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Re: [IPk] basal rates and glargine

In a message dated 1/21/2003 1:58:27 PM GMT Standard Time, 
email @ redacted writes:

> it's a little worrying that someone not doing well on glargine could be
> labelled as awkward or non compliant

Hi Abi,

Isn't this part of the general lack of understanding of basal rate needs by 
many diabetologists including, I'm afraid to say, those experienced with pump 
use in their departments?  Haven't many of us on this list been told that 
they were non-compliant on MDI etc, despite doing their best, then realised 
on going on the pump why they hadn't - couldn't have - been able to achieve 
good control?

The reassurance that glargine is available, say in case things don't work out 
on the pump, can mean that the advisor doesn't really understand how basal 
rates - or your basal rates - work.  That basals can change many times a day, 
from day to day according to work patterns / hormonal patterns etc, and that 
the times and nature of those changes differ in individuals.  So they don't 
understand your diabetes.  And you get a non-compliant label.  


(Oooh, this a subject that makes me really mad...)

P.S. Pat et al, I at least with my odd / changeable / tiny basals would have 
real trouble in putting together an appropriate injectable programme of 
different insulins.  Tried it when pump, now in USA I guess, went awry. 
Better than regular MDI (horrendous), but not good.
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