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Re: [IPk] meeting NICE guidelines

Hi Louise,

Does your hospital have a CGMS? If so, it will show the sorts of highs and 
lows you get on a daily basis and might really help your case for a pump. It 
takes a glucose measurement every 5 minutes for a few days, so no change 
goes undetected. More info on the CGMS at: 
http://www.minimed.com/patientfam/pf_products_cgms_ov_completepic.shtml . If 
your hospital doesn't have a CGMS, it's worth calling Hannah at 
Medtronic--she can explain how you might get use of one otherwise.

I would say not to go on Insulatard unless your insulin needs actually match 
Insulatard's action profile. Certainly if you're going hypo at night at the 
moment, it would make FAR more sense to try moving your Lantus injection to 
a different hour of the day before switching to an insulin that would *peak* 
while you're asleep. Remember that Lantus has a 6-hour 'build-up' time....if 
Lantus actually sticks in your system for closer to 30 hours [a recent paper 
suggests that it does--and how could an insulin just evaporate out of your 
blood stream after 24 hours, anyway?] you could be getting a double-whammy 
of tailing-off and building-up Lantus while you're asleep. If you're gonna 
go hypo, always better to be awake for it: if you are awake for it, it could 
even count as a hypo that needs someone's help and gets you closer to 
meeting NICE guidelines. I'm not advising you to plan your hypos--what I'm 
saying is that at least you will be able to show conclusively that Lantus is 
not your friend.

Good luck,

Type 1 10+ years; MiniMed pumper 7+ years
Co-ordinator, Oxford University Student Union Diabetes Network
Oxford area contact, INPUT

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