My concerns for my son after 2 months on pump therapy

My7y/o son is on minimed paradigm 522 pump for almost 2 months now, so far I like the freedom and control it gives us in managing his bs.  But, there are times when his bs would still be in 250-300's two hours after meal., 100 off the target.

My son is really picky and lately I've noticed that he's loosing some weight due to my constant watch of his carb intake. So I started giving him everything he likes to eat and a little of the sugary stuff. I give him more carbs but then I fall short with his boluses. What I do is, check his bg 2 hours after meal and give him another bolus if his bg is more than his target range.  My concern right now is his A1c. His last one was 8.8 (when he was on pen shots). I'm really aiming for a normal A1c this time but am a little concern about his after 2 hour meal results. Also, I want him to gain some weight. His 60 lbs. (lean and skinny) I feel that I should let him have everything he wishes to eat without restrictions since his body requires them for growth and development. His next A1c check would be in two weeks and am a little nervous. Aren't I supposed to be in control in managing his bs even more now that he's on a pump? Should I cut down his carb intake just so I have more control of his numbers? Is there anyone out there feeling the same way I do?

Hi there, 


I wanted to reply to your post b/c I did the same thing you did with your son. My son was dx last year--at 4.5yo. He was always a little chubby--and a very good eater--Then in order to keep his bs in range, sometimes I would skip a snack, or give him a little less food--and I figured he could use it b/c he's a little chubby... But when he lost 5 lbs in 3 months, my endo was concerned and told me that he didn't want me to cut his snacks and food(healthy snacks and food, of course) He said that he is growing and that the kids need it and we will adjust the insulin to match the food intake. Now I don't worry anymore--As long as he is eating healthy--I let him have whatever he wants(within reason of course). He is doing fine and his weight is within normal range(Lots of activity and excercise took care of that)

Good Luck and talk to your endo about it


Hi..  Our 5 year old daughter started using the pump last December..  At our first visit to the endo after starting the pump, her A1c was high too. We had a very good nurse that we would give our carelink password too and upload everything to the internet, She would call us and help tweak the bolus & basel rates.  It took awhile to get everything working right, now she can eat just about anytime, and the pump does all the magic. We still have a few weird days, but I guess that goes for everyone. Be sure to get the carelink adaptor if you don't already have it. (It's free from medtronic)



what does this carelink adaptor do? and how would it help? 


It wirelessy takes all the info from your pump and uploads it to the website. From there you can see trends, run reports. For example. I can see my daughters average at 3:00 everyday instead of having to see the entire daily average.  Helps when needing to adjust basel/bolus rates for different parts of the day. Many other reports too. Be sure to speak with your endo before changing anything..  When we thought we needed to adjust something, I would upload everything to the web and call our nurse and give her our password so she could look over the reports and suggest changes that needed to be made w/o having to drive an hour to the endo.

The main website is  But medtronic will send you only one for free.  

Hope this helps


Oh that's great! sounds very convenient. I will definitely look into this and discuss it with our endo nurse, hopefully they can do the same thing to us. Thanks Fred!

We have the carelink upload tool too.. It's very handy.  We have 2 hours to drive to our endo so it's really good! 

4Knicko ~

I completely understand your issue, and trust me, it is absolutely normal.  My son, now 11, was diagnosed at 5 and has been on a pump since 6.  The beginning is hard, just trying to get the settings where they should be, and it can take a lot of adjustments.  If you are finding that your son's BG is typically high 2 hours after a meal, then it could be the carb to insulin ratio is just not high enough.  If it only seems to be at times when he was high prior to the meal, then it could be that the correction factor needs to be adjusted.  These are all things that your doctor/clinician will be able to answer for you.  Don't let the issue go too long ~ if the numbers seem high for a couple of weeks, definitely give them a call and have them make some adjustments.  Also, if we had any issues with Kyle being high for a period of time, I started to log what he was eating.  Sometimes they have a sensitivity to certain foods that can cause the BG to go high, despite having bolused for it. 

I know how you are feeling right now, but it sounds like you are doing a great job.  I feel that feeling of frustration and helplessness  often ~ My son is now 5'2" and 100 lbs. ~ he is constantly growing and his insulin needs are constantly changing.  His BGs are all over the place, and as a result, so are his A1Cs.  But, we go to the clinic every three months and call them in between if his numbers are off and we can't figure out what adjustments to make next.  So long as you are taking care of the day to day and keeping in touch with the doctor/clinician, you are doing your job and you are being the best mom your son could ask for.  

Keep your head up ~ if I can help you out with anything, just let me know.

Laurie (from CT)


Oh thank you so much Laurie, just reading your reply made me feel good already.  Right now my son has been having fever (from out of nowhere) and my desire to increase his weight is again put on hold. His bs is all over the place and I feel bad that I have to check his BG 9-10x a day.  It's also frustrating that the only site I can use for his infusion is his bottom and with just 2 months of being on a pump, it doesn't look nice already.

You are right about the insulin/carb ratio and also the correction factor adjustments. At first, I thought I wasn't counting the carbs right or maybe not covering the enough boluses, looking back I know I've done almost everything correct. At least now I have the right questions to ask and discuss with the doctor in a week. His morning BS has been between 160-200 lately so I believe his 3AM basal rate has to be adjusted too.  Thanks again for replying, I wish you and your son the best of luck .

Keeping my head up!