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[IP] Questions for Pumpers
In a message dated 1/27/2002 7:10:11 AM Pacific Standard Time,
email @ redacted writes:
> "Inquiring minds like to ask" and OBSSESSIVE minds never shut off. I have
> never even seen a pump, and already loading up on questions. Please help.
1) The Pumping Insulin book continously refers to Humalog finishing in 3.5
hours. A Humalog injection given in the arm, as far as we can see, continues
to effect b.g. for up to 5 hours. Is it because the pump is connected to the
abdomen that the insulin finishes faster? We did one drop profile many
months ago for Humalog injected in the abdomen. The Humalog started working
in 5 minutes and dropped Gabe 150 points in 1.5 hours and then stopped
working. Now, that was without food.
2. The reason the 3.5 hour Humalog finish is curious to me is that you can
then correct high and low numbers sooner. Does everybody use the 3.5 hour
mark as the time when corrections can be made?
3. One of the pumps, apparently the Animas, measures in .05 units. Is that
for basal and bolus? DOES ANYBODY have good enough control that they can see
a difference of .05 units. That is, does anyone control the meal size,
glycemic index of the foods in the meal, activity and etc., enough to see
that the .05 is significant?
I know someone posted they love that .05 feature, but how could you tell?
4. How often do you have to change basals as your child grows? Do you really
have a set of guidelines that tell you that the basal is the problem and not
the bolus? Do you periodically do fasting tests in the different time slots
(the book mentions four time slots involving skipping different
meals/snacks)? The pump literature says that it is much easier with One
insulin in the pump and not a basal and meal insulin to tell what is
effecting b.g. But how is that the case? You still have to do a fasting
test to see if a problem is from basal or bolus, do you not?
One of my biggest problems with Gabe is knowing if a basal needs to be raised
or lowered (raised because of growth and lowered because of exercise) or if a
meal dose has failed.
b.g. before dinner 94
b.g 2 hours after dinner 81
b.g. at 4 hours after dinner 136
b.g. at 6 hours after dinner 180
Is that a failure of the morning Ultralente or is that a meal that digested
slowly and finished digesting after the Humalog finished? That is another
reason I am asking about the 3.5 hours. Gabe is a real slow digester. If
the pump then allows the bolus to be given split up, it is a real plus for
5). I am daunted by the idea of "adjusting basals for exercise". You all
must be very sophisticated in your control to know how much basal is needed
during any given period of activity. Just knowing that the overall basals
are correct seems like an enormous task.
Well, I hope I haven't given anyone a headache this morning.
Thank you for your help.
not an M.D.
opinons for Gabe only
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