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Re: [IP] Pumping Questions

At 10:05 PM 11/25/1998  Ruth Elowitz wrote:
>> Minimed uses a solenoid to push insulin a tenth of a unit at a time.  If a
>> user has a basal dose of 8-tenths of a unit hourly, the Minimed will click
>> eight times an hour, or once about every seven and half minutes.  In
>> delivery of boluses of, say, 6-1/2 units, the Minimed will click 65 times
>> and it will take several minutes to deliver.
>> Disetronics pump an infinitely variable dose of insulin through a screw
>> drive.  Five percent of hourly basal dosages are delivered each three
>> minutes.   In the above case, 8/10 unit per hour, 4/100 unit is delivered
>> each three minutes.  The above cited bolus of 6-1/2 units is silently pumped
>> in a matter of seconds.
>The slower Minimed bolus is a real advantage if you are using humalog and for
>large meals where distributing the insulin over even a slightly longer period
>helps me come out much more evenly, especially when you eat meals with fat,
>protein, or a good sized portion.  This is especially helpful if you have been
>diabetic for a while and have those small undiagnosed signs of gastroparesis.
>The fast delivery can also cause the insulin to burn a little bit and if you
>have hypertrophy from the sensitivity to the insulin, slowing the delivery
>even a little bit will help (it will help as much as you slow it down so
>obviously more is better but even a little helps)
>Having said that...the faster smoother delivery is a real advantage if you
>forget to bolus ahead, if you eat very fast high carb foods non fat candy, if
>you are too high and need a bang to bring you down.
>Since I tend to encounter both situations often, and the first ones just a
>little more often than the second, the Minimed is fine.  But basically, a new
>diabetic might find the disetronic more comfortable, someone who has been
>diabetic for a long time might find the Minimed more helpful, etc....  I 
>most of us encounter both kinds of circumstances periodically.

In the real world, I wonder how much of a difference 2-3 minutes makes.
Since the delivery of insulin to the bloodstream is not precise and subject
to lots of internal variables, I suspect that most people will never notice
any difference. No matter how fast it is injected, it still takes 15 to 30
minutes before Humalog starts to act... and even then it won't peak for an
hour or two (or in some cases even more). 

But, I'd love to see any studies that have been done on this... have any
been done? 


Insulin-Pumpers website http://www.insulin-pumpers.org/