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Re: [IPk] carb counting, basal bolus regimens

In a message dated 10/30/2002 10:37:02 PM GMT Standard Time, 
email @ redacted writes:

> Hi Pat, and all,
> This is a key point, thanks Pat for emphasising it.  The majority of IDDMs 
> can cope with the activity curves of injected long/moderately long "basal" 
> insulins, and also rapidly acting ones.  However, these curves are 
> artificial; most of us on this site have bodies which disagree and curves 
> which differ significantly, which is why we're pumping. Even the new 
> "straight action" insulins won't suit those of us whose basals vary. A 
> diabetic can also experience absorption problems, which may be exacerbated 
> by 
> injected insulin, so that they need an option which minimises these.  
> There is therefore a need for an insulin therapy which can be based on 
> tailored basal rates and boluses, together with the capacity to enable a 
> pretty accurate ratio between carbohydrate content eaten and units 
> (fractions, if possible) of insulin given to be calculated, to be provided 
> - 
> the pump can do this. Getting the basal rates right is crucial to good 
> control, but these can change so may need to be checked every so often 
> especially if you're getting unexpected readings.  They can also change 
> significantly between work/non work days, so many of us have tailored 
> schedules. With the pump, it's possible to get the dose delivered down to 
> 0.1 
> unit per hour or per bolus with Minimed pumps (I believe less with 
> Disetronic 
> - would appreciate more info here from users).  With injected insulin you 
> are 
> obviously limited to much larger doses. The availability of small doses is 
> great if you need little insulin - as a personal example, I usually need a 
> fraction between 0.5 and 3 units as a bolus and 0.1 to 0.9 as basal rate, 
> and 
> 0.1 unit drops my bg by 1 mmol on average - you can imagine how inaccurate 
> my 
> pre-pump insulin regime was!  :((
Sorry folks - in "Doc" mode earlier today (even more intensive than usual day 
at work). I'll try to do better.

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