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RE: [IP] Mixing Humalog with Regular in the pump

> Michael,
> I read your e mail with interest and I've been reading into pumping
> insulin book as well but thought that the velosulin was to "thin"
> out the humalog and really didn't have insulin in it...
> My problem exists as thus so far as I can tell and I've been doing
> more testing to confirm this...my sugars drop very close to five
> hours after I've bolused instead of the two to three that everyone
> else does.  I've tried bolusing before I eat, while I'm eating and
> after I eat but same results....
> My basals are ok and they are so small except for my pre dawn phen
> dosages that they could never cause a low....
> Where should I turn?  Do you have any suggestions?
> Kathy B.
> PS., I'm not a very big eater and I don't take a lot of insulin
> either.

Let me preface my comments by saying that I am not a medical person, 
just a dad of a diabetic child.... well, young woman now :-) From 
what I have observed over the years a low several hours after a meal 
is usually related to a insulin to carb ratio that is a little too 
low. This is a difficult number to pin down as it is not straight 
forward to test. I've seen my daughter have this problem occasionally 
and our solution has been to adjust her ratio upward in one or 
two tenth percent increments until it goes away. If the low is 
consistent you can estimate the extra insulin by simply looking at 
the carbs required to counteract the low and take that amount as a 
percentage of the original bolus. Throwing out the top and bottom 
5-10 percent of data points and averaging the rest will give you the 
numerator of the fractional adjustment needed with the bolus amount 
as the denominator. If you have a good CDE, they should be able 
to help you determine the necessary adjustment from you 
food/insulin/bg records.

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