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
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
Sue Ann Bowling, North Pole, Alaska
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