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The pump is definitely a useful tool for trying to manage DM closely, but it
is absolutely NOT for everyone.  Pumping requires a great deal of effort that
some people just cannot live with.  Also, I openly admit that I don't like
being tethered to the pump all the time, but waking up with normal BG levels
makes it more tolerable for me.  I would, however, consider giving it up if I
could find a better basal solution than Lantus (I would prefer a peakless
12-hour insulin, since Lantus never worked a full 24 hours for me).  My sister
is an RN with Type 1, but she absolutely cannot stand having an external
device attached, especially infusion sets worn in the abdomen.  She wore the
Minimed Continuous Blood Glucose Sensor briefly and couldn't sleep the entire
time she wore it and vowed she would never do it again, but that doesn't mean
she is wrong for not choosing pump therapy.

While near-normal A1C's are a good goal, they are no guarantee that
complications will be avoided (nor are high A1Cs a guarantee that you will
experience complications), and there are some legitimate reasons for going
above the recommended standards.  Some people have problems with hypoglycemic
unawareness, which may be a very compelling reason to ease up on the
standards.  Some endos will even recommend that they set their goals a bit
higher because there is little else they can do about it.  People with Type 1
rely entirely on epinephrine since the counter-regulatory system (alpha cells
also located in the Islets of Langerhans) are destroyed by autoimmunity. 
Unfortunately, over time, the epinephrine response can also become blunted. 
Avoiding hypos can help, but they don't guarantee that you will have low blood
sugar 'symptoms'.  I personally have to rely on frequent testing and
identifying patterns rather than overt symptoms like sweating, shaking, etc.

I don't think that Mary Tyler Moore is wrong for not choosing a pump, and she
may have good reasons for having a higher A1C.  We don't know anything more
about her unique situation, so give the poor woman a break!


Dx'd with Type 9/1976 at age 7, pumping with Animas R1000 since 6/2003 at age

Date: Wed, 24 Sep 2003 21:25:27 EDT
From: email @ redacted

On Sunday I walked in the local Juvenile Diabetes Walk here in Ogdensburg, NY.
  A 13 year old diabetic girl was the local rep for the Juvenile Diabetes
Meeting in Washington, DC.  Her grandmother said that Mary Tyler Moore spoke
at the meeting and MTM said that she would not go for a pump.  This 13 year
old told me that her latest A1C was 10.7.   I told her that mine was 7.3 with
the pump and a friend in KY (Nanceseven) had a latest A1C of 6.7.   This local
gal says "NO!" to the pump. Her doctor has warned her about her high A1Cs and
that complications could be coming.

I hear that MTM's hubby is a doctor, but.....what can we do?

Jimmy Durr
email @ redacted
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