[superdog683]

i agree, you are doing the impossible.

thank you for the feed back, its how i learn.

yes, 2/3 of that post is for the "average" diabetic that maybe be reading this thread, you are are already an advanced diabetic. just keeping the child alive means you are very vigilant. i have not treated a diabetic under 5 years old. i could learn more from you than you can learn from me.

so only advice i have that may be helpful for you is trust and expand on your expertise. learn the glycemic index. others md and me will be wrong in dosing "your" child. i accept that the patient or parent knows their body and listen accordingly. many medical people will not! when you know your right trust your expertise. and finally, yes the 2 issues you brought up are difficult and unexplained. fever or illness can cause glucose to be erratic. and the low bedtime could be from residual insulin in the tissue. this still wouldnt explain all of it but some of the drop could be from insulin in the tissue, can take 1-3 hours to clear. from the numbers you gave your child has some what erratic glucose numbers. the meal issue is very difficult, maybe you can use the pump just for basil and dose the the child after they eat with humalog. dosing a child before meals is impossible and humalog only takes about 15min.

my post is mainly about how the new technology has limits and using individual dose at or after meals for some diabetics will help.

in a more extreme environment ie if glucose and eating are extremely variable you could wait 30-60 min after meal and dose according to glucose reading this is usually easier than dosing ahead counting carbs etc. this is not a desirable long term dosing method. i would only use this when "forced" to by very erratic eating and glucose readings.