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Re: [IP] Brittle Diabetics

In a message dated 8/5/01 11:31:16 PM, email @ redacted writes:

<< I was wondering if there are any brittle diabetics out there who are 

and has being on the pump helped give you better control? >>

There are many, many reasons why people have trouble predicting what there 
blood sugar is going to do.  I had a doctor years ago (before home blood 
glucose monitoring) who was critical of a high reading for me one day, and 
wanted to know why it was high, because there was always a reason.  Well, 
probably, but that didn't mean I knew what it was.  A major one, the 
unpredictability of longer acting insulins with peaks, is mostly solved by 
using the pump.  When I first went on the pump, that was certainly a major 
advantage for me.  With that problem under control, figuring out basal rates 
when fasting was the next step (which always varied for me with menstrual 
cycle), and then amount and timing of boluses for food and high blood sugar 
readings, along with reaction to exercise (and aerobic vs. anaerobic), hot or 
cold weather, stress, drugs and other medical treatments, different illnesses 
and body changes, sun, water, white coat syndrome..........

If your basal rate needs are shifting a lot, as is true for me now with 
perimenopause, it is very hard to get a handle on that or anything else.  
Could that be your problem?  I find there at least 3 distinct levels of 
sensitivity to insulin I go through, including changes in both basal and 
bolus rates.  But they sometimes seem to change gradually, one part of the 
day first.  The best I can say is that I can generally get an idea it has 
changed within a few days -- sometimes sooner, sometimes (as when I start 
eating more) not as quickly.  With the MM507c, I have to change everything by 
hand each time, but maybe that is just as well because I can change one 
period of the day at a time.  And it is not just a constant percentage 
higher, either -- sometimes I have a very strong need for more insulin in the 
early morning and sometimes that disappears (always during the periods when I 
seem to become very insulin sensitive and have to change my carb bolus from 
1:15 to 1:20).  I have no idea how I could have possibility dealt with these 
changes even on MDI with long-acting insulin that peaked and had residual 
effects on me for so long -- maybe it is better now with glargine, I don't 
know what the residual effects of that are.  I do a LOT of very small boluses 
to bring down blood sugars that are creeping up, something not possible with 
a syringe.  By testing a whole lot (I average almost 10 a day, which means a 
lot more than that some days), I am still able to keep normal A1c's with a 
fair number of lows and short-term highs, but no really serious lows.  So I 
am going through menopause reasonably functional most of the time <gr.>, 
which I don't think would have been the case without the pump.

Linda Z    
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