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Re: [IPk] refilling the cannula

If it's not too boring, I'll contribute a little more on the theme of
switching off the pump, because I think it touches on the aspect of diabetes
which is known so much better to diabetics than to the medical
practitioners, namely the variability of requirements hour to hour, day to
day and person to person.
The medical profession hates such things, because it complicates their life.
I can remember in the early eighties being told (by a woman consultant) when
I complained of daily variations despite rigid adherence to insulin, diet
and activity, that the reason was that I must have the hormones of a
"hysterical adolescent girl".
Such a comment, of course, went nowhere to providing an explanation, and
though it was not meant maliciously, even if in dubious taste, it was
symptomatic of the fact that they were satisfied with that sort of quality
of analysis then, when they were not simply blaming the patient for being
erratic. Such head-in-the-sand attitudes to instability were regularly
echoed in "Balance."
On the question of switching off the pump: surely unless it's been off for a
considerable time you can't say you are running on no insulin, because you
probably have some residual insulin in the blood not yet metabolised (even
0.1 iu, as pump users know, makes a difference).
 In hospital, on intravenous Actrapid, four years ago, they had regularly to
turn my pump off for two hours in the early morning, but was that really a
nil insulin requirement? (my Humalog requirement now for the same hours is
half a unit per hour.)
Does exercise change one's basic insulin requirement or does it only
accelerate the speed of metabolism of insulin due to the increased blood
circulation? Is there a hormonal effect of exercising on diabetes (other
than a hypo) which is documented?
Whatever the answers to these questions, I hope we are moving towards a more
general recognition that diabetes, when looked at closely, as some of us
clearly have, is an unstable condition for many people.  If that were the
case, we should in time be able to get better support from the medical
profession for active management of our condition, because they have the
advantage of first-hand contact with many patients (I don't mean GPs here,
unless someone has an exceptional one!) and more wide-ranging research.
Besides that, I envy you lot your extended exercise periods, which would
floor me,.... and also your unexpected "highs", which would suit me fine as
the upper limit on a good day!
Simon Duckworth

-----Message d'origine-----
De : John Neale <email @ redacted>
 : email @ redacted <email @ redacted>
Date : lundi 15 novembre 1999 11:40
Objet : Re: [IPk] refilling the cannula

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