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[IP] Re: Morning insulin boost
On Tue, 20 Apr 1999, John Bowen and Nancy Morgan wrote:
> I read your note to another parent about Lily's previous need for a little
> insulin boost in the morning. Was that during her early puberty growth
Yes, her size was relatively static for a few months and then she started
growing like crazy. Of course, we didn't know that right away, but it was
obvious within a few months.
> How did you decide on the amount?
We tested as I described. The fasting test showed nothing, but tests with
varying static carbo count breakfasts revealed the same high blood sugar
bolus requirement that was independent of the breakfast bolus size.
> Did that seem to work better than
> changing the breakfast bolus ratio? (Obviously, it did, or you wouldn't
> have done it, but how did you know?)
Sure, because she could get up in the morning bolus for breakfast and
just add a fixed additional bolus
> Jenna can wake up with nice target range blood sugars, but be 100-200 mg/dl
> higher 2-3 hours after breakfast, regardless of what she eats, with the
> bolus ratio of 1:10 that's worked all along. It doesn't happen on weekends,
> seems to be related to school.
Yeah, she sleeps in and her body wakes refreshed instead of having to rev
up, stressed out.
> This morning, we did a modified fast (small,
> protein only breakfast consisting of 1 egg, a piece of cheese, and a Crystal
> light); her 7 am sugar was 130, by 9 am it was 235, then it stayed there
> (didn't rise or fall) till she ate lunch at noon. We tried increasing her
> basal rate last week, but all we succeeded in doing was making her
> hypoglycemic by lunch and in the afternoon. Is this kind of what happened
> to Lily?
Yep. Just a suggestion, for her ratios, calculate her high blood sugar
bolus for the 235 or and average of her morning highs and have her bolus
that amount with breakfast or square wave it in over a couple of hours if
she comes down too quick. See if that smooths things out. Just remember
not to do it on sleep in days. For Lily, and extra hour or so of sleep in
the morning was enough to stop the morning rise.
> I look forward to hearing your insight on this, since you've "been there,
> done that".
We did this by the seat of the pants as you can see from the description
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