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RE: [IPk] Continuous Glucose Monitoring and other things



Aisling,

I can see why doing both (injecting & pumping) would be both useful and
beneficial for various reasons.

What sort of pump break would you have?  Do you consciously have a few
weeks off or does it depend on site issues?  

It's been mentioned here that absorption rates are different for some
when they inject as opposed to pumping.  Do you find this and is it due
to using a different site or is there another reason?


Marion 


-----Original Message-----
From: email @ redacted [mailto:email @ redacted] On
Behalf Of Aisling
Sent: 22 January 2005 20:09
To: email @ redacted
Subject: RE: [IPk] Continuous Glucose Monitoring and other things

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email @ redacted wrote:

Nanette mentioned injections. I still use injections quite a lot. 
Injected Humalog hits me faster than bolused Humalog. 

I'm certainly getting odd BGs at the moment. I know I have other 
health issues on the go which certainly won't be helping, but I may 
ask my clinic for another CGMS. 

REPLY:

Hi John

 Have you ever considered that erratic insulin absorption can be a sign
of
lipodystrophy - that skin damage at injection sites might not always be
manifest
with visible indentations or bumps - but that unpredicatable insulin
absortption
can be another sign of it?

 I find that the issue of skin tissue damage in injection sites is
largely
ignored by the medical profession, as if subcutaneous tissue damage does
not
exist when in fact it does.

 The manufacturers of synthetic human insulin claim that it has
virtually no
risk of skin damage and I'm not aware of pharmaceutical companies or
independent
scientists having carried out any studies to contradict this or to
identify the
actual rate at which insulin-induced skin damage can occur or which
individuals
might be more prone to it or of any guidelines being set out for dealing
with
the issue of skin changes - especially for people (even if we are in the
minority we still count!!) who go on to develop this problem and have to
find
ways to deal with it (often without support from the medical profession
or the
manufacturers of insulin).

 .. (sorry - I realise I'm on my rant for the day but this problem is
rarely if
ever spoken about and I feel strongly about it!).

 For those of us who are more prone to skin changes / damage taking a
"pump-vacation" for a period of time gives the subcutaneous tissue a
chance to
heal itself, while temporarily going back to injections provides more
predictability in insulin absorption at the same time. When insulin
stops
working in a predictable timeframe this can indicate that the
subcutaneous
tissue in the current injection site should be given a break from
insulin
infusion and a chance to heal.

 Maybe this is not an issue which affects you but I'm glad to discover
that I'm
not the only one who thinks pump therapy doesnt have to be all or
nothing - I
combine insulin injections with using my pump too (- when I first went
on the
pump I never thought that I would end up using both treatments - but I'm
finding
that's what works best for me).

Aisling
T1 12yrs



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