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RE: [IP] Unrealistic expectations?

At 04:07 PM 1/7/2005, Sue Ann Bowling wrote:
>This is one of the few things that annoys me about Walsh's book, Pumping 
>Insulin.  On page 30 he states that "'Brittle' diabetes is just an easy 
>name for incorrect dosing or variable insulin action. This instability 
>occurs only when insulin is being given in the wrong amount or at the 
>wrong time."
>Literally this is true--but it needs the additional statement that there 
>is no way of delivering insulin that comes close to the negative 
>(stabilizing) feedback provided by a healthy pancreas.  The insulin pump 
>is about as good as it gets right now, but the feedback through monitoring 
>of blood sugar and food intake is nothing like as good as that of a 
>healthy pancreas, and a system without negative feedback is inherently 
>neutral to unstable.  I'm convinced that at times I even have positive 
>feedback (insulin doesn't seem as effective when my blood sugar is high, 
>and carbs don't absorb as fast when it's low) which is really 
>destabilizing.  I'd say "brittle" diabetes is due to a lack of normal 
>negative feedback.
>Sue Ann Bowling, North Pole, Alaska

There are other issues that affect bg besides what we eat, how much insulin 
and when we take it.  Stress, hormones, among other things are all 
relatively unknown effects on bg.  A normal pancreas is able to adjust for 
the hormone unbalance you just experienced, but we as pumpers don't even 
know it's happening until well after it's happened and we many not even 
know what caused the bg fluctuation, but we just correct it.  So, nothing 
is as efficient as a real pancreas.

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