My husband is still having issues with the PD. He is a diabetic and has always been able to keep it well under control with Glipizide. His numbers are going up, even on the 1.5. I remember reading where there is a non sugar fluid diabetics can use, but his dialysis center doesn’t/won’t use it. He hates to go on more meds, as he is a PTSD Viet Nam vet, with Multiple Myeloma (which is stable right now), diabetic and now kidney failure. Any suggestions? My second question is how much fluid is left in the body after a night on the cycler for during the day. He still is quite uncomfortable with alot of fluid in him…cannot eat much at all. Thanks for any advice. Diane, caregiver

My husband is also a diabetic. We put insulin in his bags of 2.5 at night. This is what we were told to do as soon as he went on PD. Ask your clinic about this. He does not have any fluid during the day after a night on the cycler. When we start the dialysis at night he never has more the 10ML on the initial drain… Most of the time is is lower than 5ML. We were told that the solution should not stay in your body for over 6 hours.

A couple of thoughts: the non-sugar dialysate is called Extraneal (icodextrin). It costs a lot more than usual PD fluid, which is why most dialysis centers try to avoid it. One way to get it might be if your husband has insurance other than Medicare. It is in the best interests of an insurance company to help your husband stay healthy and out of the hospital, so they might be willing to foot the bill for Extraneal, which is usually used for the nighttime exchange.

As far as having a lot of fluid in at night, the cycler PD prescription can be tailored very finely–in amounts as small as 100 mL. Please read our article about tailoring the APD prescription and show it to your husband’s doctor. The nephrologist who wrote it is a PD expert (most are not), and I think his doctor will find it helpful. It’s here:

Hi Diane this is virtsmaHow are things going with you . and your husband you say that your husband is diabetic and puts insulin in the bag at night. I am also diabetic I have an insulin pump. the doctor wanted me to give it up and put insulin in the bag I told him no way. I used to have a pump nurse but she quit . I haven’t been able to find another one the doctor tells me I don’t need a Diabetes doctor . I don’t understand. . bye for now. Virtsma

Did you call your pump company to find out if there is a diabetes educator with pump training in your area?

Your nephrologist may not think you need a diabetes doctor but you have the right to go to any doctor you want and that your insurance covers or you can afford to pay. I suspect your nephrologist would be appalled if your diabetes doctor told you you didn’t need to see a kidney doctor. Both of these conditions require careful monitoring. It would be of great benefit to you if the two doctors maintained open lines of communication about plans for your care and changes in your prescription.

Hi Beth! I have called meditronics several times and they tell me some one will call you. but nobody Nephrologist tells me I am a poster child on the pump. even if my A1C is low 5.4 I still need help. what are good numbers for UF on the cycler. Ikeep getting 800 sometimes 1000 anther time . I am using 5000 of 2.5 and 5000of the 1.5. and either1.5 or 2.5 midday.
Cheers virtsma