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Re: [IP] Re: Velosululin

Betty J Pegram wrote:
> When I got my pump about 5 years ago, I was told that
> the buffered insulin was THE one for the pump, since
> it caused less clogs in the tubing. Then about a year
> ago, a Customer Service Rep from MM told me it was
> then "safe" to use Regular. I stayed with the Novo,
> since that's what Velosulin is, but my supplier
> doesn't seem to differientiate between Lily and Novo.
> (I still occasionally have clogs at inopportune
> times, but no more than with the Velosulin.) And no
> one ever talked to me about Humalog, plus I had no
> idea that NPH could be used in the pump! I've been
> deprived!

A few things here. Humalog can be used in any pump. It 
hasn't been tested by the FDA, but experience of many 
users here has shown it usually works, as long as your body
doesn't have an allergic reaction to it, as a very few have.

Of course, NPH, like any insulin, COULD be used in the pump, 
but why in the world would you want to? The whole point of 
pumping is to get pinpoint control, not a fancy way to pump
in an insulin that will go to work hours later. I think you
misread or misunderstood something.

I've been using Lily insulin since just after I started pumping
4+ years ago, and Humalog since it first went on sale. Much more
useful, I can punch in what I need for NOW, and it goes to work
and finishes off before I've reached THEN. Saves a LOT of 

> Also, what is a "sqaure wave?" 

The "Square Wave" feature on the new MiniMed 507 gives an
increased basal rate over a given time period by just punching it
in on a new menu (compared to the 506). So if you need to have the
meal bolus spread ver a longer time period, rather than all at once,
it's simple to do. This can be faked on other meters, but you 
have to figure it out first. Square Wave is just simpler, if you 
need it.

Is it just a
> calculated/multiple injection for high BG? My CDE
> told me to use the pump for highs, and not to give
> any insulin for it until it was time to eat again. 

Meaning no other extra bolus given in the meantime? Fine if
you got the bolus amount right, but if it wasn't really enough
(or you didn't really understand the situation), another bolus
may be in order ONLY if you stay fairly high.

> said to just check every hour or so to make sure it
> was coming down and showed no ketones, and if it
> remained the same or went up, to change the infusion.

Perhaps, but that depends on if you know EXACTLY what drove
it high in the first place and have corrected it.
> He also said NO Boluses for highs at night, since
> regular insulin works too fast to make it safe. 

Excuse me, he's confusing pumping R or Humalog with shots
here. He's also ignoring the fact that almost all diabetics will
wake up during the night if hypo. Also Regular insulin is used 
in the pumps BCAUSE it's fast. We have very precise fast acting 
systems which use fast acting insulin to control us NOW, not 
sometime later in the day. That thinking applied to shots, NOT
pumps. Sounds like he needs to learn how to determine how much
R (or even better, Humalog) to infuse for a given high level.
Myself, I just divide daily calories consumed by insulin
infused on a reasonably steady day. The calories/.1 unit insulin
works out to about .1 unit for each 10 mg/dl or 10 calories, 
so I adjust accordingly.

> and I are discussing whether it's wise to have a
> snack at night, to avoid low BG's during the night or
> in the morning. I've tried it both ways, and have had
> no consistent results, so I prefer not to eat
> anything at bedtime.  Sure is complicated...sure is
> nice to have choices!  :-}

Do you rn a low basal rate during the night? I use .4 or .5
units per hour from midnight to 4:30 AM, then increase it to 
cover my Dawn Phenomenon. That's why the pumps have multiple 
basal rates scheduled in.

Ted Quick
email @ redacted
Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/