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[IP] RE: Follow up on basal questions



 Thank you for your good questions responding to my request about how many of
you pumpers out there use a 00.00 basal rate for part of your day. To respond,
here is probably more than you want to know.

 Let me mention that in their talk with me a few days ago the Animas customer
service rep and her supervisor seemed to be saying, but only guessing, that I am
not infusing enough insulin with some of my basal levels to maintain enough
pressure on the plunger so that maybe a backup or leakage of air is occurring,
at my site. My major question to Animas was about the spaces that appear at the
end of the tubing when I disconnect to check and make sure I will have insulin
flowing and not just air when I bolus. I now check frequently. My scientific
husband found it very hard to believe that the pressure on the plunger would
change for ANY reason. The Animas pump is gear driven so the syringe is
basically locked unless there is insulin delivery by basal or bolus so why would
there be a backup of insulin at the end of the tubing? Also, to repeat from my
earlier email, the Animas people I spoke with had never, ever, heard of anyone
using 00.00 as a basal rate. So my question to all of you was, am I the only one
doing this?

 Some answers to your questions: my total Daily Basal Rate, currently, is 3.45
units. Below, Im showing my basal rates starting, not at 12 a.m. but with my
lowest use of basal insulin:

noon                        .1u/hour  
5  to 7 p.m.              .025u/hour   
7 p.m. to 2 a.m.    00.00  
2 a.m. to 3 a.m.        .075 

 After 3 a.m. I have a gentle rise in basal delivery until 7 a.m. and then it
reduces during the morning until noon. I still see room for reducing my early
a.m. and mid morning basals. I will add that I consume a quantity of carbs, with
no bolus and no IOB and based on by bg, to withstand a frequent but not always
drop of 60 to 80 points before 2 a.m. My record keeping helps enormously to
figure out how much to eat based on previous 10:30 bgs.

 My TTD, Total Daily Dose, averages around 12 units (yes, including basal
units). I vary my I/C ratio as well as the combo ratio for insulin delivery. For
example, if my bg is 72 before a meal, I may up the I/C ratio a little and/or
put in a combo bolus at perhaps 65 percent of the dose as a Normal bolus and the
rest is delivered over the next hour. I should also mention that Im a low-fat
vegan and my husband and I tend to eat very repetitive meals.

 I had to laugh a little at the question about whether or not I am really a
person who has diabetes? Im just extremely sensitive to insulin and there is
not a lot of room for adjustment when I use such small amounts. As for the
question about the amount of insulin I might bolus for 40 carbs, it would depend
on my BG, my IOB, time of day, and what I might be doing after consuming the
carbs, etc., but would probably be somewhere, very roughly, between 1.7 and
2.25u. As you all know, there are always several calculations involved in a
bolus.

 The comment about tissue pH affecting pump use was completely new to me. I do
not know what that would mean.

 Im not completely alone doing all this. I have a terrific Nurse Practitioner
and Dietitian and they are just as interested in whats happening as I am. But
there we are, we each have our very own form of diabetes YMMV.

Barbara, 63 years of diabetes since age 5, pumping since 2000.
.
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