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Re: [IP] re: fear of DKA

> Hey everyone,
>   I have one little question that is weighing on my
> mind as I decide whether or not to joint he world of
> pumpers. Many of you have told me about your fear of
> DKA because apparently you can become detatched from
> the pump and not realize it, and because there is no
> long acting insulin DKA can occur rapidly. Is coming
> detatched a common thing? Pardon my neivity, but how
> can you not notice it? Doesn't it feel diferent? 

There's two ways (that I know of) for my pump to come 
disconnected.  At the Quick Release point (a joint about 4-5 inches 
away from the infusion set that twists apart--not all infusion sets 
have a Quick Release joint) and at the infusion site itself.

At the Quick Release joint, the only way I'd know is if I noticed the 
free-swinging tubing.  That happened to me once during a basal 
test.  Ruined the whole test cuz I didn't know how much insulin I'd 
missed, if any.

Since then, I've been very careful about how I reconnect--I make 
darned certain I've twisted it passed the "click" point.

Since I use Minimed's Micro QR (a "SofSet" type infusion set), 
which leaves only a plastic cannula instead of a needle under the 
skin, most of the time I can't feel a thing.  The 6 mm of plastic 
tubing could potentially slip out of my skin and lay on top and I 
wouldn't know it.  Because of the tape, I wouldn't feel any moisture 
either.  Also, they're such tiny little droplets that I'm not sure they'd 
cause the cooling effect when evaporating.

Some of this potential problem can be alleviated by taping down a 
small loop of tubing that would take the brunt of a yank.  There was 
one occasion then I forgot I had my pump off my belt, got up and 
walked away.  The loop was yanked out, but not the set.  I got 
another piece of tape and taped down a new loop.

Since I test several times a day, I'm not likely to have a problem 
during my waking hours.  The main concern is at night.

I've gotten in the habit of checking my pump, the reservoir, the 
tubing, everything, while in bed just before turning out the light.  I 
also check for bubbles and "prime" them out of the tubing (while 
disconnected, of course!) at that time too, which also helps me 
verify that insulin is definitely coming through the tubing.

I don't consider it to be a big fear, for me.  At this point, I'm still 
producing a little bit of my own insulin (I think that will end within 6 
months).  But even then, I'm not terribly concerned at this point.

It's mainly something to stay aware of and be prepared for.
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