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Subject: [IP] Newbie Pumper Update -- kinda long

RoseLea writes:
<<First, when I removed my set this am,
there were a couple tiny spots of blood in the cannula.  My bgs during the
night weren't as good as they should have been and I was a little on the
high side this am.  Could this have caused the higher bgs?  What causes
this?  Is the only remedy to change the site?  And is the only way you know
is higher bgs?>>

Blood in the cannulas happens because they move back and forth a little
under the skin, and there are blood vessels under the skin.  If one of the
cannulas hits one of the blood vessels, you may end up with blood in it.
Those sites often don't work well - I always figure it's a combination of
reasons, you're pumping insulin into an area of blood under the skin which
doesn't absorb well, plus the mechanical blockage of the cannula by clotted
blood.  The only remedy is to change it.  Sometimes, with Silouette/Tenders,
you can see the blood in the catheter in the little window that's right
where the tube joins to the hub, but otherwise, high sugars are your only
clue.  But, please remember, while you're adjusting basal rates, there are a
dozen OTHER reasons for high sugars, too, so it's just one thing to make a
note of and watch.

<<How much to drop my basals when
Definitely a YMMV, but Jenna drops hers to 60% with a fair degree of success

<<how to figure an extended bolus with an H-Tron Plus pump>>
Use the temporary basal increase.  We found that having the temp basal
increase set to 4 hours (instead of the factory pre-set 12) let us do this
pretty easily.  For high fat / high protein meals, we set the pump on 200%
for 4 hours.  Since Jenna's basal rates are 0.5 units / hr for most of the
hours that are around mealtimes, that means she gets an extra 2 units over
those 4 hours.  If you find you need less insulin, you can always set it for
lower.  If you need more - well, you'd have to reset basals, it's probably
not worth it, just do a correction bolus later
<< how to figure boluses for more fatty meals.>>
Good luck with this one!  We really don't change boluses for more fatty
meals.  The fat doesn't kick in for several hours, and if you increased your
boluses to cover the fat, you'd be hypoglycemic before the fat got
metabolized.  Just use the temp basal, see above.>>

Nancy Morgan
  This has been so exciting, I stopped
to pick up some Ketostix at the pharmacy this afternoon (my CDE requires
that you have them on hand in case of problems), and I just had to show Max
off to the ladies working there.  *vbg*

I'm so grateful to everyone on this list,  your suggestions and help have
been so great.  :o)

Assimilated with Max 05/15/2000!

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