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March 29, 2000

Blood Tests and Insulin Injections, Insulin Pumps

Question from Parramarra, New South Wales, Australia:

I have been insulin dependant for 48 years and reading questions etc. I can't understand blood sugar levels of 100, etc. Are blood sugar readings done differently in the US to Australia? Also is it possible to get information on pumps; I have never been mentioned to me by doctors here and after 48 years of injections, for last I can't remember how many years on 4 a day, a pump would be like a miracle.

Answer:

In regard to your first question, I think that your confusion about blood sugar levels is due to the use of two different measures. In North America blood glucose is expressed as ‘mg/dl’ and in Europe and Australasia the units are in ‘mmol/L’ and 1 mmol/L = 18 mg/dl.

It may be difficult to decide about using a pump especially as your main reason seems to be to avoid having to stick your finger. If you have had autoimmune diabetes for all this time and if you have no diabetic eye problems, no peripheral neuropathy, a normal microalbuminuria level and on top of all of this your Hemoglobin A1c is below 8% and you are on a fairly simple insulin regimen, then I would think twice about going on a pump. First of all it is expensive, at least $5000 US to set up and there is no system yet where an implanted sensor will directly control the pump so that in effect you have an external pancreas. You will still have to do lots of blood sugars especially at the beginning. Also most people making the conversion really need the support of an experienced diabetes care team that has experience in the field: I sense that this is not available to you. Nonetheless if you wish to pursue this further you might first contact MiniMed or Disetronic for the name of a representative in your part of Australia and for a copy of their users manual. You might also, if you can get to a medical library try to look under ‘insulin pumps’ in PubMedThe Diabetes Educator 24:78,1998 and Diabetes Care 22:1779,1999. In summary, if you feel you need to be in better control or need more flexibility you might try to go it alone; but otherwise I would think twice.

DOB