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[IP] Colleen's extreme morning lows

In a message dated 12/10/99 3:01:18 PM Eastern Standard Time, 
email @ redacted writes:

<< My minimed educator told me that i
 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? >>

Dear Colleen,

I have been on the pump for 6 weeks or so now and my Endo. says to go ahead 
and adjust my basal's as needed. Although I'm also an RN.   I did call him to 
let him know that I had adjusted my basals to cover increased BG's during a 
bout with intestinal flu this past week.  I've also adjusted for a temporary 
basal rate change during exercise.  Today my numbers have been on the high 
side all day (200's) which I was able to bring down with a bolus.  I'm pretty 
sure they are high today because it is 6 days before my period is due and the 
hormonal shifts seems to effect my numbers, so I increased all my basals by 
0.1 unit.    The book"Pumping Insulin" has been very helpful.  My doctor even 
told me to refer to this book.

 I'd suggest calling your Dr.....that's what he's there for...and explain 
your  concern about these severe a.m. lows.  If you start slow, such as 0.1 
unit change at a time, you should be okay.  It does sound like you need at 
least another 0.1 unit decrease at night and maybe even 0.2 units decrease.   
I would think it would be safer to be a little higher in the morning than 
risk such dangerous lows.  It's safer to be high than low, as I'm sure you 
know.  How much insulin were you taking each day  (Mult. injections) before 
going on the pump?  My Dr. took that amount, decreased it by 25%, divided 
that amount in half and then divided that amount by 24 (hrs) to come up with 
my basal rate of 0.4

MM 508 since early Nov. 99
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