Thursday, January 08, 2009

Answering My Own Questions

Thank you guys for your responses to my last post. They have really helped a lot. Mostly they have made me realize that I'm not alone and that maybe I'm not doing things so badly after all.

It was interesting to see how many of you eat cereal for breakfast. I've always heard that's a big no no (even though that's what Riley eats).

I thought I'd share my answers to the same questions.

1) What do you/your child eat for a typical breakfast? (I’m looking something relatively low carb that would be of interest to a 6 year old and doesn’t require a lot of time to fix. I barely get to work on time as it is.)

Riley used to eat cereal for breakfast. I’d switch the brand every once in a while, but not much. The cereal and milk usually ranged around 25-28 g carbs. The past few mornings he’s eaten mini sausage biscuits (24g total) and he’s been high at lunch and even higher a couple of hours later. I’m wondering if the fat and protein in the sausage is doing this. So, he ate cereal again this morning. I only switched to give him something different, but he complained and wanted cereal anyway.

2) How often do you typically change your basals? (I know this will vary greatly for everyone.)

I’d say it’s at least a couple of times a month. But, I think I should be doing it more often.

3) If you test 1- 1/2 hours after lunch and you’re in the 300s and your pump says you have enough insulin on board to cover the sugar do you override the pump and give insulin anyway? If so, how do you determine how much to give?

It depends on what Riley ate. Sometimes I override (like the last two days at school when he was in the 300s and the pump said not to give him any insulin). And, sometimes I wait and see if it comes down with the insulin he has on board. I have no formula for how much I give.

4) Do you or your child stick to a routine pretty much all of the time? (ex: breakfast , snack, lunch, etc at the same time every day.)

He is in a routine at school. On the weekend he’s not in as much routine. He used to be. He used to eat his meals and snacks at around the same time every day. Now I’ve gotten to the point that if he’s not hungry I don’t make him eat. He ate a much later supper than usual last night because he wasn’t ready to eat yet.

5) Do you count carbs by measuring with measuring cups or do you weigh your food to find out carbs?

I measure every single thing (except at restaurants). I don’t weigh but use measuring cups. Or if it’s chips or something like that I figure out how many carbs per chip and count them out one by one. I really need to invest in a scale.

6) Do you bolus before, during, or after meals?

Some of all. I prefer to bolus before if I know he’s going to eat everything. But, I never bolus until the food is in front of him and he’s getting ready to eat. If we’re at a buffet or something like that I’ll wait until after. Occasionally I’ll do it during because I’ll see that he likes it and is going to eat it all. He gets bloused after at school.

7) Do you log sugars every day?

No. I used to. I used to be obsessive about it. I’ve always said how important it is and I do believe it’s important, but just got out of the habit. It’s one of the things I’m working on for the New Year. I’m starting to use Kevin’s excel logbook again and I’m going to purchase a cord for the Freestyle Lite so I can just download his sugars onto the computer.

8) How long do you wait for a pattern before changing basals? (For example, I look for a three day pattern and make adjustments by that.) If you do this, do you wait 3 more days and if the numbers still aren’t responding adjust basals again? ( I feel like maybe I’m not being aggressive enough with the changes?)

Already said I wait for a three day pattern. I have increased again after another 3 days, but usually wait at least a week before making more changes. I really feel like I’m not being aggressive enough with my changes. I think changing every three days may be what I need to do until his sugars start doing better.

9) How much do you increase basals at one time? Do you do it by a certain percentage or just for one part of the day?

I usually see what part of the day he’s running high and change that first. I’ll change a couple of different basals at a time usually. I don’t change by any certain percentage. I used to increase by 0.025 but have found that’s not doing the trick anymore. So, now I go up by 0.05 at a time now.

10) Do you have different basal rates for different days (for example a weekday basal rate and a weekend basal rate)? If so do you use the weekend rates for long weekends and holidays?

Yes. Riley has a weekday rate and a weekend rate. When he’s not in school he’s on the weekend rate. For some reason at school he needs a big increase in his basal from 11 Am to 2 PM that he doesn’t need when he’s not in school. Riley also has 8 different basal rates in every day.

11) If you /your child is at a birthday party and you/their sugar is high do you/they skip the cake and goodies or eat anyway and bolus for the high too?

I let him eat the cake. There may have been once when I didn’t. I feel guilty about it every time though. I know it’s not what’s best for his body. But, it is probably what’s best for his mind.

12) Do you think I’m completely insane for wanting you to answer all these questions?

No comment. I don’t want to incriminate myself.


Anonymous said...

It was a happy day for him when he gave us our new lives, through the truth of his Word, and we became, as it were, the first children in his new family. JAMES 1:18 LB

Jill said...

Just keep reminding yourself that you ARE a GREAT Mom and things will be fine :) I really like using Kevin's logbook. It's helped us to spot those trends and I feel so much more in control than I did before. Kacey uses the Freestyle Lite too :)

Good luck and I'm here if ya ever wanna talk :)

Anonymous said...

Hi. Your solutions seem perfectly sensible and you are dealing with a six year old, not a preteen or teen so you must be more cautious. You can always "preview" a basal change or try one out by using the temp basals. Big temp basal fan here. If you feel you should be more aggressive but unsure of what changes to make you can always try out a temp!

Lee Ann Thill said...

The last answer made me laugh. You might be insane, but really, no more than the rest of us :)

Amber-Bams said...

Penny those are great answers! Honestly the only thing I think I can add is to the first two questions:

Usual Breakfast:

IF, and thats a big if, I have time I make eggs with cheese and salsa. If sugars are good then add toast, if not skip the toast. Otherwise (most days) I have a yoguart like the light-n-fit which are low on carbs and calories and fat. Now it doesn't fill me up is the only problem. I'd usually have a larger morning snack those days too though. The yoguart is there for me to get something, anything, in my stomach. For Riley maybe yoguart pared with one slice of toast and PB would do the trick? But you may have exactly the same # of carbs with that as the cereal depending on your bread so...?

How often do I update my basals?

I am not the best at it actually. And when I do I only update one part of my day at a time like just the dawn/morning/lunch/predinner/dinner/bedtime/midnight basals. I try my hardest to not update more than 2 at a time if at all possible. One thing I do is wait to see how long this trend of highs or lows continues. Because I don't have a regualr routine I don't like to attribute highs/lows to basals but to food or activity fluctuations. If I am bolusing more for a couple weeks between meals then I know something else is off. For me three days just isn't enough time. Then again thats me though.

I hope this helps! Hang in there :) (oh and forgive any typos, shouldn't comments have a spell checker?? :P)