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[IP] Disetronic Versus Minimed and other info


Prior to finding out that Kaiser HMO only uses Minimed, (on contract)   we
had contacted the Disetronic folks who sent a rep out for a demo.  He walked
us through all the steps and he was very helpful.  I had done much research
on the internet and I came up with a testimonial that 'potential pumpers'
might be interested in.  This helped to clarify alot about the differences
between both manufacturers.
If you have a choice...which we don't...I would go the D. route.  Just from
the facts in this intelligent testimonial.

The website is:


I personally would like to see my daughter on a totally waterproof pump, as
she is a swim team member.

I also like the idea that (and you will know what I mean once you get a
handle on the terminology and function of the pump...i.e.   basals)  when
you finally get your basals settled and you want do a sport/exercise  for a
select amount of time...you can program the Disetronic to reduce the basals
by a percentage.  My daughter usually needs about 40-50% of her basals for
several hours after her swimming practices.  With MINIMED, you have to set
the temp basal by increments.  I like just doing a percentage rather than
guessing how many units to drop her insulin delivery.

Both companies are reputable and user friendly and have high standards.  I
just happen to have been sold on the Disetronic, based on the website
mentioned above and my own observations.  Plus, now that we are on the
MINIMED we are encountering situations in which I am saying,  DARN .....wish
we had the D !

> The idea of the Quick Release appeals to me.

You can interchange infusion set/tubing with either pump.  I believe the D.
has a quick release...but not real sure.  Read about it on the website.

> I assume one can still get hypoglycemia with the pump if one uses too
> much insulin.  Does that happen often?

My daughter had a terrible phobia about going low while doing MDI>   We had
to keep her target zone around 150!  On the pump...she is now able to target
for 130 after one month on it.

She says the lows are not as intense.  She doesn't wake up at night unless
below 80.  Before, she would come into bedroom if 100.  Last night she was
95 and did not wake up while I was testing.

  >I also don't understand the
> ratios and mixes people refer to here.

We have been keeping faithful logs for a month now...and we were seeing that
my daughter would go very high on and around the 2 1/2 day of her site.
Now...we were under the impression that you could go up to four days, right?
We could never get beyond the third day because her sugars would be in the
300's with extra bolusing and checking for kinks in tubing, no insulin,
clogs, etc.  I finally did research on the net and got a huge amount of
response from pumpers who mix the Humalog with Velosulin in the pump at a
ratio of 5 H to 1 V.
Velosulin is manufactured by NOVO and is a buffered Regular insulin.  Don't
ask me any more about that.

So..we see our endo tomorrow and will approach her with this theory.  I am
sure she will be open to it as she is about just about everything else.
(wonderful UCSF endo in the SF bay area!)

 > Is it difficult to get the
> basal set properly,

For us,  YES...only because with this site degradation ...due to Humalog
alone in the pump...our numbers have been way off and I was accounting for
this in changing her basals each day.  Needless to say...once we changed her
site..her levels plummeted and we had to start all over again.!!!  Now that
I understand that we either need to use this new mix of insulins, or change
the site every two days  ( not fun for a ten yr. old...or anyone, for that
matter)...we know if the numbers start to creep up, it is time to change
sites.  (after ruling out kinks, malfunction,  forgetting to bolus, etc.)
This situation, unfortunately for us, has occurred right around midnight.
I, in my deepest REM do not feel like struggling down in the kitchen with a
sleepy child who hates putting in the site anyway  at midnight.  We have had
to just give injections every hour,  setting our alarm until morning when we
could change the site at a reasonable hour.

 >and to calculate the meals <

not hard for us either.  We have been counting carbs for about a year now,
with the use of Humalog.  Especially since after school Geneva eats every
hour it seems.  I had to figure out how much of a shot to draw up for every
single carb.  The tricky part is that we figured out pretty quickly  (and if
you have a good educator who happens to be on a pump herself...she can help
you through these kinks)...that Geneva covers her carbs differently at
lunchtime than at breakfast and dinner.  For some reason,  at this time,
the insulin is working harder.  We go from a 1 unit to cover 19 carbs at
breakfast and dinner to 1 unit covering 25 carbs at lunch.  Go figure!   It
is that fine tuning time when the BASAL just don't cut the mustard.
Changing the carb bolus will take care of it.

>and the amount of bolus
> to use?

Not difficult to figure out the bolus, as my daughter has had Humalog drop
her like a bullet  (100 points per unit) almost since DX'd three years ago.

 Is the bolus a different mix than the basal?

NO.   You are on the same thing all of the time.

You will most likely start with Humalog solo as some folks do fine with the
straight insulin.  If you see your numbers go up for no good reason..then
think about the cocktail mix.

We are still struggling with the basals, and my desk is littered with her
"logs"...very detailed with all food eaten, times, sugar levels,  exercise,
you name it.

It will all make sense though.  It is mathematical.  You will see patterns
emerging just like with injection therapy.

Once the basals are fine tuned, all you have to do is sit back and enjoy
that donut!

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