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July 6, 2002

Insulin Pumps

Question from Massachusetts, USA:

I am a fifteen year old girl who has had diabetes for a little over two years, and I had a very long honeymoon period (about a year and a half). My honeymoon just ended about a month ago, with my daily insulin totals going up, and I use a pump. However, just in the past week things have been strange. A I have started feeling very lightheaded a few times which has lasted for a while (from a few hours to a day). Then yesterday, I forgot to bolus for dinner (about 60 Grams of carb; Insulin to carb =1:10), I went to pool, and, when I got back, my sugar was just 149 mg/dl [8.3 mmol/L]! Today I ate a snack (about 60 grams of carb), didn't bolus, and my sugar about an hour and half later was 88 mg/dl [4.9 mmol/L]. I ate dinner tonight, didn't bolus, and my sugar was 180 mg/dl [10 mmol/L] about an hour afterward which I corrected for. I also haven't gotten my period lately, it's about 12 days late but there's no way I could be pregnant. Are there any cases in which people have had diabetes only for a short period of time?

Answer:

You really should be asking these specific questions to your diabetes team. If you are using a insulin pump, not eating meals, and not taking a bolus at that time, then your basal rate should hold you, at least in an ideal world. If you are eating without taking a bolus and still having no increase in glucose levels after the food, then it is likely your basal rate is too high — or that you really are still making some of your own insulin — at least intermittently.

SB