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[IP] Re: Upmp Bolus cals & Medicare Quandry

My Endo has had me on a complex sliding scale of Humalog and Humalin-N
for several YEars.  Now he advocates my using a pump.  Here is what I
see as my main problem ... OVer many years I find myself afraid to use
bolus doses not prescibed on my "scale" regardless that I often get BG's
as high as 350-400 and know I'm entering a DKA state. 
   THis is just fearoof my own guessing of dosage and at times my
housemates have to tell me to use an extra few units to get out of DKa. 
Why I hesitate I don't really know, I just sort of freeze up when the
BG's get badly out of control and fail to take action as fast as I
clearly should.  Won't I experience the same problem using a pump ? 
Where it seems that the bolus dose especially is pretty much the
patient's to determine ? and carb counting is something I've never
before done, Too many years on the ADA DIet I guess...
What kind of training could help me overcome my inability to calculate
my own bolus doses ?

Different Question - Insurance and Pump + Supplies ---

Also I am on Medicare which I'm now told doesn't pay for either pumps or
pump supplies. I Live in the state of MAryland and have State pharmacy
assistance card and a weird form of partial Medicaid they term QMB. 
Does Anyone know how one goes about trying to obtain a pump if the
patient is clearly suffering frequent poorly controlled BG'ss with all
other regimens ? I've already gotten A Painfull Neuropathy and have had
some episodes of Microhematuria  Why do the Feds pretend to be behind
tight control and then seem to deny access to the Pump ?
I had worked as a carpenter for 25 years but finally became too impaired
with neuropathy to function at work and was able to receive Socail
Security Disability Insurance PAyments  , and Medicare came with that
but the income is far too small to pay cash for pump and supplies I'm
extremely puzzled as to what Patients like myself locked into The
Federal Reimbursement System Run by HCFA are Supposed to do, Simply
forgo all advances in Moodern Medicine or what ?  Any oone oout there
face a similar situation and discover an answer ?  

My Endo seems to feel that he can get the company he works with to give
me a pump due to the fact that he sends numerous referals who have
superior insurance. To me this seems an unreasonable assumption
especially for ongoing supplies like soft-sets... 

Any ideas Appreciated.

(Diabetic Male age 49, Diagnosed and IDDM for 29 years considering   
ability to utilze and insulin pumping system versus sliding scale with 6
feedings and 8 BG readings per day... Bolus dosing 6 times per day with
mixed Humalog & Humalin-N  Long history of poor control.)

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