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Re: [IPk] NICE Guidelines

In message <email @ redacted>, Carmel Matthews
<email @ redacted> writes
>They are suggesting that established users of CSII be trialled back on MDI 
>or glargine?!? Personally I would kidnap my pump and run away with absolute 
>terror at the thought. Iremember some years ago being tried on Ultratard 
>with MDI I dont know if it still exists but I know it was really 
>unpredictable and very frightening. I gues they needed a professor of 
>pharmacology of old age on the committee!

Yes, that's exactly what they are suggesting.  Glargine isn't as
unpredictable as Ultratard (which, in fact, I found very predictable),
so if your only problem was that sometimes it was slow in starting, or
that it had unexpected peaks and lows of activity, maybe Glargine
_would_ be an option for you.

But .... what are your basal rates?  If they vary at all, Glargine will
drive you high and low.  Do you ever vary your basals (e.g. after
exercise, during menstruation, when sick) - if so, the glargine will
drive you high or low at these times.  That's what you need to explain
to your doctor, if he or she doesn't already know it, and _if_ these
recommendations go forwards as are.  I am hoping that PUMP and INPUT
(and anyone else on the list of formal consultees) will change the
recommendations so that simply by showing that your pump is programmed
to deliver a variable basal, or recording that you need to reduce or
increase the basal rate, or set temporary basals from time to time, is
all you need to do.

Best wishes,

(dm 30+, 508 1+, and going to walk the streets at King's Cross (having
informed the tabloids) before paying for supplies).
Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
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