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Re: [IPk] my response to the DAFNE trial published in the BMJ
In message <001f01c272f8$d8bcc160$email @ redacted>, Diana Maynard
<email @ redacted> writes
>You completely missed my first point.
>Having a stable basal insulin (as MDI would give me if I had Lantus) isn't
>enough - I need to be able to set my basal insulin to give me differing
>rates at different times. That's pretty much impossible with MDI unless
>you're very lucky and can time the peaks and troughs appropriately.
I still don't get it. If you need different basal rates at different
times, and there is a long-acting insulin which gives you those
different rates, then you don't need a pump to give you those different
Say you needed to have 1 unit p/h from 5am to 10am, and then 0.7 ph
until 5m, and then 0.5 p/h until 5am. It might be that Monotard (or
some other insulin) would give you that pattern. Then the pump wuuld
have no advantage. But if you can't find a long-acting which matches the
pattern, then you need the pump. Having 'different rates at different
times' isn't a problem which pumps solve. Having 'different rates at
different times which cannot be matched by any long-acting insulin' is
the problem - but you seem to be ruling that out as your problem.
One extra advantage to the pump: basal patterns need to be delivered
with some regularity. On the pattern I gave as an example, the 1/unit h
rate needs to start at around 5am on virtually every day = i.e. not
starting the 1/unit at 5am on some days, but on others starting it at
2ma, sending you hypo, and on other days, not starting it until 8am,
making you high.
dm 30 +, 508 1+, had a day thinking in Dutch, obviously ...
email @ redacted
"It might look a bit messy now, but just you come back in 500 years time"
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