Bare Naked Pancreas

My humorous friend Reyna, from BetaBuddies, started the whole gettin' "Naked with your Pancreas" thing!  So here I go...Bare-ing it all for you!  (No, not THAT!  Ally's pump settings...)

1. What kind of insulin management mode do you use?
Ally pumps insulin 24/7 using the Purple Medtronic MiniMed Revel.

2. How often do you inject/change pump sites?
We change Ally's pump site every 3rd day.  We recently switched to the new Mio infusion sets and really like them.

3. What type (s) of insulin do you use?
Novolog.

4. What are your basal settings?
Wow, Reyna needs to teach me how to do that!  She has 7 different basal settings for Joe....impressive pancreatic work my friend!!

Ally, on the other hand, only has 2 different basal settings.  (I still have so much to learn and this is an area where I really get nervous...so the endo always helps me set these numbers.)

12AM: 0.35 units/h
8 PM: 0.40 units/h


5. What are your correction factors ?

12am - 6am it is 1:230
6am - 12am it is 1: 140

6. What are your meal ratios?
I have heard others say this too...Ally is more insulin resistant with breakfast than the rest of the day.

Breakfast 1:20
Rest of the Day 1:25

7. What do you do for activity and/or PE?
At this point, we do not make any changes for PE at school.  It's hard because one day may be a very light activity and another day very strenuous.  Ally keeps her insulin pump on for PE and so far it does not seem to bother her...wearing her Tummietote by Tallygear, of course!  She also goes to the clinic and checks her BG and has snack shortly before PE, so I know that she is not going into the acitivity low.  She also checks her BG at the end of the day (which is right after PE) before getting on the bus, so again I feel comfortable that she is not low after this activity.

Ally is also a swimmer and a soccer player (and is going to try basketball this winter).  We take her insulin pump off for all of these sports.  This is another area where I feel like I don't have it all figured out yet.  (Ok, let's be honest...there isn't really much about diabetes that I can say, "Yep, got that figured out!")  What works for Ally seems totally different from what I hear other people do for activity.  See, Ally tends to run high after exercise.  Immediately after anyway.  HOURS later she drops.  I mean like 12 hours later!  So, sometimes I pre-bolus for her basal before these activities...and sometimes (even though I KNOW she won't go low during exercise -she never does!) I still worry about her going low, so I don't pre-bolus for the basal and just correct the high after.  Some other "naked truths" in this area have given me the idea that possibly I should set a temp basal a few hours AFTER her exercise.  Although, I'm still trying to figure out the timing of that since it is usually so many hours after.

8. How do you manage Pizza, Macaroni and Cheese, or any other "difficult to manage" foods?
Oh those wonderfully, awful foods!!  I'll take Halloween candy over those foods anytime.  Our MiniMed pump has a really cool "Dual Wave" feature...which I am learning to use.  Sounds like the "combo" that I hear some of you talk about.  You can do a % of bolus upfront and stretch the remaing % out over an amount of time that you choose.  It has taken a little bit of trial and error...and we still don't have it right!  I also think that what works or one child may not necessarily work for another, so even when I get ideas from other wonderful D-Mamas, I have to make changes to fit Ally's needs.

9. How do you prefer to manage your logs/data?
We download Ally's pump and CGM to the CareLink online program.  It is great!  I can look at all kinds of reports...and the best part, my endo staff can log on and see all my data if I need help making changes.  However, I do still keep a simple log because I only download every 2 weeks.  I need to see it on a daily basis to help me make decisions about activity and carbing or bolusing!

Ok, I took Reyna's challenge and exposed myself "as a naked pancreas" to the whole D-OC.

Who else wants to play?