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Re: [IPp] Re: Difficult basal rates; Was choosing a pump and using a Continous Glucose Monitor

I totally agree with David (who, by the way, taught me almost 3 years ago
over the phone how to dilute insulin - wasn't that nice?).  We  started with
U10 (10% insulin), then U25 (25% insulin), and are now using U50 insulin
(equal parts diluent and insulin).  Those changes have been made as her
insulin needs have increased.  Even basal changes of 0.025 uph is sometimes
too much for Andrea.  Diluting really helps us.  Plus, Andrea's correction
factor is 480 (used to be 600), so diluting is a must unless you want to
manually calculate correction doses (which I don't).

If anyone wants more info on diluting, I pasted together (for someone on
another list) a whole bunch of emails that had been exchanged about diluting
- pros/cons, things to watch out for, how to get the supplies, etc..  Email
me if you would like to read it.


On 7/26/06, David Jensen <email @ redacted> wrote:
> All,
> My suggestion for small kids and sensitive adults:  Dilute your
> insulin.  We've been doing it for 3 years now and it has been
> fantastic.  We had the same issues when we first started pumping.  The
> standard U100 is too strong and trying to get the basals correct was
> difficult.  Our pump group suggested we dilute and told us how - Have
> your pharmacist contact Lilly and ask for diluent and empty vials.
> Then, because the pharmacist can't sell the diluent, he can give it to
> you for free and you do the work (you can buy syringes), or s/he can do
> the dilution for you.  We've been diluting to U25 (one-fourth the
> concentration of the usual stuff) and it's been great.  We simply tell
> the pump that the correction number is 1/4th what it really is (90
> instead of 360), the food bolus is 1/4th (1:6 instead of 1:24), and the
> basal rates are 4 times what they should be (0.4 instead of 0.1).
> What this does is put the pump out into a basal range that is "away
> from the edges" (the variability of delivering 0.05 u/hr if *far*
> greater than the variability of delivering 0.2 u/hr).  We are just now
> getting to basal rate numbers that might allow us to not dilute (Sigrid
> will be 5 in Oct.).  It is my opinion that diluting the insulin will
> allow you to smooth out the basal rates and give you better control of
> you childs' diabetes.
> That's my 2 cents!
> David Jensen
> Dad to 4 yo Sigrid (dx'd 11 mos; pumping since 17 mos.) and 1 yo Vibeka.
> On Jul 26, 2006, at 5:16 PM, pop-digest wrote:
> > Date: Mon, 24 Jul 2006 14:13:00 -0700
> > From: "Joy Simon" <email @ redacted>
> > Subject: RE: [IPp] Re: Choosing a pump and using a Continous Glucose
> > Monitor
> >
> > Hi Stephanie:
> >
> > Welcome!  You are very smart for emailing the group.  I think you'll
> > learn a lot from the responses.
> >
> > My son Jake is 20 months old.  We use the Medtronic's pump.  AND we
> > bought the Continuous Glucose Monitor last month.
> >
> > We went with the Medtronic's pump last April - when Jake was 17 months
> > mainly because we heard that Medtronic's was coming out with a
> > Continuous Glucose monitor solution and we wanted it.  We love the pump
> > technology!  It has saved our lives.
> >
> >    My husband spent many hours researching pumps and the CGM
> > technology.
> > We were leaning towards Animas pump because Jake was so small and
> > needed
> > very small amounts of insulin. Yet we thought  we should have a pump
> > that had the CGM technology connected.     So we went with Medtronic's
> > Minimed pump
> >
> > It's now 3 months later,  and I kind of wish we went with Animas.
> > There
> > are several reasons why.  I list a couple of the reasons.
> >
> > 1.  We can not seem to get Jake's basal right with the Minimed pump.
> > We
> > really do need smaller doses of insulin & Minimed does get there for
> > us.
> > We have been playing around with the basals and  we are close but not
> > 100% perfect.  I like the idea that the doses are smaller with Animas.
> > 2.  Animas pump is water proof.  I didn't think this would be a big
> > deal
> > - - but it really is.  Jake likes playing in the sprinklers, and in the
> > sink and I'm always paranoid that he will get his pump wet.
> >  3. Customer service has been an issue with Medtronic's.  I have had to
> > wait on the phone rather long at times when we call Medtronics.    As a
> > matter of fact - this morning I called them with a problem and they
> > told
> > me no one was available and they would have to call me back.  I called
> > them at 11 am and they returned my call at 1 pm.  Last time I held on
> > the phone for 25-30 minutes.   This was the time that Jake's pump
> > locked
> > up and would not give him any insulin.  I really needed to talk to
> > someone right away since I had already fed him. Not acceptable in my
> > mind.  Today they apologized and told me they are hiring new support
> > reps.
> > 3.  Communication is not clear.  I bought the GCM last month and was
> > never told to get trained on it.  I guess they assumed we would know to
> > ask for training.   My husband read the manual and then tried the
> > system
> > on Jake.   WE had an extremely hard time and bad experience with it.  I
> > wrote about it last week.   Needless to say, when we called Medtronic's
> > to discuss our problems with CGM  they told us we should have been
> > trained on it before we used it.  Well - my husband is a physician and
> > thought he would be able to figure out how to use the system by reading
> > the manual.  Not so!    We did get trained recently and feel better
> > about the CGM technology now.
> > 4.  I am told Animas will lend you a pump when you travel - free of
> > charge.  Medtronic's charges you $50.00.  WE called Medtronic's
> > recently
> > to see if they would loan us a pump when we go away for free.  I think
> > the answer was they couldn't.
> > 5. Finally from what I read from this internet group - most of the
> > young
> > kids/toddlers seem to be using Animas pumps.  I wish I had joined the
> > group prior to buying the pump.  I think I would have seen this trend
> > and went with Animas.
> >
> > Anyway - this is strictly my opinion.  Others may have a great
> > experience with Medtronics.  Take it for what it's worth!
> >
> > Good Luck!
> >
> > Joy
> > Mom to Jake- age 20 months, dxd 12/05 pumping Minimed since 4/06
> .

Mama to 4 wonderful children - and 1 on the way!
Andrea Jean 4/99 - dx 1/28/03, pumping Cozmo 10/2/03 - diluted H (U50)
                                                  testing with Freestyle
Flash & CoZmonitor
Alicia Liliana 6/01
Carlos Kenneth 5/03
Anita Viviana 3/05 (has low risk gene combination - TRIGR study)
Baby #5 - due end of February 2007
Happily married to Tommy since 6/96
Salt Lake City, Utah
CWD and IPP member since 10/2003
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