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Re: [IP] Another Newbie with questions

At 10:55 PM 6/5/98 -0700, Cindy wrote:

>Hello to all. I wanted to announce my pump birthday-May 26th, 1998. So far,
>it has been a challenge. I've had some lows which are my BIG fear. I'm a
>little frustrated 'cause I expected that my CDE/endo clinic would be doing
>things pretty much the "Pumping Insulin" way, but it seems their systems
>are a little more hit and miss. I've told the two CDE's I've worked with

Pumping won't eliminate lows or highs. Hopefully, most of your BGs will be
in your target range, and the lows and highs will be more predictable and
easier to manage. That's really what many of us aim for.


>Now some newbie questions:

>1) Does one typically suspend the pump when BG drops?

Some pumpers do this, others (like myself) don't. I try to treat the low
with glucose tablets, wait approximately 15 minutes, check my BG again. A
single glucose tablet raises my BG 20 points, very reliably, so I use this
to estimate how much to adjust for a low. My BG starts to rise to normal
levels after 15 minutes, so I don't need to suspend the pump. If my BG was
not coming back up, I would suspend the pump, then try to do some detective
work to figure out what was going on.

>2)Anybody out there manage OK with just carb counting and label reading, as
>opposed to weighing? If so, any tips (ie: I know I read somewhere something
>like "one serving is as much as you can hold in your hand" or something
>doofy like that)

Weighing food has always been the basis for  accurate carb counting for me.
This is actually a habit my wife got me started on, way before I realized
the real value of carb counting. Not all foods require weighing to
calculate carb content (examples might be things like crackers, bread,
milk, etc). Check the HowTo page on our web site for info on carb counting.
Mary Jean wrote a "How To" for estimating carbs in recipes. It's at

>3)I was started on Velosulin. Anyone out there doing OK on it (I know
>Humalog is all the rage, but I had never been on it, and we were worried
>about more Hypos)? I would especially like to hear from anyone who was on H
>and switched back to V.

I started on Velosulin in April 96, switched to Humalog a couple months
later, used it for 14 months and switched back to V about 4 months ago.
Humalog may be "the rage", especially for pumpers just starting out, but it
presented some real problems for me after this amount of time. I won't
drone on with all the details, since our list mates have endured my
discussion countless times. Let's just say that switching back to V was a
*very* good thing for me. I seem to have fewer hypos with V, but this is
partly due to adjusting back to Velosulin and re calculating basal rates,
etc. I've probably been somewhat higher than target while doing this, but
the past several weeks have seen very "flat" BGs.

The major difference when I switched back to V was the long lead time I
need for the insulin to "kick in". This means I need to program a basal
rate change approximately 2 hours prior to when I want the change to take
effect. When I bolus for meals, I require a one hour lead time. This lead
time takes care of serious rises in BG after meals.

When I started pumping and was using Velosulin, my team advised a 20 minute
lead time. Now it's so obvious that this was no where close to what I
needed. Humalog was originally prescribed to deal with this post prandial
rise, and it did so quite effectively. I now realize that a sufficient lead
time with V would have accomplished much the same effect. This was a good
example of prescribing a different medication to deal with a problem,
rather than revising the procedure with the original medication. In other
words, I needed to use the tool properly.

>Now, I hope this goes to insulin pumpers digest as opposed to the Pentagon
>or something (my computer skills are at times uncanny).  Pumpazoid Cindy in
Look out your window. If the street in front of your house is filled with
Army trucks and there are helicopters over head, your message also went to
the Pentagon ;-)

Good luck with pumping and welcome ;-)

Bob Burnett

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