ISF and I:C for a 10 year old?
I have a lil 10 year old friend who is also a type 1. He's on an insulin pump and bouncing BGs all over the place. She is getting little results from the so called specialist. Looking at his numbers it's like his I:C and ISF are way more than he needs. His mom is only giving him 1/2 the bolus suggested due to him bottoming out after every correction. Right now his ISF is 80 and I:C is 16. Giving 1/2 the suggested coverage for the I:C has been working great. But the doctor isn't listening to her. Is it common for a kids to have such a high I:C as 1:30? And should mom go ahead and take charge by changing that on his pump to make bolusing easier for him when school starts. I know I had to research and take charge of my pump settings. But I am scared to encourage her, for fear the Dr. would stop taking care of him since he's the only specialist in this area. But on the other hand this kid could really use better control. He really feels like crud bouncing up and down all day. I'm conflicted. I want to pass on a Pumping Insulin book to help.
Any suggestions?
Also his ISF is 1:80 but he was 322 at 11:30 am. His pump suggested 2.75Units. Mom had him take only 1.5U. At 1:25 pm he was 111. that would make is sensitivity like 150. But now it's 1:54 pm and he's at 75 and feels like he's bottoming out.
Replies to This Discussion
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Permalink Reply by FlyWilley on -
Mine lasted several years, that's why they had a hard time figuring out which type I was. Finally got the right tests for the right diagnoses.
He had not eaten since 8AM and he had 48 carbs of cereal (not sure what kind) and about a cup of milk. He was 117 when he ate. And he wouldn't eat lunch till he got down to 75 at 1:54pm because his head hurt. Yes he is skinny but the Dr. says he's not under weight just on the border. He's about 62 lbs.
I'm going to try to help mom find a good I:C and ISF so that they can fine tune his basal.
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Permalink Reply by Chris on -
At 8:00AM he was 117 which is good and he had 48 gms of carb+ milk (16gms) =64gms. with 1:16 ratio he should have taken 4 units of bolus? Assuming that he did this and he is at 322 at 11:30.
There could have been something wrong with that bolus in the morning.
Anyways what is his basal rate. based on his weight, i feel about 8 units a day should be sufficient.
try with the hourly basal rate of 8/24 = 0.3 units per hour. Between 1:25 and 1:54 it kept dipping and this makes me believe his basal rate is high.
also when u give him correction bolus its important to understand the effect of insulin remaining from his previous bolus!!!
Remember, For every high there will be a corresponding Low and hence its important to correct the lows before we start addressing the highs.
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Permalink Reply by Cheryl on -
Mom and son might be able to get some one-on-one assistance from trained personnel that work for the pump manufacturer. It would certainly be worth making the inquiry. If the manufacturer does not have skilled personnel available for one-on-one training, they might be able to refer Mom and son to a few pump education sessions to get them on the right track. Sites like medtronic have on-line pump tutorials, but I believe these just cover the basics of pumping.
Cheryl
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Permalink Reply by Kristin on -
It could also be that the basal rates aren't right. Pumping insulin would be a great guide to getting the settings right -- step by step.
We all have different insulin needs. For example, my I:C ratio is 1:13, but my ISF is 70-80. It seems that my ISF should be lower based on my I:C ratio, but I checked them and for whatever reason, it seems right.
I feel for your friend, as incorrect pump settings are so difficult to live with and hard to correct.
You could also suggest that she meet with a CDE (if there is one available) or the pump representative for the region to see if either could make suggestions.
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Permalink Reply by solobaricsrock on -
By stark contrast my I:C is 1:5 and my ISF is 1:12...........Insulin is like air to me.
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Permalink Reply by FlyWilley on
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WOW...That's some insulin resistance. Do you take any oral meds to increase your sensitivity? I have seen high insulin resistance like that in the ER. It's hard to believe though.
My I:C is 1:9 during the day but 1:8 after 7pm. My ISF is 1:40.
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Permalink Reply by FlyWilley on
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I didn't mean for that to sound like I didn't believe you. By hard to believe I meant scarey to me. We had a man just last week whose sliding scale called for 76 units of Novolog for a 348 BG. That's more than my daily dose on a high carb day.
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Permalink Reply by brandi on -
I used to be with a doctor that didnt really listen to my mom either. Im 16 now, but at the time I was around 10 or 11. Mom ignored the doctor and changed my pump settings herself. Turned out that the doctor was not listening to the point of not really caring that she changed it. We've switched doctors since then. Either way we have to drive 2 hours for a specialist. I say let the mom do whats safe for her kid. I mean, this is a kids life we're talking about here. The kid staying healthy is way more important than them getting into some trouble with the doctor.
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Permalink Reply by carb101 on -
My ten year old has I:C ratios of 1:15 to 1:11 and ISF from 30 to 50. If the Mom is already disregarding the pump settings for siding then she might as well change them. I would suggest Pumping Insulin to guide her.
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Permalink Reply by FlyWilley on
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Thank you carb101. I have been researching some and ratios do vary widely from person to person. So mom has changed the settings. His lows have improved and as stated by several the highs have come down in response. It's amazing how 1 thing can make such a difference.
Thank you, everyone!
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