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[IPk] Thoughts re. Dahedi

Hi Trev,
Yours questions are interesting, in that I had not realised U40 was still
available anywhere and that pumps such as you describe are still made. I
attempt to make some suggestions.

Q1 - The clinic here recommends and makes available only one pump for the
school, the Dahedi 25E40. This takes U40 insulin. If I move back to the UK
how easy will it be to get U40 insulin?

As I mentioned above I did not realise U 40 was still available, but U100
can easily be diluted with saline, which is available on prescrpition. This
was how the pumps I used from 1981- 1999 worked. With the saline it is also
possible to vary the basal rate, if that cannot be done by any other means.
What John says about Humalog not being dilutable, due to preservatives, I
would not know but I cannot believe there is not some form of liquid that
could be used, after all it must have a base liquid. I do not think it would
be easy to U40 in the UK.

Q2 - The Dahedi 25E40 does not allow you to cancel a bolus once you've
pressed the button, and does not allow you to lower the basel rate a given
percentage. How useful are these things in real life? (I think the H Tron
plus has these features)

I also have never needed to cancel a bolus, what I usually do is take about
50% of what I believe I will need before a meal and the rest afterwards,
depending upon what I actually eat. I (still) use Actrapid and have never
found any need to take insulin half an hour before I intend to eat. If
blood-glucose goes up for a short period that is no different from a
'normal' person (the raised bg being the signal for insulin output). The
change in basal rate can be very useful, even if only for changes in the
weather, but if you do end up diluting U100 you can do that.

Q3 - I have been using Humalog (Lispro) as my short-acting insulin for the
last 2 years with great success. The school argues that using Humalog with
a pump brings a higher risk of ketoacidosis due to the high absorption
rate, which seems to make sense. What experience have people had with
Humalog and a pump?

I cannot answer that having never used the insulin, but I do not understand
the reasoning behind the theory. If Disetronic have taken Dahedi over I
would not be surprised if before long they either offer to replace the
Dahedi or offer a Disetronic at a much reduced rate.

Hopefully this may be of some use,

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