Severe reactions & Suspending
I guess I opened a big can of worms! :}
I would NEVER recommend suspending without some other type of
treatment (glucose tabs, juice, coke, etc), but in some situations it
can be really helpful. I don’t recommend suspending for normal hypo
reactions regardless of severity… I sometimes have severe extended
reactions, or reactions that don’t respond normally to treatment…in
those cases suspending is very helpful.
Also, please forgive me…I often ‘forget’ that my severe lows are
not the norm. For example, just last Thurs. I went out for my lunch
break & stopped to do some price checks before eating. My bg had
been in the high 200s just 1.5 hours before and I had treated it very
conservatively, so I should have been fine. I started having vision
problems and feeling like I might pass out. My thought was that my
blood pressure was low…I went out to the car, sat for a few
minutes, and the vision thing didn’t clear up…so just to be sure, I
took my blood sugar…it was 39! If I had been smart I would have
suspended…here I was at a home improvement store, with an
unexplainable low, needing to drive to find food… Fortunately I
had some glucose tabs with me, so I at 4-6 of them…did deep
breathing (to keep from hyperventalating). I then went to get lunch
(by then my bg was 45). I got Fazolis…spaghetti, bread sticks,
cheesecake, and a regular soda. Went back to work and ate. 1 hour
later (when I checked before taking my insulin) my blood sugar was
still below 120.
With the humalog I don’t notice the long delay in insulin to blood
glucose response. Of course my absorbtion and response to insulin
has always been a little atypical! I suspend when I have problems
with no response to treatment…the pump alarms frequently when
suspended, so I don’t have to worry about forgetting it’s suspended,
UNLESS I go to sleep. That is the one thing I fight against like
death, if my sugar is low. Usually I discontinue the suspend when my
blood sugar reaches 85 or 90. (Of course I treat 80 as a hypo, which
is what I’ve been instructed to do by my dr) I also tend to have
significant rebounds (I’ve gone from 65 to 230 due to a rebound with
only 4 oz of juice used as treatment…and I had measured it out to
see!) So I wouldn’t necessarily see or recognize any ‘delayed’
response due to suspending my insulin.
The one thing I do tell my friends and family when I’m having
frequent problems with low sugars is how to suspend the pump. If I
get totally out of it and they have to intervene, I feel that is the
safest thing to do first. Of course glucagon causes me to vomit for
3-4 hours straight, and then I usually end up with a problem with
dehydration, followed by ketosis. As long as the med techs who end
up treating me are aware of the pump and that it is suspended, I feel
safer with no insulin going in temporarily. To each their own!
I do believe that the ability to suspend should be covered in
training, because special circumstances may present when a person and
their co-caretaker(s) may need to use it. It is also an excellent
way to stop a bolus that you program accidentally or incorrectly. Or
even stop a square or dual wave if you have a reaction during the
extended release time.
Suzanna
June 1st, 2006 at 1:39 am
I agree wholeheartedly with the above snip. It is an available feature. (~_^)
BTW - you didn’t open a big can of worms, you just got a new thread going.
It’s what you learn after you think you know it all that really counts.