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Re: [IP] High Blood Sugar Bolus

At 05:32 AM 1/19/1999  email @ redacted wrote:
>Neal, I don't see how anyone could consistently maintain good control with
>a protocol like that, besides it being additional work.   Maybe if you did
>and ate the same thing every day, but I think your endo is being much too
>cautious here.  There is much too much lag time in the sytem to try to do
>this slowly.  It just adds more lab and engineers have known for decades
>that lag in any system makes it very hard to control.  If I have a Bg of
>260 and I bolus 4 U, in 3 hours I'll be at around 100.  No undershoot, no
>"chasing", no problem.  If I can figure out what I ate that made me go
>high, next time I'll bolus more for that.   If you're getting lows after
>bolusing for highs, then you are simply bolusing too much.

I'm have to agree here... I find this to be one of the advantages of the
pump, that I can bolus to keep those weird highs down. Unless you have an
on-board computer, there is no way you can always totally accurately
predict what your BG is going to be after eating, etc. So, you miscalculate
a little (OK, so I miscalculate a lot... <vbg>), no big deal... just bolus
a bit and not to worry. Otherwise you almost might as well be on MDI with a
rigid time-schedule. 

Over-bolusing, obviously is a problem... but I think this is basically a
learning problem. Once you figure out how much it takes to bring you down
to a certain level, then there should be no major problem. I also wonder
about the doctor's concern about coming down too quickly. Doesn't the body
of a non-diabetic reduce higher BG's fairly quickly? I've heard of
non-diabetics going as high as 180 for a very brief period of time after a
heavy meal, and then coming right down to "normal". 


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