On Sat, 28 Jan 2006 22:46:41 GMT, Alexander Arnakis
<invalid@address.none> Huffed and Puffed the following into the
madness of usenet:

actually the closest thing we have to a cure right now are either
complete pancreas transplants or islet cell transplants.  Both are
done.  Both have been successful.

Both have their limitations.

as for the pump you describe.  Their is one already developed, and an
insulin developed specifically for it.  The only short fall is the
meter.  They are still a long way off from perfecting one.

The Deltec CoZmore has all of the same features as the other pumps,
although named differently.

The biggest differences are in the BG meter integration and the pump's
ability to calculate meal boluses, correction boluses for the pumper
as well as determine how much insulin is actually still on board and
for how long from the last bolus plus the basal (IOB insulin on
board).

You sit down with your endo and pre program you insulin and carb
ratios and fine tune them over the first few days/weeks of using the
pump.  From there the pump does almost everything for you greatly
eliminating human errors.

We've talked in here about needing to know our ratios in order to
calculate insulin doses and how much to eat in a single meal.  With
this pump you take your pre meal BG reading and say it comes up 75
mg/dl and you are going to eat 45 grams of carbs in the meal.  Your
target BG is 100 mg/dl.  And your correction ration is 30.  The math
would look like this on paper 100 - 75 + 45 / 30 = 2.33 units of
insulin  Try to remember that in your head when you are out and about
with friends and family and then an hour and a half to 2 hours later
remembering to check your post meal BG to see if you got your carb
count right and determine if you need a correction bolus.  With a
little practice most pumpers have no problems with this.  However some
of have multiple ratios through out the day, due to keeping non
standard hours and having complications such as gastroparesis.  

And depending on what we eat we have to pay particular attention to
extended boluses (boluses that are split and or spread out over an
extended period of time) to cover foods like pizza.

With this pump you can pre program some meal boluses for specific
types and amounts of foods using the included software (IR port ships
separately).  So if you like having pizza on Friday at a specific
place and always get the same thing  and amount you can program a
personal meal bolus and simply select it when you have that meal.  Or
you can do the same if you always eat the same thing for say breakfast
or lunch.  This works great for those people who always eat the same
things or at least the same amounts for each meal.

Because of how fast novolog works and how slow food will be digested,
especially for those of us with gastroparesis we need to know how much
insulin we have in our systems and how long it's activity curve will
be so as to avoid over lapping boluses.  This pump takes that into
account and displays this reading.  You have test and correctly
establish how long your insulin will stay in your system.  That's
spelled out in the how to section at the insulin pumpers web site if
anyone is interested.  

Say for example that your insulin stays in your system for a total of
3 hours.  You take a meal bolus of 4 units at noon and then at 1 you
decide to have a late dessert and take another bolus for that then at
1.5 hours past that you check your BG and find that you need to take a
correction bolus because you are a bit high.  The pump will calculate
your correction bolus based on your correction ratio plus the insulin
you still have on board from your previous bolus'.  

One of the things I always hated about diabetic log books was that
they always recorded times in standard 12 hour clock settings during
day light times only.  Lots of times even the computer generated logs
only recorded times during the day.  This pumps software allows for
the data to be transferred to the computer and displayed/printed in a
log book format in either a 12 or 24 hour clock and the data fields
are not pre locked to the standard day time hours.  For example
breakfast at 8 am, lunch at noon and dinner at 6 pm.

There are a couple of draw backs.  The screen is small and some of the
text on some of the menus is small.  So when I have to go in and use
them away from the computer I use a magnifying glass to read them.
Most people won't have this problem, but I've been dealing with some
vision loss for a while now.  And the audible alarm is too soft.

A lot of people complained about the minimed's clicking and motor
whirring when delivering boluses.  This pump is literally silent.
When this one delivers insulin, you can press it to your ear and still
hear nothing.  Some people I have spoken with were very self conscious
about that noise.

Deltec's customer support so far has been the difference between night
and day when compared with minimed.  No long ques, no arguing about
bills, no having to track down someone who only gave you a first name.
Deltec's people give you their whole name and extension and tell you
to call them back directly or they call you back directly.  And when
they say they are going to call you back at a certain time, they do
it.  Granted most of my calls were in setting up the initial order,
filing the paperwork etc, but because of the way my insurance and
deductible work I have to deal with the billing part directly,
especially in January when this yearly deductible starts all over
every year.  But these people have been great.