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Re: [IPk] Thoughts re. Dahedi

----- Original Message -----
From: Johanna Pocock <email @ redacted>
To: <email @ redacted>
Sent: Monday, 31 January, 2000 18:23
Subject: [IPk] Thoughts re. Dahedi

Thanks for the answers.

>> Q3 - ... The school argues that using Humalog with
>>a pump brings a higher risk of ketoacidosis due to the high absorption
> ..I do not understand the reasoning behind the theory.
Humalog gets absorbed about 2* quicker than ActRapid, so if the pump
fails/blocks then the unabsorbed 'buffer' of insulin in your subcutaneous
layer is gone 2* faster with Humalog, leading to a faster development of
ketones due to lack of insulin.

Hi Trev,
It may be my eccentric way of thinking but I think the theory above could be
used to promote Humalog, rather than put it down (re. pumps).
Before Ketones are produced the blood sugar has to reach very high levels
(well over 20). Most people with diabetes would be feeling affects of some
sort (wearyness etc) before that (especially if they had been using a pump
and were well controlled). Furthermore I cannot believe any pumps are
produced, nowadays that do not have a blockage alarm, therefore the patient
should be aware of problems before ketoacidosis begins. If such a blockage
did occur and the person was not able to solve the blockage immediately it
would be to his/her greater advantage to have a very quick insulin injected
when able to do so as this would solve the problem more quickly.
After all one unit of Humalog and one unit of Actrapid both have the same
amount of insulin. The idea of there being a 'buffer' would really only mean
that the highest blood-sugar occured half an hour later with Actrapid than
with Humalog (while the person has to wait half an hour after injecting the
Actrapid, for it to take effect). Furthermore when first taught about using
a pump I was told to be prepared for problems and when far away from home
always have a syringe with me in case of problems.
If you can work out what I am suggesting, you're better than me and could
use it as another reason to use Humalog rather than a conventional insulin.
Best of luck,

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