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[IP] RE: To pump or not to pump


There are a number of medical reasons why Lantus does not truly mimic what a
pump is capable of accommodating.  Whether this will be true for you is best
determined you and your medical team.  Lantus is an insulin analog designed to
provide basal coverage at a more or less constant rate for approximately 24
hours.  Lantus cannot accommodate the additional basal insulin coverage that
many people require to deal with early in the morning.  For people with Type
1, it may be the dawn phenomenon, and for people with Type II, it may be the
liver releasing stored glucose levels in the morning.  Lantus also does not
enable people to adjust their basal coverage temporarily (up or down) to
accommodate things that can come up during the day, like illness, stress,
menses, exercise, etc.  If you dosed Lantus 12 hours ago, you will have to
wait until its run its course before making any adjustments, which is not a
matter of convenience, but a matter of having to schedule your life around an
insulin regimen, even though there may have been no way of predicting how much
more or less coverage you were going to need 24 hours ago.  In my experience
with Lantus, I found that it tended to peak slightly during its first 6 hours,
resulting in my waking up with low blood glucose levels every morning.  A
reduction in my evening dosage of Lantus resulted in my waking to "normal"
blood glucose levels, but also having insufficient basal coverage for the rest
of the day.  Lantus also did not deliver on its claim of full 24 hour basal
coverage for me, so by the 18th hour after injection, my blood glucose levels
began rising despite not having eaten for hours.  Your mileage may vary (YMMV)
with Lantus.

I can't really say how much of will be applicable for you, but the bottom line
is that an insulin pump can be programmed to accommodate your need for
differing amounts of basal coverage at different times of the day, and the
same thing cannot be said for any of the long-acting insulin formulations on
the market, including Lantus.


Dx'd Type 1 9/1976 at age 7, pumping with Animas R1000 since 6/2002 at age 33

Date: Mon, 12 May 2003 18:57:48 -0500
From: "john cooper" <email @ redacted>
Subject: [IP] To pump or not to pump

 I am a type II insulin dependent diabetic, using Novalog and Lantis.
Minimally acceptable A1C. I do produce insulin.

Doc has recommended using a pump.  
 Question - Is there is any medical reason (convenience does not matter) for
using the pump when Lantus (I think) seems to mimic what a pump will do? I've
researched this, but haven't found a clear answer.

Any comments?


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