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Re: [IP] Was south beach now insulin intake



>Okay please bare in mind we are not pumping yet but will be soon.
>Does every one on a pump use strictly carb/insulin ratio for how much
>insulin to take?
>Why or how could you get away with no insulin for a meal?
>As you get older does it meal that as someone with diabetes you can eat no
>carb meals

The pump allows, in fact, requires, that you split the insulin dose 
into two parts.  One, the basal insulin, effectively covers your 
basal metabolism.  This has nothing to do with the carbohydrates you 
count.  If you eat a very low-carbohydrate diet consistently, this 
might be all the insulin you need, but only if the same food is eaten 
at the same time every day.  Not very likely with a nine-year old, 
and it negates half the purpose of using a pump.  Further, a small 
child may need carbohydrates.  Since basal metabolism (which includes 
the energy needs of growth) varies with time of day, so does the 
basal insulin.  This variation with time of day is programmed into 
the pump, and differs with every person.  If the basals are right, it 
should be possible to skip a meal with no change in blood glucose. 
Getting the basals programmed for the individual is the first step in 
pump use, and should be done in coordination with your doctor.  With 
a growing child, especially as puberty approaches, the basals will 
need tweaking regularly, but basically once the basals are set you 
can forget about them as the pump delivers this insulin automatically.

The second half of the equation is the bolus insulin, and this is 
where the carb/insulin ratio comes in.  Boluses are given for two 
purposes--to correct blood glucose readings that are too high (in 
which case the important number is the sensitivity--how much does one 
unit of insulin lower your blood sugar) and to allow proper 
metabolism of the carbohydrates eaten.  This is where the 
carbohydrate to insulin ratio comes in--how many grams of 
carbohydrate does 1 unit of insulin allow to be metabolized properly. 
Again, this is something that differs for every person and getting 
the pump fine-tuned involves working with your doctor to get the 
values right.  With most modern pumps, the target blood sugar value, 
the sensitivity and the carb/insulin ratio can be programmed into the 
pump, and all you have to do is enter the measured blood sugar and 
the number of grams of carbohydrate into the pump and the pump itself 
will calculate the correct bolus.

It is unlikely that you would need no insulin for a full meal, but 
small snacks to raise blood sugar or to cover the extra energy needs 
of exercise may not need a bolus.  This of course depends on how you 
handle exercise and lows.

As for an older person eating no-carb meals, you could, but it would 
be a pretty unbalanced diet.  Carbohydrates are needed to completely 
metabolize fats and proteins--that's why low-carb diets often result 
in ketone spillage, and say drink lots of water.   They force your 
body to burn fat for energy, but the process isn't very efficient 
without carbohydrates.  Of course that means more fat is used to 
provide energy, as some of the potential energy winds up in the 
toilet.
-- 
Sue Ann Bowling, North Pole, Alaska
http://mosquitonet.com/~sbowling (general)
http://bowlingsite.mcf.com/DogPage.html (dogs)
http://climate.gi.alaska.edu/Bowling/Bowling.html (professional--retired)
.
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