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[IP] Re: insulin-pumpers-digest V7 #234

Subject: Re: [IP] Re: low carb diet???? anyone doing this

>> I just suspend my pump off for a time to counteract the lows.
>This isn't really a good idea, especially if the sugar is still in the
>process of dropping.  The insulin you would get while the pump was 
>would not enter your system and affect your blood sugar for a period 
>of time
>after that, when you could be still lower than you were in the first 
>Think about it -- it is recommended you adjust your basals ninety 
>minutes to
>two hours PRIOR to the time your sugar needs to be adjusted, in order 
>to get
>the desired result.

WHile it is true this method isn't as quick as treating it...it does 
work effectively.  The reason that you adjust basal rates 1 1/2 to 2 
hours before you need it is because it takes almost an hour before you 
actually start getting any EXTRA insulin (or less insulin).  Why?  
Well, let's say that your basal rate is .5 u/h, and you need to 
increase it to .7 u/h.  That is only an extra .2 u/h.  WHen you spread 
that out over an hour, that works out to an extra .03 units every 10 
minutes.  Most pumps can't even handle that resolution of delivery, and 
the Minimed pumps use a resolution of .1 units.  So, the FIRST time 
that you get that extra first .1 unit is about 30 minutes after the 
time you set the adjustment (on average).  

However, suspending (or better, using a temporary basal rate of 0) 
takes effect immediately.  The only delay is the delay that it takes 
for the insulin to start (or, in this case NOT start working) which is 
on the order to 10-20 minutes.  And, in the case of Humalog, which has 
its peak sooner than Novolog (Novolog is more an "even" curve), you 
would see even faster results.

I have used a temporary basal rate of 0 to treat some mild lows quite 
successfully.  BG levels start to return to normal within 30 minutes 
usually, which is fine for mild lows.  Novolog users MAY see a slightly 
longer delay in the rise, but probably not by much.

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