[Diabetes-talk] question about high numbers and pumps

Mike Freeman k7uij at panix.com
Sun Feb 17 14:26:27 UTC 2013


Veronica:

No quarrel with your post below. I stand corrected about epidra. I'll have
to look up the equivalent of lantus -- the company makes such an insulin but
since I haven't thought about this for quite a while, I gave the wrong
insulin name. Hafta look it up.

Perhaps part of my differences with some on this list is that I don't give a
rip *where* I test or inject. I figure if someone else is squeamish, It's
*their* problem, not mine. After all, no one asks me if I wish to be
subjected to their cigarettes, crappy music, dog or cat or any number of
other things that some folks think are the next thing to Heaven and I could
bloody-well do without! I figure insulin and meters and such are part of me
and if you're all that disturbed, you can just tell me to stick it up my
aorta sideways and I'll give it right back to you! (grin)

But we all can agree that to get the best diabetes management, one should
master the skills for intensive diabetes management, whether using a pump or
not. Otherwise, you'll be at the mercy of your diabetes care staff and while
they can do a lot for you, they aren't there 24/7 to make the critical
day-to-day decisions that mean the difference between a high quality of life
and a life filled with anxiety and, perhaps, diabetic complications.

Hope everyone's Valentine's Day went well.

Cheers!

Mike Freeman


-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
Veronica Elsea
Sent: Saturday, February 16, 2013 9:53 PM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] question about high numbers and pumps

Debbie, there's no harm as Bridgit has said in playing around with some
pumps to see what they're like. If you aren't yet on the intensive insulin
therapy as Mike described it, that's a good way to start because you'll get
familiar with the terms and all of that. But for me, once I had my pump set,
yes, I pay attention to all those things everyone's mentioned, but it
doesn't really run my life. And Mike, Apidra is a fast-acting insulin. And
boy did I find out the hard way not to put that stuff in a pump. Wow! It
gells up after two days and I actually burned out my pump's motore because
it had clogged out the tubing so badly. So, back to Humalog even though
there was a lot to like about the Apidra. It worked fast and I wasn't
allergic to it.
For me personally, the best thing about the pump is the flexibility it gives
me. Yesterday I was out walking and just ran into someone who said, hey
let's get some coffee. Since I was wearing my pump, I could say okay and
then just push buttons to bolus for what I had to eat. For me, the challenge
of managing tubing and features that quite as accessible as I'd like was no
match for the discomfort of figuring out where to go to inject insulin in
public and carrying all the stuff around me. And I imagine some of you are
probably laughing right about now. I am too, by the way. But that's me. It's
just like some of us use canes and some of us work with dogs. And each of us
vows to stick with our chosen methods. Choices are good. 
But the Omnipod will supposedly have new smaller pods starting in March. But
since nobody has beeps any more, I probably will take another look at it,
just because. What drove me nuts four years ago was the number of alarms.
Not only that, you do kind of have to know what those alarms say. But I even
figured out where in that remote the speech chip could be housed. It would
be oh so easy to do. Sheesh! 
But feel free to explore, making the decision based on what you need, not
just on what someone else says you can or can't do. And all questions are
welcome. But everyone's been giving you great advice here. Yay team!

Veronica


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-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
Bridgit Pollpeter
Sent: Saturday, February 16, 2013 3:52 PM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] question about high numbers and pumps

I agree with Mike despite being a pump *fanatic,* grin. Like I said, it's an
individual choice, though most newly diagnosed type ones are placed on pumps
ASAP.

Personally, I've never been bothered by wearing my pump except when wearing
dresses but even then it's not been a huge deal. I have never experienced
major annoyance with it to the point of this being a reason to not use a
pump. However, this is again a personal thing. You will wear it at all times
except when doing things like showering or swimming, though I know some
pumps can be in a little bit of water like a shower.

Mike is absolutely correct in that pump users must be cautious and aware of
their carb/insulin ratios. You and your doctor will determine these things
and what works best for you. And you will most likely adjust both basal and
bolus rates from time-to-time. I'm currently on a 1/20 ratio for breakfast
and lunch and 1/15 for supper. This can change though if anything in my life
changes like activity, eating habits, illness and phases in the moon, grin.

And I agree with Mike that a fully accessible pump is the preferred way to
go. In ten years, I've never had complications with my pump because it's not
fully accessible, but that being said, if I could access my pump with
complete accessibility and independence, I would just be in heaven. If I can
use my IPhone with complete accessibility, I don't know why it' so difficult
to make a pump in this way. All any company need do is create a
text-to-speech program to read out the menus, and it can be an option yu
turn and off like an IPhone so no *special* pump is required for a small
group of people.

Anyway, I recommend a lot of research and discussion with your endo so you
can best decide what's best for you. Play around with some pumps if
available, but from what I've discovered, the MedTronic and the Animas Ping
seem to be the two currently that will work best for nonvisual users.

Bridgit

-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
Mike Freeman
Sent: Saturday, February 16, 2013 4:27 PM
To: debbiewunder at centurytel.net; 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] question about high numbers and pumps


Hi, Debbie.

You've gotten a lot of good advice from Bridgit, Veronica and other
confirmed pump fanatics. I don't dispute any of it. However, let me give you
a few thoughts from someone who is *not* a pump fanatic and who doesn't
trust machines in this realm -- at least not yet.

First, without knowing a great deal more about what sort of treatment
regimen you are on, it's difficult to say whether you'd benefit from use of
a pump. What medications are you on? What have you tried to bring those
readings down? You say you count carbs. Do you know your insulin-to-carb
ratios at various times of day? Are you on a basic insulin regimen (two
shots a day of mixed regular or short-acting and intermediate or long-acting
insulin) or are you on an "intensive" or "physiological" management regimen
where you give shots of fast-acting insulin at meals according to the
anticipated carb load plus a once-a-day or twice-a-day basal insulin dose
(something like Lantus or, I think, Epidra). Or are you on pills only or
pills plus lantus? If so, you haven't even tried a full-fledged manual
intensive insulin regimen yet to see if your readings come down a bit. This
is not to say that a pump might not help but it's no panacea and IMO you may
not have enough info to make an intelligent decision.

Second, the "secret" that's not often mentioned by pump advocates is that
you need to be as conscious -- or *more* conscious -- of your
insulin-to-carb ratios, basal dosages and the like, when on a pump as you
are taking shots, unless you blindly trust the pump.

Third, the pump (either pod or the regular kind with tubing and canula) is
attached to you at all times except for short periods. Can you put up with
this?

Fourth, although there are ways and work-arounds to handle most pumps these
days as a blind person, there's no truly accessible pump yet and probably
won't be for some time. I don't know about you but I don't trust a machine
unless it gives me direct feedback. But that's just me although I know a
person working for Omnipod who says her husband is an engineer and has my
exact attitude. (grin)

Bottom line: we don't really have enough information to comment
intelligently.

Mike Freeman

-----Original Message-----
From: Diabetes-talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of
Debbie Wunder
Sent: Thursday, February 14, 2013 9:46 AM
To: 'Diabetes Talk for the Blind'
Subject: [Diabetes-talk] question about high numbers and pumps

Hello everyone. Do any of you use a pump, and can you share with me the pros
and cons of using one? 
I recently did a four day glucose monitor test where they inject the gadget
in your stomach. I will get the results later today. My nurse educator keeps
bringing up using a pump, I am not sure this is for me. I have numbers
between the 200 and 300's, I drink water, count carbs, and walk for
exercise. I am at a loss, any thoughts on this would be greatly appreciated.

Debbie


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