[christie]

i saw a new endo last week and i was asking about if he recomended a pump,i am on lantus and humalog,but he says if my routine is working he does'nt always say for a pump,i've told him that i've seen those who have a pump loved it. so he decreases my lantus because of too many lows and said next month he'd like to start symlin,i'm concerned because i already have bad lows,but i do have the midmorning high no matter what breakfast i have. my past a1c for a year always were 5.3, so with symlin does it make you low severly?and is it expensive?

[middnite03]

Originally Posted by christie

i saw a new endo last week and i was asking about if he recomended a pump,i am on lantus and humalog,but he says if my routine is working he does'nt always say for a pump,i've told him that i've seen those who have a pump loved it. so he decreases my lantus because of too many lows and said next month he'd like to start symlin,i'm concerned because i already have bad lows,but i do have the midmorning high no matter what breakfast i have. my past a1c for a year always were 5.3, so with symlin does it make you low severly?and is it expensive?

ok i'll be the first to say it,....... might wanna take a look for a new endo.... if you are diabetic, using insulin, you can go on a pump... the first 3 endo's i have seen in PA said I am not the type to go on an insulin pump, yet the forth I found signed the papers and a weel later I was pumping.... my a1c went from the high 12's (very horrible) to around 7.9 (still bad but better). and this was in a matter of 8 months.... if you are interested in pumping, call a pump company and they will point you to an endo that will help you out... as for symiln... in a nut shell it slows down the speed in which food passes through your system, and slows the absorption of carbs from that food, at least from what I hav read.... for some it can work wonders, for others it's not worth the extra shot before a meal. YMMV, as with all types of treatments... just remember the golden rule with it comes to dr's..... if you dont like what your dr is doing, you can always choose another, they work for you and can be replaced like any other person that provides you a service..........

[christie]

it was funny because my reg dr always preaches on how t1s should be on a pump.i am not sure about getting a pump,i guess since i've been this long on mdi that i'm scared.but i've read some of the threads from those who have a pump makes me think of getting one.as for seeing a new endo there are only 2 in my area and now i've seen both,both are only here one day a week.his partner is the dr who gave me a bottle of lantus and said here.he did'nt tell me about lantus,did'nt tell me that it only lasts 28 days,and such,so i never went back to him. i will do whatever it takes so that i will be here to see my kids grown,but more lows scare me,since i already have bad lows,and the endo was telling me about a patient who never recovered from a hypo.the endo also cut my lantus because he said most patients take less basal and more humalog that what i take.i take 20 units lantus am and 2 units at night and i take 4 units humalog am,none afternoon since i don't eat lunch anymore,and 4 units dinner and sometimes i take someat bed depending on my levels.the dr also puzzled me since he kept saying i feel you are depressed,i take a small dose of zoloft,i told him i have some concerns now with my son and my mom is very ill,and lately i have trouble sleeping.he wants a vitamin d check to see if thats why he thinks i'm depressed,but i don't feel i'm overly depressed. sorry i'm going on and on.

[jenet]

Originally Posted by christie

i saw a new endo last week and i was asking about if he recomended a pump,i am on lantus and humalog,but he says if my routine is working he does'nt always say for a pump,i've told him that i've seen those who have a pump loved it. so he decreases my lantus because of too many lows and said next month he'd like to start symlin,i'm concerned because i already have bad lows,but i do have the midmorning high no matter what breakfast i have. my past a1c for a year always were 5.3

I'm on MDI with Humalog/Lantus since they came out, and other combinations before that. I'm thinking the question is, why do you want a pump?

My reason for wanting a pump is that MDI has never worked well for me, and I'm hoping for fewer lows and highs. Although Lantus was supposed to be the magic bullet - flat 24 hour insulin, it has never worked that way for me. I have a very strong dawn rise, and will go up anywhere from 100-150 points without eating anything when I get up in the AM. Lantus was increased to the point I was having lows every night and I still have morning highs. Then we reduced and split it into morning and evening doses, I still have lows at night and if I don't get a chance to eat on time, and highs before and inbetween meals that can't possibly be caused by the humalog.

If you have thought this through and really do want a pump, I encourage you to look into the pump further.

j

[koblenz]

Originally Posted by christie

i saw a new endo last week and i was asking about if he recomended a pump,i am on lantus and humalog,but he says if my routine is working he does'nt always say for a pump,i've told him that i've seen those who have a pump loved it. so he decreases my lantus because of too many lows and said next month he'd like to start symlin,i'm concerned because i already have bad lows,but i do have the midmorning high no matter what breakfast i have. my past a1c for a year always were 5.3, so with symlin does it make you low severly?and is it expensive?

First: I only pay copay for Symlin, but it lists for about $86.00 per vial. Same rules as insulin, lasts 28 days after opening. 600 units per vial (yes, smaller than usual insulin vials).

Next, I went on a pump to better control my night time release of glucose. Like the others mentioned, if I took more lantus to cover that, I would have lows if I didn't have snacks during the day. If I took less lantus, I would wake up around 180 or so. Now that I am on the pump, I can wake up at about 100 every day. It takes time and experimentation to find those magic numbers for each person. I discussed using a different type of insulin before bedtime to help control this, and he said it is certainly possible, but thought I might enjoy the precise control and additional freedom the pump offered. I thought long and hard, asked many questions from the folks here, and decided it would be the right decision for me. I guess I am lucky that I found an endo that has no reservations about prescribing a pump if he feels the patient can handle it.

As far as lows with symlin, it can CERTAINLY happen if you aren't careful. I only take about 45% of the insulin I would usually take with breakfast when I take Symlin. I DID have a few lows (nothing dangerous) during the first few weeks of trial and error, but I have the balance figured out now and so far, no additional problems. Also, the package says you should not take it if you eat less than 30 grams of carbs in a meal. So IMHO, it is no more dangerous than just taking insulin really; if you take too much insulin, same problem.

There is my 2 cents and you have a lot to think about and investigate. Whatever you choose, please choose what you feel will be best for YOU, and if you don't like what the Endo tells you, try and find a second opinion. Can't your regular doctor write a prescription for the pump? It doesn't HAVE to be an Endo does it? I don't know. In any case, PM or email me if you have any other questions.... not that I am the end all be all expert or anything... :smartass: