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[IPk] Re: insulin sensitivity
Date: Tue, 28 Aug 2001 06:19:33 +0100
From: "Morag McLaren" <email @ redacted>
Subject: Re: [IPk] Insensitivity
>How many units of insulin are you using per day ?
>It is only young children who dilute to U40 . We have many pump users
>with high insulin sensitivity and they achieve very good contril with
>the Minimed pump . Infact those requiring small insulin doses are a
>good selection criteria for pump therapy .
>A normal pancreas delivers a small pulse of insulin approx. every 6 -
>7 minutes and so the Minimed pulses of .1 units approx. every 6
>with a basal rate of 1u/hr [ which is the average ] provides extremely
>physiological delivery .
Ah, now I remember, this was the reason which finally convinced me (3
years ago) that for me the Disetronic, though it is also not perfect,
was probably a better choice than the Minimed.
1u/h may be the average - but average of who??? and anyway average is
just that, with many people needing more or less - I know many type 1's
who use less - if you look in the tables in 'Pumping Insulin' for
suggested starting basal rates according to body weight, you will see
that many people's (particularly small/light people - would include
many adults, not only children) best initial estimate of how much
insulin to use would be less than 1 u/h.
I am a quite tall and not particularly light person, and use only a
little less insulin than the average suggested for my weight, but for
me this translates into basal rates from 0.4-0.6 units per hour,
depending on time of day. I appreciate fully the argument of trying to
simulate physiological delivery as closely as possible, but the problem
is that suppose you disconnect for a few minutes to take a shower (and
I certainly would not want to take showers on a regular basis with the
pump connected and in a plastic bag - I tried that when using the
CGMS), you can easily miss one of the little pulses of insulin, and if
this was a whole .1 unit out of your total of 0.4 (or less) units that
hour, you may miss more than a quarter of the basal insulin for that
The reality is that this is probably a minor point in the grand scheme
of things, but it is good to be aware of it.
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