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Re: [IP] Re: diligent diets (was glycemic index)


I think that you are doing just fine. The numbers that you mentioned for
your son sound pretty ok to me (I am also still on MDI) and they justify
whatever you are doing right now. So, the simple question is: if everything
is fine why change it? Just because an endo mentioned it??
Well, I don't know. I believe that a lot of people on this list have a
different diabetes history than you have. I also assume that you never were
in a situation of a HbA1C of about 10 or 15 or higher so switching to a more
'fitting' insulin regimen doesn't really makes sense.
The marketing lingo of pump companies 'eat whatever you want to and whenever
you want to' sounds pretty scary to me and I personally think that it sends
the wrong message to people who are investigating pump options. You still
have to watch out for your nutrional intake and adjust the medication
accordingly. So, I don't really understand the big difference between MDI
and the pump concerning this point either.
Anyone correct me if I am wrong but I believe that the DCCT found that MDI
and the pump therapy are equivalent in their treatment of diabetes (ohoh, I
am getting flamed for this - I can feel it already).
Skipping a meal is no big deal for me either - I just don't eat and let my
basal (NPH) take care of it. Most of the time it works.
I personally consider the pump to be a tool to help in the treatment of the
diabetes. It is a tool which will hopefully allow me to finetune my bg's to
a degree where I want them to be and to take care of some other things that
are bugging me right now at the moment with MDI. But I would caution anyone
that the insulin pump is just one form of treatment and definitely not the
only one.
On the other hand, I don't think that you or your son will have any problems
switching to the pump. 'Rough housing' with friends, messing up insertion
sites, .... I think that those are just initial worries of a newcomer to the
whole pumping business. It will be something to get used to and be only
minor adjustment to the new 'lifestyle' - and not limiting factors. Should
you expect to see better BG's - probably not, but then the values won't get
worse either.
You've mentioned that your son is 12.5 and maybe when he's a little older
the BG's will get a little more jumpy and as such the number of injections
will increase. Maybe THEN the pump will make more sense but unless anything
is bothering you or your son at moment I could only ask 'Why change it??'

So far from what I know, I could only say, Marion, keep up the good work and
good luck for the future.


> I honestly am struggling to see how a pump will help my son.  His HBA1Cs have
> been 6, 6.2, 5.9 and recently 5.8.  He eats anything he wants at meals (and I
> mean anything) on the condition that I weigh it, account for its glycemic in
> index and dose it.
> We often get through the day with only 3 injections, U and H before
> breakfast, H at lunch and U and H at dinner.  His post prandials are rarely
> over 130.   I have found that when he eats a large meal or pizza type meal, I
> can simply split the dose of insulin.  He corrects high b.g.s maybe four
> times a week.  The dawn rise is a problem, but I am working on that by
> gathering data on how much it is and possibly correcting it before it hits.
> It is not consistent.  Even if he rises from 4-7 a.m., those hours of high
> sugar still won't hurt him.
> Tonight we were at the synagogue at a prayer service.  I imagined Gabe on the
> pump and the pump starting to alarm during the silent prayers.  Or him rough
> housing with his friends after services and messing up the insertion site.
> And so on and so on.  I was glad he was already finished with dinner, covered
> by a shot of Ultralente and H and hopefully finished with diabetes for the
> evening.  
> When the refreshments were served, he really wasn't hungry and I don't
> encourage him to snack.  He had a few grapes and that was it; the cake and
> cookies weren't appealing to him since he had dessert with his breakfast,
> lunch and dinner today (usually only dinner gets dessert, but he wanted to
> try some of the home-baked leftovers from the night before).
> So what in the world would he have done with a pump today?  I simply need to
> convince myself; he is going to give it a trial one way or another, but I am
> not on the bandwagon yet.  I have heard that the pump gives people a "license
> to eat".  Gabe is only 12.5; no license yet.
> That's all....still can't figure it out.
> Marion
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