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Re: [IP] re: Carb to Insulin Ratio Fluctuations

On Wed, 6 Dec 2000, Darrin Parker wrote:

I can only tell you what my observations have been based on a study of 
one patient :-)

The syndrome comes and goes -- usually staying for weeks at a time, but 
changing when circumstances change. For Lily it is now gone. Last school 
year, it was every weekday when we usually get up at 6:30 -- never 
fasting, only after eating breakfast. When the school year was over it 
disappeared and has not returned except for a couple of weeks several 
months ago. During the prior year it would be evident for a few weeks at 
a time then go away for a few weeks or months -- I can't explain it, I 
only guess that it has something to do with the level of stress and 
amount of rest. My recollection is that is related to the production of 
cortisteroids(sp) that is higher or occurs in the morning. Perhaps someone 
more familiar with this can add to this thread. The fix has always been 
pretty easy. She does not change her ratios, but uses the same for all 
meals, which is about 11/1. Without regard to the size of the breakfast 
meal, she boluses about 1.5 - 1.8 units -- it changes, but only on a very 
long term basis, not daily. 

Bottom line, toast and a glass of milk ~ 33 grams calls for 1.5 u for the 
mystery phenomena and 3 units for the food. A plate full of pancakes, 
syrup and milk ~ 66 grams is 1.5 u for mystery and 6 units for food. Bg's 
come out right. YMMV


> Never heard of this one but it sounds painfully familiar to me.  in fact I
> have noticed this and blamed it on dietary error.  so my questoin is:  How
> do we know when this wierd phenomenon is occuring?  sounds as if one just
> has to test after each am meal to see if it is ocurring.
> >Test:
> >on a NORMAL day, do fasting morning basal profile
> >repeat and eat protein only, no carbs i.e. eggs, crystal lite
> >repeat with a small carb breakfast that's vanilla i.e.toast, milk
> >repeat with big carb breakfast that's vanilla
> >
> >definition: vanilla -> known response meal, no weird stuff like lots
> >of extra fats, high glycemic foods, etc...
> >
> >Try to get a repeatable data set from another run.
> >Out of all this you should see a bg rise that is independent of the
> >#carbs eaten and requires about the same high bg bolus to bring down.
> >You should NOT see it with the fasting basal test.
> >
> >This is the isolated bg rise which I call the 'motor start' phenomena
> >for lack of a better term. I've seen and documented it with my
> >daughter. It comes and goes. Her solution is about a 1.5 to 2 unit
> >bolus when she wakes up (when it is occuring), ya have ta know or
> >crasharoonie!
> Darrin Parker
> Nova Scotia, Canada!
> --------------------
> Pumping for 10 days thanks to the support of a lot of wonderful internet
> friends!
> In 5 days on the pump I obtained better control than I had done in 27 years
> of MDI!
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