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Re: [IPk] Insulin requirements pump vs pre-pump
>Pre-pump I was taking between 50 and 65 units a day (around 16 units
>Insulatard am and 18pm, and the rest in Humalog).
> I now take between 30 and 40 units a
>day. I have a pretty high basal rate of 1.1 during the day, 1.2 at night,
>and 1.4 in the early hours of the morning, although this gets reduced by at
>least half when I'm exercising.
Mine dropped by a similar amount: as far as I remember I was on 20 units of
Insulatard pre-bed, and 10 or so units of Actrapid pre-meal - so just over
50 units a day. I remember that because my car insurers rated you as higher
risk if you were on over 50 units a day - so I might just possibly have had
48 units on the day I renewed my insurance ;o)
Now I'm on between 30 and 40 units of Humalog a day, depending on what I
eat. That's about 17 units basal, and about 3 units with a meal, for 45g
I don't fully understand why usage seems to fall on the pump. I know that a
significant amount of long acting insulin does not actually enter the blood
stream, but degrades instead. So 20 units of Insulatard, with 6 units
"degrading", would be equivalent to a daily basal of 14 units of Humalog.
That's just a thought. And the body generally becomes more "sensitive" to
insulin when it has the correct amount of insulin in the blood, rather than
the great slugs of insulin that get thrown at it when big injections are
1.I. Lager et al. Reversal of insulin resistance in type 1 diabetes after
treatment with continuous subcutaneous insulin infusion. BMJ 287:
2.H. Beck-Nielsen et al. Improved in vivo insulin effect during continuous
subcutaneous insulin infusion in patients with IDDM. Diabetes 33: 832-837,
3.C. Binder et al. Insulin pharmacokinetics. Diabetes Care 7:188-199, 1984.
4.T. Lauritzen et al. Pharmacokinetics of continuous subcutaneous insulin
infusion. Diabetologia 24: 326-329, 1983.
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