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Re: [IP] pre-pump protocol

On 20 Nov 98 at 20:06, Neal & Kara wrote:

> My endo won't put me on the pump until I see his diabetes educator pump
> specialist AND a psychiatrist he uses for prospective pump users.  He claims
> this protocol of his has great results because 95% of his patients that
> ultimately go on the pump, stay on the pump.  Has anyone heard of this?  I
> think he's overdoing it a bit.   He also wants me to go into the hospital for
> two days when I first go on the pump but says this is "negotiable."  Do most
> people spend the first 2 days on the pump in the hospital?

Many doctors want you to have as much information as possible before you get 
going on the pump.  The diabetes educator should be able to give you some 
startup-type information about the changes in your protocol, diet etc.  The 
shrink is probably just a check to make sure you can handle things.  The change 
to the pump is like many other significant life events and can cause major 
stress.  If it's really for your benefit the team (doctor, educator and 
psychiatrist) should help you get a better understanding of some of the ups and 
downs of pump therapy so you can make an informed decision.  The investment in 
your time is a good indicator of your desire and willingness to handle the 

Hospitalization is more questionable - I only missed a couple of hours of work 
the day I started my pump.  I left the office, went to the pump consultant's 
office, reviewed the information, hooked up the pump, talked about contact 
times, pager numbers and cell phone numbers I'd need for the next week, then I 
went back to the office.  I talked to the CDE and consultant several times each 
day for the next week, phoned my doctor after a week, and then maintained daily 
contact with the CDE and consultant for several weeks while we tinkered with 
the basal rates...  this is definitely a case of YMWV - depending on the 
experience your doctor and CDE have had with pumps.

> 1 more question -- I read the Pumping Insulin book by Walsh and Roberts but it
> doesn't talk about Lispro and the pump.  This seems significant, especially
> for setting nightinme basal rates because the onset of lispro and R is so
> different.  I have the 2nd edition of this book.  Is there a more recent
> version that incorporates Lispro?  Or does anyone know of similar pump books
> that incorporate the quicker acting insulins?

The basic concepts are the same for Lispro and Regular, as far as setting basal 
rates goes.  You just adjust the timing slightly to accomodate the quicker 
onset if needed.  It's all done by trial and error anyway...

Randall P. Winchester
* The views expressed here are mine and do not necessarily *
* reflect the official position of anyone in particular.            *
* There's no guarantee on anything said here...
* If I say I understand something completely the only thing
* we can both be assured of is that I must have completely
* misunderstood something. 
Insulin-Pumpers website http://www.insulin-pumpers.org/