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Re: [IPk] ketones- again

In a message dated 4/12/2003 8:11:29 PM GMT Daylight Time, email @ redacted 

> Sorry Mary but I don't understand what you are saying. You would presumably 
> give injected insulin when you have high bgs that won't come down after 
> bolusing with the pump. It is at this time that you should check your set 
> to 
> see if something is wrong. I don't understand what you mean by not knowing 
> for hours if your set has been inserted incorrectly.
Sorry Ken for not being clear.

If I have changed site, I often don't know for several hours whether the new 
cannula has been inserted correctly because in my case it can take up to two 
hours for even humalog to have any effect.  However, if my bg is high after 
about three hours and I can't find any problems with the system and there are 
no ketones, then persevering with boluses will eventually bring it down. The 
clue to an unsuccessful site - cannula outside, kinked, too shallow etc - for 
me is ketones.  I do appreciate that delivery of insulin can also be the 
culprit so always check the rest of the system. If I get urinary ketones (and 
yes, blood ketone measurement would probably be more useful) I will check 
everything and if nothing's amiss will change the site.   However, several 
hours then follow when I don't know whether or not the new set has been 
inserted correctly.  If I gave an insulin injection before I changed the 
site, I would not know if the change had been successful for hours because of 
the effect of the injection (a single injection of Humalog can affect me for 
six hours plus).

This scenario has occurred multiple times since I started pumping back in Nov 
2000, and whole days can be ruined.  (I would obviously appreciate any 

Thanks for your interest,

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