Dial that dosage up to 25u of Humilog for me and add another bolus of 5-10after a few hours. That shows how different one person's dosage may vary from another's. I go into the hospital for one day, eat only one meal of hospital food, get to go home and test -- wow...450. Told them they were not giving enough, but they said "We use the sliding scale."
Err yeah right Terrie.Ugh!! Well, there are many Diabetics that use more units of Insulin than that for the same meal, as you probably know Reido!! Not that that makes you feel any better. That's where counting carbs helps also.
And I would get to learn how to count carbs in november in the D.A.F.N.E. course.You and your Dietician decide how many carbs you should eat and then how many units of Insulin for carbs that works just for you. Carb to Insulin ratio(C:I). It's determined by how many carbs:Insulin unit it takes to bring/keep your sugar level to a Good area of control.
I can just see to use the 1:5U Carb:Insulin ratio for me as I am F F Fat!! May be that's an exaggeration I think. It's something that I would have to work out.Generally, 15 carbs to 1 Insulin unit. This ratio does vary from Person to Person and sometimes even if a Diabetic has the same meal another day, since we are such complicated machines. Quite often we see however, People with Diabetes who use 1 unit to 5 carbs or 1 unit to 30 carbs. Insulin (IR)Resistance and Insulin Sensitivity can contribute to these ratios.
Pump!! What pump as I cannot afford one. Gee I can just see lunchtime as I look at the calculator, Scales, And the knowledge of what's is a carb and what's not. But all jokes aside it is an art to judge what to do as practice makes perfect.It is quite simple to learn but it can be a pain in the application of this system. That's where that big box of motivation(that you have hidden in your closet)becomes a necessity. I'm sure you will put you Best foot forward when it is your time since you need it in order to use that pump that you want. Keep us in track with all of that please.
A recent analysis of the records of CGMS and pump users showed that the average improvement in A1C was 0.5 . The average time spent by users to manage these devices was 50% more than with 5x MDI. There were notable increases in episodes of hypoglycemia and weight and no reductions in oter medical costs by by users.
The pump costs 3x vs syringes and CGMS 4x vs syringes and standard metering. When combined with the recalls and product defect reports on the pumps and CGMS systems available today in the US, there's no substantiation yet for the position that either is a significantly superior alternative to MDI by a well-educated person with diabetes.
When these devices are merged into a reliable moderate cost artificial pancreas that doesn't require user intervention they'll merit serious consideration, but until that time the users will be guinea pigs who will continue to drive up the cost of medical care with no improvements in outcome.
My experience is that if you have to (search) for something, it becomes more valuable to you than if it's spoonfed to you.Dear "psdaengr"
Interesting analysis that you are referring to. Could you please provide the relevant references?
I'm happy that you doubt; it's people who accept what they are told without question that prevent progress.... I rather doubt that your statistics are valid for pumpers in the USA.
I'm happy that you doubt; it's people who accept what they are told without question that prevent progress.
It gives me no pleasure as a US citizen that even though the US spends far more per capita, the US trails most EU countries in quality and access to education and access to medical care for diabetes.
psdaengr, I confess that I don't know a lot about the subject of pumps, so I am actually changing the subject a bit. I'm Type 2 and don't take insulin. I do work in the health care system, as a customer service representative for a major insurance company, and I have talked to literally thousands of people this year - a few hundred last week alone. I have heard the same frustrations voiced over and over.
Thus, I would like to make a comment about our health care system in the US. One of the reasons I think our "health care system" and "cost of health insurance" is so high is that in the past 30-40 years we have spent more money and time educating our kids to play basketball and football and play with computers than we have ever done educating them about their body and health, or anything else for that matter. Now it is taking its toll healthwise. Likewise with adults; we are too busy earning a living and raising families to have time for "proper living." No one is pushing "health." Just a "health system" or "insurance." And I think there is a reason for that.
Our government knows what is wrong with the system. I offer the following document as a reference: Citizens' Health Care Working Group: Health Report to the American People
This study was sponsored by the US Government by means of the MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND MODERNIZATION ACT OF 2003, Public Law 1080-173, Sec. 1014 c, which I'm sure anyone over 65 is now familiar with. (Citizens' Health Care Working Group) The act did a little more than just make the first ever major change to Medicare.
The study shows that: (page 8)
"In 2004, almost half of all people in the United States had a chronic condition that ranged from mild to severe. That year, 23 million Americans had heart disease, 22 million had asthma, more than 13 million had diabetes , 400,000 had multiple sclerosis , and more than 750,000 had cerebral palsy ." (The bracketed numbers are footnotes found in the report - references for the info).
(page 9) "Health care for people with chronic diseases accounts for 75 percent of the nation’s total health care costs . For example, people with diabetes incurred an average of $13,243 in health care bills in 2002 ."
"Health promotion and disease prevention - One way to reduce the amount of health care we need might be to take better care of ourselves. For many of us, better diets, exercise, or not smoking could reduce the need for some kinds of health care. Nearly two-thirds of American adults are overweight or obese . Unhealthy lifestyles contribute to this statistic. Not everyone is able to exercise regularly, but many of us who are able to don’t. Nearly 40 percent of adults are not physically active during their free time, and 1 in 3 high school students do not get the recommended amount of physical activity . Lack of exercise is just one lifestyle habit that can increase the risk of certain diseases, such as heart disease or stroke."
It seems to me we work very hard in this country trying to cure things after they develop - but not to prevent them. Would there be some $ signs in this equation - would anyone make as much money if people were healthier? But I don't hear one Congressman taking a stand for promoting "health" rather than "health care", although they have the information in the study directly before them. Could there be some $ signs from drug and food lobbyists blocking the legislators eyes?
Food is another thing - how much do we really know about what is being put into our food? What about our water supply - is there a better way than pouring clorine and floride in it?
I'm not saying prevention is the answer to every health problem, but isn't it at least half the answer, at least for future generations?
The only thing I can see is that it will take a huge grass roots effort, and research, to make a change.
I can say this, "lowering the cost of the health care system" by just cutting out waste and fraud, or limiting people's ability to sue drug companies, isn't going to work. Those costs are small compared to the overall costs. Nor is "insuring all Americans" the answer. I hear the pain in people's voices when they get their rate change letters as a birthday or policy anniversary gift, and they are forced by economics to choose a higher deductible or policy with fewer benefits. They don't go to the doctor or get health care checks thinking that is the cause for their premium being raised, but it isn't. They're actually paying for others' medical bills through their "unused" premium if they are healthy. Also, in the last ten years, I believe the health insurance companies have drastically lowered the percentage of total premium they are paying out in claims. So its a money deal, too.
If the government takes insurance over, people will still have to pay the health care through the tax system, and government will have control of access. So, the only thing I can see as being beneficial if to attack the root causes and the symptems.
Sorry to rattle on like this. I'm not siding politically here with either party. However, I do agree with you, psdaengr, we do need to be always asking questions.