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[IP] Re: rebounds

I am not snipping this comment because it is so important to NOT deplete
those glycogen stores. It is also important to avoid getting over aggressive
about using correction boluses for the big highs you see after a low. I can
usually predict a following low worse than the first when I am reviewing BG
records. Most of the time I am right. IF you like the Hi/Low rollercoaster,
then overtreat both the lows and the highs and continue to be frustrated
with your BG control.

I observed this same event in hospitalized people with DM when the "sliding
scale" and long acting insulin doses were not coordinated with meals.  I
personally observed it when it happened to my mother, who had a heart
condition, when she was ready to be discharged.  The low BG delayed her
discharge by 2 days while she was re-evaluated for the chest pain the low BG

I also had to advocate for a college student who was accused of sneaking
extra food because all her pre-lunch and pre-bedtime BGs were high. Guess
when she had lows?  Before supper and during the sleep hours.  Cause?  not
enough fast-acting at breakfast and at supper and peaking fast acting at the
same time her long acting began to peak..  It is important to have the
timing of insulin and meals in sync with the peak action times of the
insulins. (Yeah, for pumps, using only one insulin!)

Singing to the choir, I know, but there are some new members.  Newbies might
find previous discussions of the topic in the archives.  The "emergency
glucose dumping" also happens when your BGs are high. This is a response to
your cells NOT having enough insulin around to help feed them. The bigger
problem with this situation is the potential for DKA.

Barbara A. Bradley, MS, RN, CDE

<<"The body has its own resources of sugar that it stores for
emergencies.  When it senses you are in an emergency situation it dumps some
into your system to help you out.  This is why your bgs are going up when
you have been low.  However, if you have enough of these emergencies in a
short amount of time you will deplete your emergency supply and have nothing
left to counter your lows.  So the reason you are having these really bad
lows several weeks apart, is that your body can't take care of them any

15 years later it still makes sense.  If you don't have stores in your liver
to dump then you are going to fall like a rock when you need them.  When my
insulin was cut back my highs and crazy lows went away.>>

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