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[IPk] Re: ip-uk-digest V2 #94

In a message dated 5/1/2002 11:48:33 AM GMT Daylight Time, Caroline writes:

> After just two weeks on a pump, its all come crashing down around me. I ended
> up in hospital on the brink of full blown DKA.Don't ask me how this 
> happened,
> as I, and my consultant and his registrar and my DSN all have no idea. All I
> know is that my blood sugars have not dropped beow 15 since Saturday, and 
> I've
> had ketones for most of that time. This was despite running huge basal 
> rates,
> taking boluses of up to 15 units at a time - both through syringe and pump,
> checking the pump out for problems and changing the infusion set several
> times. I'm not even ill!
Hi Caroline,
Really sorry to hear that things aren't working out well so far.
I guess it might be a bit naive to make suggestions when you've an 
experienced team looking after you, but sometimes things are missed or 
overlooked - better to say them twice than not to think of them at all, has 
always been my motto.

There are many things which could be causing the problem (and you're welcome 
to correspond with me if you'd like), but a quick summary: the insulin itself 
(type, potency and how it's stored, etc), pump (set-up, delivery, practical 
problems such as bubbles), or absorption.  You're in the hands of a team 
which I hope is experienced in looking after the first two, but may not have 
thought round the last.  

I had major problems for four or five months when I started on the pump - 
worse results than the awful (swings from hypo to 20s) control I'd previously 
had.  I experimented with several types of set and cannula length, and 
eventually found what appeared to be the solution - a simple change of 
cannula length reduced the dramatic swings almost overnight.  Perhaps you are 
doing the same, giving insulin at too deep or shallow a level for good 
absorption to occur...
...which brings me on to the next point - you've been diabetic for a long 
time, do you have absorption problems which could be contributing to this? (I 
did - my thighs are still unusable after a year and a half of pumping 
elsewhere, no way could I use those sites.)  

Hope things improve.  When pumping's successful it's GOOD!

IDDM 30 yrs, pumper 1.5 yrs  
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