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Re: [IP] Bolusing at bedtime
> do you do a correction bolus to get to 100 at bedtime?
Usually she does. If she is high, say >> 150 and she knows she is
going up (not a post prandial high) then a correction is in order.
The farther away from the dinner bolus you are, the safer this is.
Figure after 3 hours, worse case senario is that 30% of Humalog will
remain in the tail (probably less, but YMMV). Likewise if she's low,
the calculation works the other way and a small snack of toast + milk
may be in order to insure that unused insulin will not cause a
problem. Bear in mind that my daughter runs an artifically low basal
rate until 1am and sets a temp rate when she goes to bed. This allows
her a great deal of flexibility in tweaking her night time insulin at
bed time. If she is high, she can pre-bolus her basal + set a temp
rate if necessary. If low, she just leaves it at the lower setting.
She's rarely "right on" since she works out 3 - 4 days a week and is
sedentary on the other days. This produces a hugh swing in night time
> our endos
> say not to do a bolus after exercise or at bedtime. but....if
One size does not fit all!
> geneva was 296 at 9 PM (like last night), I feel compelled to
> correct to 150. By midnight she dropped to 164. this whole
> nighttime thing is so perplexing!
> I am not sure I am ready to deal with puberty! that brings on a
> whole slew of basal quirks.
Not that bad. What you will probably see is big basal shifts that are
pretty linear i.e. 20 - 40 % increase or decrease in all basal
requirements for a few weeks at a time. Just be aggressive about the
adustments. You can tell how much by the average high bg bolus or low
carb intake requirements. It seems to be flat %wise accross the
board. The carb/insulin ratios change by a similar (but smaller)
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