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[IP] High Blood Sugar Bolus

> Date: Sun, 17 Jan 1999 21:16:25 -0500
> From: "Neal & Kara" <email @ redacted>
  . . . 
> My doctor does not agree with the Walsh and Roberts Pumping Insulin book
> directions to bolus for high BGs.   He says bolusing for highs causes more
> lows and drastic drops that are in themselves harmful.   He says gradual
> drops are preferable.
> I have been fighting him for years about this.  It is just so hard to not
> bolus to bring down a 250.  Since I went on the pump last month, however,
> I made a deal to follow his directions and IT IS WORKING.  240s drop
> gradually to target over 3 hours and I have none of the rollercoaster lows
> following highs that I used to get all the time when "chasing" highs with
> extra shots of H.
> Does anyone else do this/have any comments?

I have a way to meet things half way.  If I were over 200, then it 
would probably take over 1 unit to bring it down.  With my daytime 
basal of .2/hr,  this would take quite a while.  I was told to use a 
sliding scale to about 200, then just take 2 units (this would 
depend on the person).  If you don't go down, then take two more, 
   With a pump, I routinely and accurately correct after meals.  If I 
am 180   2 hours after a meal, I will be a perfect 100 if I take 0.8u 
at this point.  It seems to me that the more time spent at around 
100 the better!
   I have had problems with large meals.  I may 200 at 2 hours, but 
then I take 2u and at 4 hours I could still be 250!  It just depends 
on many things, and just taking lots of insulin is not the answer.  
Often if I am high and not sure how much I will need to correct, I 
will increase basal and take some bolus.
   Anyway,  I think the sliding scale works to a point and then it's 
just take it slow and monitor.

Good Luck,
Michael O'Hara
Galehouse Construction
Insulin-Pumpers website http://www.insulin-pumpers.org/