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[IPk] Pus from a site; adjusting basals to allow for exercise

Any site that oozes pus is likely to be infected and should be evaluated by 
a physician who can prescribe oral antibiotics if necessary. The one v. bad 
site infection I have ever had (in 1996) abcessed by the time I'd seen the 
third GP I'd sought out for advice. That doctor fabulous doctor, who had 
retired from the Royal Army, had moved to my hometown in Virginia and was 
practicing part-time at an evening drop-in clinic. I think if I ever need a 
doctor to look at a site again and I can't find a wound specialist, I'll 
look for somone who worked in the military!

If a little bit of insulin comes out of the site and there's some blood in 
the cannula, it's likely that the site wasn't absorbing well. Check bg and 
give extra insulin for correction if necessary after inserting the new set.
It's important to note when Danielle has clear patterns of highs and lows: 
if she goes low three times out of 4 on days when she exercises, the pump 
makes those lows preventable if y'all can think ahead. The ability to 
manipulate bg without necessarily consuming sugary stuff is one of the 
advantages of having one. Many people need starting bgs of at least 10 to 
get in a strenous workout without going hypo, though some don't. It is 
imperative that someone with type 1, whether on a pump or on injections, 
test his/her bg before heart-rate raising exercise. We all hope we can tell 
when we're hypo or high but fact is sometimes we can't, and we can never 
guess the exact number even when we know it must be 'low' or 'high'.

I know from years of experience that my bg must be at least 13 for me to be 
able to do 45 mins. of strenuous exercise or I'll have a hypo and need 
calories that will basically render the exercise counterproductive. Letting 
my bg rise naturally by testing an hour or so before I plan to go to the gym 
and reducing my basal rate (occasionally eating an apple too) makes me feel 
a lot more like I'm accomplishing something good for myself when I get all 
sweaty and don't need a full meal immediately after! I sometimes suspend my 
pump completely for an hour and then run a 30% temporary basal during 
exercise so that the exercise + the small amount of insulin will work 
together to lower my bg, but sometimes I do it the other way round, reducing 
the basal beforehand and supending during exercise. Depends on the activity 
I'm doing: running uses more glucose during the 45 mins. than does 
weightlifting, for me, at least. I have figured out that I get 70 mg/dl (3.9 
mmol/L) per mile when I run--it's good to know one's mileage to glucose--we 
care how much petrol it takes to run our cars; useful it is to know how much 
glucose 'runs' us. :)

IDDM 10 years; MiniMed pumper 6+ years
Co-ordinator, Oxford University Student Union Diabetes Network

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