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[IP] Lispro study..what does it say

Michael, love your posts.  But I'm not sure about your take on this study.  
However, I have only read the exerpt posted to the list, so my understanding 
may be incomplete.  You felt it documents that one should not have to worry 
about CSII interruption at night on lispro.  I though it just showed what we 
expected, that when cut off from CSII on Lispro we rise  (glucoses) faster 
that when cut off from Regular insulin.  And then predictably, when the 
supply is restored,  glucoses come down quicker on Lispro than on regular.

However, for those of us with type I so long that we make ZIP insulin now, 
there is a crucial significance in cutting off the supply for the 6-8 hours 
during sleep: for me, at this point I am over 500 and in DKA, vomiting, 
taking phenergan, and missing work.   For many of my patients, this would be 
in the ER .  While the study showed that we drop our glusoses faster when 
lispro is restarted, I don't think that this study really alleviated the 
concerns of the short action of Lispro.  I think that the decision would have 
to be very indiviually tailored.

This is a philisophical debate, you may know more about the study than I, and 
despite my concerns, I feel that I get better overall control with Lispo and 
switched 2 years ago.  However, I have had more DKA (but manageable at home) 
problems on it.

I would be happy to hear other input about it.

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