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Re: [IP] Correcting High Blood Sugars
From: Swaminatha V. Gurudevan <email @ redacted>
To: email @ redacted <email @ redacted>
Date: Monday, January 18, 1999 5:46 AM
Subject: [IP] Correcting High Blood Sugars
>Bringing it back within range is best accomplished with a bolus.
I have read in this forum about everything from 2x bolusing to temporarily
increasing basals for high blood sugars. I've tried the 2x without the
problems with insulin shock that some doctors and (over-) cautious (IMO)
The temporary increase seems to me to leave the pumper in a state of high BG
for way too long. See, if my BG is 400, I need a minimum of 7 units above
my basal to get it back down to 120. At a 100% temporary increase it will
take 9 hours for me to infuse that increase. I can't see it coming down and
me being awake to know it over that period of time.
And what to do if (when) the 7 units do not necessarily bring BG to within
target? As Guru suggests, high BG can lead to insulin resistance. Or the
pooled BG can still be on the rise.
Another regimen is suggested in a publication written by Pharmacist/Pumper
Gary Gilstrap who owns Medical Pumps and Supplies, Johnson City Texas. All
the pooled insulin will ultimately affect the BG causing insulin shock ,
according to Gilstrap. Gilstrap boluses the normal infusion algorithm for
target, then only 1/2 the bolus algorithm for subsequent corrections.
In other words, for my 400 BG, bolus 7 units (40mg/dl per Unit). After an
hour, if BG is now 380 (260 above target), bolus only 3-3.5 Units. The next
hour, if BG is now 260 (140 above target), bolus only 1.5-2 units. Hour 3
might be 280, so bolus for this 160 over target would be 50%, or 2 units.
And so on. By hour 4 I'm usually back within target.
Using Gilstrap's regimen, it probably about adds up to a 2x bolus, just
spreads it out over time.
email @ redacted
Insulin-Pumpers website http://www.insulin-pumpers.org/