Re: [IPk] Pump Holiday
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.
IDDM 10+ years; MiniMed pumper 7+ years
Co-ordinator, Oxford University Student Union Diabetes Network
Oxford area contact, INPUT
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