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[IP] Who gets to lower basals? (was: how low can you go?)

...the one who is trembling, sweating or vomiting from
   That you are having so many reactions on the pump means your basal
rates are TOO HIGH. And your doctor is doing this back-assward! You don't
start out with basals set on the high side and gradually lower them until
you stop having reactions. Your basals should be set conservatively,
meaning, you will likely run some high numbers and then you gradully
raise basals. That is done to avoid LOWS.
    Please accept, on your behalf, my irritation with your doctor, (and
educator) who
should be calling you back without delay (at least within an hour) when
you are starting out a pump and adjusting basals. But by all means, lower
your basal and don't wait for anyone's permission. 
   BTW, have you checked Pumping Insulin regarding estimated basal
start-up rates? It is there suggested to start with the lowest number
given for your weight or old dosage and work your way up. 
    Also, I'm sure Michael can tell you where to look on his website for

my regards and concern for your well-being,

Sent: Thursday, December 09, 1999 12:41 PM- Subject: how low can you go

   >> (snip)...when i woke up this morning my bg was 19.  25 minutes
and .5 OJ later it was 36.  After another 25 min, 4 dextrose tabs, and
vomiting  episode, it was up to 56.   I felt horrible - nauseated,
headache, dizzy.
When i checked at 10 am, my bg was up to 300!  I haven't felt this
out-of-control since i was a child.  I've been low just about every
morning since i started pumping last week, and the couple of times i've
slept thru'
my 3 am alarm it's been dangerously low by morning.  Obviously my basal
should be lower at night.  I'm taking 0.6/hr, and yesterday my dr.
approved dropping it to .5/hr for 12-5 am.  After a horrible morning, i'm
about reducing it again to .4 for 12-5.  My minimed educator told me that
can't adjust my basals w/o my dr.s approval.  I'm not getting very quick
feedback from her, though.  Can i get some feedback from the list on
self-adjusting your basals?>>

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