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[IP] RE: Pump/Lantus alternative, was MARY TYLER MOORE

>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). 


You can achieve a "peakless" 12-hour insulin by using Lantus.  Device your 
Lantus "bolus" in half, and give it 12 hours apart.  The first 12 hours you 
will only have half a basal rate, but after that, the overlapping of the 
insulin will give you a full basal rate 24 hours.  There will be a slight dip 
each 12 hour mark because the shot from 24 earlier will have started to 
 stop...but, in this case you have the Lantus from 12 hours still working, so it
is closer to a smooth curve.

 Another option, if you truly don't need a flat basal is to use a 3-4 shot-a-day
NPH method.  This allows you to have, effectively, 3-4 basal rates throughout 
the day.  I did this prior to Lantus and found it worked better than Lantus 
did.  I was able to give a higher bedtime NPH dosage to prevent a rise in the 
 early morning, while keeping my daytime basal rate lower with a smaller morning
 and lunchtime NPH shot. If I were to have to go off the pump for any reason, I
would switch to this before going back to Lantus.

> 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.

I had this problem with the pump at first.  For the first 6 months, I did not 
sleep well at all.  I finally figured out it was the pump!  I just couldn't 
sleep with it.  So, I made myself out of spandex a thigh-pocket that holds my 
pump while I sleep.  I wear the pump on my thigh, just below the groin (the 
inner thigh area).  This keeps it out of the way throughout the night even 
 though I change positions frequently while sleeping. I have tried, on a couple
of occasions, to not use the thigh thing to sleep with...and I end up not 
sleeping well at all again.  I usually end up getting up and putting on the 
thigh thing anyhow.

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