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Re: [IP] Help! Basals/Pumping Lispro

> I just had a very disappointing visit with my new endo (2nd visit)
> and need some advise.  I have been having a lot of trouble with lows
> then consequently highs and trying to adjust my basal rate.  The
> endo said I should try Lispro in my pump since it has a shorter
> acting time span.  
Lispro makes it more difficult to stabalize you basal rates if you 
haven't gotten it straight yet. Regular insulin or Velosulin is more 
predictible and should actually make it easier to establish basals. 
When you do switch, Humalog acts faster so you have to set the time 
for a new basal rate LATER than the equivalent time for regular 
insulin. The different timing is a compromise between the difference 
of the onset and peak of the insulin of interest and may vary 
somewhat for each individual, but using the "package inserts" as a 
guidline, Humalog peaks in about 2 hours, regular/Velosulin in 4 
hours. I use basal start times of 1 hour for humalog and 2 hours for 
regular. i.e. if I want a basal change to take effect with 
Humalog, I make the change 1 hour before I want to see some 
results.... that would be 2 hours for regular.

> The problem is he gave me NO advise on how to
> adjust my basal and re adjust boluses after the switch. 

Switching from Regular/Velosulin to Humalog, set all the times 1 hour 
later. This is what WE do, YMMV and you should seek specific medical 
advise (disclaimer).
> He just
> told me to drop my basal to .6u/hr and see how it goes, and see you
> in a month.  After an illness last year my basals have gotten off
> track so much I am not bolusing for meals.  I know this needs to be
> changed but I rec'd no advise as to the best way to go about doing
> it.  
Read the section in Pumping Insulin on doing basal profiles and 
setting a basal rate. Read the HOWTO's on the web site. These 
documents should give you a good understanding of how to manage basal 
rates for your pump.

> I have had low after low and right now I am on the verge of
> tears and feeling wiped out from the sugars.  Any advise regarding
> Lispro or any of this would be appreciated.  I am re-reading pumping
> insulin but I'm having so much trouble with bloodsugar swings right
> know I couldn't even attempt a basal test as I don't think my sugars
> would stay in range long enough to get a result.
Try starting with the most stable part of your day. And work forward. 
Dropping your basal rates as suggested is the more conservative 
approach. Bear in mind that is easier to bolus down from a high than 
to recover from a low. 

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