I was recently going through my son's pump and stopped in shock. I was struck by how much things have changed since he first began pumping.
When my son first got a pump, we needed to have the ability to use very small basal rates. Despite having a 300 unit cartridge, we would only fill it to 200 units and still have to throw some out after one week.
His carb to insulin ratios were of course much different and his basal rates were never close to 1 unit per hour.
Over the years, I have gotten used to some of those changes. I learned that sweeping changes would no longer kill him. Puberty was turning his insulin to water and my brain was on overload.
The one thing I never expected however was the importance of the midnight carb to insulin ratio. My son didn't eat that late. On a really special night of roasted marshmallows he might eat at 10pm but we didn't need to worry about anything after that. The ratio set after midnight was just to satisfy the pump. It had no real significance...until now.
Now that carb to insulin rate is just as important and used as often (or more) than breakfast! He often finds himself creeping the halls late at night searching to see what goodies are hidden in the fridge.
It took me a bit to realize this. At first I thought, oh he needs his overnight basal rates tweaked. I began to look much more closely at my son's eating habits. There were boluses at midnight and one in the morning! This time now mattered. I had to make changes and pay close attention. What had happened?
Oh yeah...I have a teen son! What was I thinking?