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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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