[Previous Months][Date Index][Thread Index][Join - Register][Login]   Help@Insulin-Pumpers.org
  [Message Prev][Message Next][Thread Prev][Thread Next]   for subscribe/unsubscribe assistance

Re: [IPk] Pump Holiday

Hi Julian,

If your results have not been so good, do you think you will get better 
control if you go back on injections? If you think your control will improve 
(lower HbA1c, fewer bg swings, feeling good about life, etc.), then by all 
means take a pump holiday.

But if you think it's your basals and bolus amounts that need fine-tuning 
and you don't think you will feel much better about life while on 
injections, I would not take the risk of getting out of control. Before 
deciding to go back to MDI, I would first do a few sessions of fasting from 
waking until lunch to see if my a.m. basals were right, a few sessions of 
eating breakfast, no lunch, and a good-sized afternoon snack to see if the 
mid-day basals were right, and a few on-time lunches but late suppers to see 
if lunch-to-dinner basals were on target. I would also be more vigilant with 
2-hr post-prandial tests to see if my boluses were right.

I'm having to do the above at the moment myself...seems that in the past 
week my dawn phenomenon has eased up (had a 2.7 waking bg the other day), my 
late-morning basal needs have increased (haven't had a pre-lunch bg below 8 
without an 11 a.m. correction since Monday), my late-afternoon basal needs 
have decreased (I'm going hypo right now...but like Pat, 'gotta finish just 
this one thing'), and my carb ratio has gone from 14g CHO : 1 u. Humalog to 
9 or 10g CHO : 1 u. Humalog. Charming, eh?? But I don't know how I would I 
meet those changing needs on Lantus + NovoRapid or Humalog.

If your HbA1c is close to 8 now (I dunno what it actually is!) and it were 
to go to 10 while you were off the pump, that upward change would mean 
extra, undue stress on your nerves and kidneys. It's not like the risk of 
complications is the same if your HbA1c is over 7.5, no matter how high it 
goes. Rather, complications get only more likely the higher one's HbA1c.

All best,

IDDM 10+ years; MiniMed pumper 7+ years
Co-ordinator, Oxford University Student Union Diabetes Network
Oxford area contact, INPUT

Tired of 56k? Get a FREE BT Broadband connection 
for HELP or to subscribe/unsubscribe/change list versions,
contact: HELP@insulin-pumpers.org