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[IPk] hypos on a pump



Hi Paul
What you say about carb counting makes sense, and I don't think it will be too 
much effort for you to count carbs a bit more proactively if you do go the 
pump route.
On the subject of hypos, I am much better controlled on the pump than I was on 
MDI, which means also that I can run my BGs a lot lower than I could before. 
However, this does mean that sometimes I slip into a hypo without realising 
and very occasionally I will get a really bad one that takes a lot to bring 
back up. It is still generally a lot easier to bring them up on a pump, and if 
it is not too bad a hypo, sometimes you can just turn off the pump for half an 
hour to have the desired effect, especially if the BG is hovering around the 4 
mark. I do occasionally get bad rebounds but most of the time they're a result 
of overtreating as a result of NEEDING to get my BG up fast (in the middle of 
a softball match, for example). I had a bad one last night, woke up at 3am (on 
my own in a hotel room in Montenegro!) with really low BG, treated it with too 
much carb because I was a bit concerned being on my own etc, and woke up this 
morning with a nasty rebound of 20 that has taken all morning (and a swim) to 
bring back down despite aggressive bolusing. However this is rare for me. I 
find that in general hypos and highs are a lot easier to deal with on the pump 
without going to extremes, ie it might take a lot to get my BG back up after a 
low, but it's much easier to do in a controlled way on the pump. And the same 
(more so, in fact) with highs.
Hope that helps
Di


Paul Coker wrote:
> Di
> 
> I am not too concerned about counting carbs, when I was diagnosed in 1977
> (aged 5) that was the main stay of diabetes control combined with a once
> daily dose of long acting insulin (e.g. monotard).  Whilst I don't not
> actively count carbs I am aware of the general doseage of carbs on most
> foods and passively assess the foods, after all this was instilled in me
> from a very young age but I do not analyse the foods to the same level that
> a pump requires.
> 
> I am encouraged by your comments it seems that with a little thought about
> the foods, and at least initially a little effort, that the pump may well be
> the best solution.  I am particularly interested in what you say about the
> types of food, I too find that rice and pasta require less insulin than say
> bread or potatoes and nuts (eg, brazil nuts and cashew nuts in particular)
> will also elevate my bg beyond the proportions of the CHO count, even though
> they have a very good GI index.  The story here I think is to look at the
> energy we derive from protein, fats and carbohydrates... ...it really is
> back to the same old story with the pizza.
> 
> In an earlier e-mail you mention that you have much worse hypos than on
> MDI.  Are they more frequent or of greater severity?  How do you treat
> them?  Do you end up in a rollercoaster with lows followed by highs?  I try
> to avoid these and am usually succesful but sometimes it takes a lot to
> combat a hypo and the bounce back is then a problem.  Does the pump help to
> prevent this situation, given the lack of long acting insulin?
> 
> Thanks
> 
> Paul
.
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