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Re: [IPk] changing insulin needs

In a message dated 12/16/2003 7:36:49 PM GMT Standard Time, email @ redacted 

> Remember that it can take 4 units (or so) not getting delivered for a 
> MiniMed 50-whatever model pump to tell you there's a problem.

Hi Fiona, also Melissa and all,

And don't forget that a) a right-angle cannula trapped above the skin can 
 merrily leak away insulin without any alarms and b) one just under the skin,
shallowly sited, can still be delivering, but the insulin isn't being absorbed 
well (although many hours later you may have an unexplained hypo...) - so you 
won't necessarily get a pump alarm. After changing a site/set, I always check 
for ketones whatever the bg, if bg high and no ketones I try a big bolus, and 
if bg's not coming down as expected (allowing for the "exponential" effect 
many of us see with high bgs) then change the site. (Obviously you will have 
checked for other problems eg with the pump, infusion, etc.)

Different sites have different absorption profiles and your activity level in 
general and at these areas will influence these.  In your job it might be 
better to use leg/abdomen/back areas. Also, if you're a muscular and/or thin 
lady, a site in/near your arm may mean that your cannula will kink when you 
insert, especially if you're tensed up when you do this either positionally or 
 naturally! I had a lot of trouble for the first few months of pumping with
the first problem, corrected by using the smallest cannula size and abdominal 
sites.  I have also been using Quicksets for some eight months and have never 
had any problems with cannula kinking, I had lots of trouble with the 

HTH and hope your problems are solved soon,

Best wishes,

IDDM 30+ yrs, 508 3 yrs
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