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To Pete, was: Re: [IP] Any last minute advice before I get my pump?



Pete:

Your starting insulin dosages for pumping will be determined by your endo
and the rest of your health care team (if there is a "team" involved in
your pump start).  Starting dosages often are a fraction of the total
insulin you had been taking previously and will probably be only estimates
of what you eventually end up with.  Some endos start with a basal rate
estimate based on your weight. This seems to be a good starting point.
Bolus estimates are also arrived at based on body weight. These initial
rates will surely change, probably quite soon.

Many endos and other health professionals like to start their new pumpers
on Humalog. It is quick, which makes some of the initial rate adjustments
easier. Its quick onset and relatively short duration also make it easier
to administer supplemental boluses to bring down the high BGs which you
will surely encounter while fine tuning  your basal and bolus rates. Work
with your team and weigh their experience and judgement when deciding on
the type of insulin to use. This is by no means a *final* decision - you
can always change the type of insulin you are using some time later.

Re: Infusion sets. You may find the Silhouettes *very* comfortable - that
seems to be the general consensus. When starting out, you may find these
sets very easy to work with, since there is no extra tape to fool around
with, so the number of variables you are dealing with is lessened.

I find that it is a good idea to also have a supply of bent needle infusion
sets handy. I revert to these whenever my BGs start taking some strange
"excursions". By reverting to bent needle sets, I eliminate any issues with
the cannula bending, etc. while I am troubleshooting (I admit that using
the bent needle introduces another variable into the troubleshooting
scenario, but I have a proven track record with them and know what to
expect from them).

Try not to be talked into buying a whole year's worth of supplies. You will
probably change your mind several times about tape, infusion sets, etc. and
it's important to have the flexibility to change your mind. Stock enough
initially to see you through any unforeseen emergencies - in other words,
err on the side of "over planning". You should be o.k. with this approach.

Make yourself a large sign which reads: YMMV - Your Mileage May Vary. Stick
it up on the wall and remember to look at it from time to time when things
seem to be getting a little off track when compared to other users ;-)

We're here most of the time - seems like none of us sleep, so holler if you
have any questions.

P.S. Get the name and address of that other pumper in the Yukon - you're
sure to meet each other at the next pumper's meeting ;-)

Bob

mailto:email @ redacted

<snip>
>was excellent)  Now, does anyone have any advice about insulin?  I am
>currently take R on a sliding scale at meal times (about 20 units a day)
>and 17 N at bedtime.  I have asked my endo about switching to Humalog
>but after reading everything you have said, I am having serious second
>thoughts about switching; any advice?  What about infusion sets?
>Originally I planned on using the Sof-set QR but then I heard about the
>Silhouette sets?  Which have you found to be better?  I need to get
>feedback on infusion sets especially since I live in the boonies (over
>2000 miles from my endo and my Minimed supplier).  Also as far as I know
>I will be one of 2 people in the entire Yukon using a pump.  Would you
>please let me know as I hit the road in 60 hours or so.  Thanks.
>
>Pete
>
<snip>
Bob Burnett

mailto:email @ redacted
Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/