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Re: [IP] how long does it take

I've had an insulin pump for 17 years and I'm afraid I have to second that -- using UltraLente with a pump is madness!

Suggestion:  If you are having a hard time getting an insecure doctor to believe you, instead of arguing, sit down with some small square graph paper and plot on a 24 hour axis the ultralente insulin duration and exact strength (which of course is impossible so you will have to demonstrate that it is vague -- between x and y -- on your graph :-)).  Then plot the humalog, the meals, the exercise and anything else you've noticed.  What you should be able to demonstrate is that with the ul you can't get within .1 unit bg accurancy.  Then, try plotting it with only humalog or use Michael's great computer helper on the web page to show what those doses ought to be.  If you are good at graphing in something like EXCEL you could do on the computer.  Either way, the point is that you can clearly demonstrate what the problem is and present it as "surprisingy" evidence that suggests what "we're" doing wrong.  Pumping Insulin  has more helpful info so you might take that along too!

Basically you've got to convince this person to think about how it works with you instead of just following prescriptions.

Best of luck!


Randall Winchester wrote:

On  8 Apr 98 at 15:38, Timmy and Debbie wrote:

> Hello there...It's my wife who usually posts here but today it's my turn...
> I'm wondering how long it took you all to get your basal rates and bolus
> ratios set...
> Our endo insists on keeping our son TJ on Ultralente (one a day injection)
> along with Humalog in the pump..For three days now we have been trying to
> set basal rates and boluses and well, it's been nothing but eratic..60 to
> 600....If any of you can tell me how long it took you I'd appreciate it
> greatly...

It took us about a week to get the basal rates set to the point where
I wasn't going over 200 or below 40 regularly.  Ultralente is a wild
card because of the erratic way it is absorbed.  Are you absolutely
sure that this endo is a doctor?  Mixing Ultralente and a pump is a
recipe for failure - maybe this doctor is setting your son up to fail
so the "doctor" can perform a "miracle" and rescue your son from the
"evil" of good control...

>    I have reluctantly agreed to allow the Doc to try this method (for a
> while) because arguing about it in front of TJ isn't a good thing ......He
> needs to think all is going well...is it? I just have nothing to compare
> to...
>  also..any further comments about the use of Ultralente along with a pump
> will be greatly appreciated...I just wish there were some literature to
> back up this method..I'm having a very hard time coming to grips with it
> seeing as so many are having such successes the "standard" way...

Contact the pump vendor (MiniMed or Disetronic) immediately.  Ask for
someone who you can call from the doctor's office and get on a
conference call.  Get another real endo with real pump experience
involved even if it's only as a phone consultant.  Get a good CDE
involved too.   Get the doctor to explain to these people exactly why
Ultralente is "required" when the pump supplies the basal insulin.
You've got to be aggresive on this - the doctor is bordering on
malpractice with this kind of foolinshness.
Randall Winchester

* The views expressed here are mine and do not necessarily *
* reflect the official position of my employer.            *
* There's no guarantee on anything said here...
* If I say I understand something completely the only thing
* we can both be assured of is that I must have completely
* misunderstood something.
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