. She is likely to be more active on school days, which causes the body to react differently. Physical activity makes insulin act more efficiently, keeping the BGs lower. We used to have a different basal rate at weekends, although we don’t anymore. 

You’re not ignorant, you’re on the steepest learning curve you will ever be on. Even if you don’t realise it, you are becoming more knowledgeable and experienced every day. It won’t seem possible now, but the day will come when it’s all so normal, you don’t realise what you are doing, it’s just a part of your life. 

Bu the way, there’s no such thing as a silly question.


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## trophywench (Dec 11, 2020)

@Bronco Billy - she can't do a cannula change separately, the Solo is a type of 'Patch' pump.  That's why I was asking how you prime it - which I don't know as mine have always been tubed pumps - cos if you go high after changing it, to me that would indicate you aren't getting any insulin at all for far too long at a time - and there has just GOT to be a way of not causing that, hasn't there?


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## Docb (Dec 11, 2020)

Hi @Harpersmum.  I tend to keep out of the T1 stuff, even the novices know more about it than I will ever know but I do know a bit about dealing with what others think!  You need to remember that mostly they are trying to help but are useless at it.  Almost certainly it does not occur to them that they are going about it the wrong way and have no idea that their approach can be upsetting.

You have to remember that they know only a tiny part of the story. You, your daughter and the team helping you are the only people who have all the information and are able to make a proper assessment.  So smile sweetly, thank them for their concern and then get on with the great job you are doing.


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