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Re: [IP] basals

On Mon, 19 Apr 1999 email @ redacted wrote:

> I am having trouble with my daughter's 11 am readings and was hoping for some 
> advice.  Sat. when she slept in till 11am bg at 11am was 78 but on school 
> days when she has breakfast at 7:30am she usually runs around 180 at 11am.  
> Do I need to increase her basal from breakfast till noon or does it sound 
> like she needs more insulin to cover breakfast?  She currently takes 1u for 
> every 15carbs for every meal. I  am thinking about having her do 1 unit for 
> every 10 carbs at breakfast but not sure.  I have read that most people need 
> a little more insulin in the am to cover breakfast.  
Lily went through a period of about a year and a half like this. We 
finally determined that based on her schedule (wake up time) it was 
necessary for her to bolus a fixed amount a "wake up bolus". The bg rise 
triggered when she ate her breakfast and was independent of what she ate 
or the total carb intake. Her's was about 1.8u and varied a few tenths 
over the time she had to do it. If she didn't eat, the bolus was 
unnecessary and it made it hard to find because a fasting morning showed 
nothing. We determined the bolus size by having her eat a "standard" carb 
breakfast and looking at the high blood sugar bolus required later. Then 
doing the same thing with another standard breakfast that had a different 
carb content. i.e. cereal one day, eggs the next.... or something like 
that. This might not work for you, but it's worth a try. The problem went 
away after when she got a little older and has not returned.

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