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RE:[IP]doctor's visit

Hi Kathy,
> while I'm going through pre menopause, there isn't going
>to be much that can help me stay stabilized as the hormones have a mind of
>their own and mess up the b.g.
>We have sort of agreed that when I see my b.g. start to stay low, to move
>back my basals .1 across the board, lower my insulin sensitivity to 50 and
>we are also going to try to lower my breakfast ratio from 1/15 to 1/13 as 3
>1/2 hrs after I eat and bolus, my b.g. are starting to crash.
I adjust my basals in both directions - if I see I am consistently high for a whole day, but I
know my site is OK because corrections do some good, just not as good as they should, I increase
my basals.  Then when those higher basals start causing lows, I switch back.  I think you got your
breakfast change backwards - 1/13 is more, not less than 1/15.  If you want to avoid the crashes,
you need to use a higher carb ratio.

>Oh, another thing, the fat issue.  I told her that the square wave or dual
>wave doesn't seem to work as it slowly delivers insulin over a period of
>time and that if the pump would be able to deliver some insulin now and some
>insulin several hours down the road, it would work better.
I agree with this, too.  I take a normal bolus, then WAIT 1 to 2 hours, then add in a square wave
over the next 1 - 3 hours depending on how much fat was in the meal.   So you can accomplish what
you suggested, it just requires that you think about it an hour or so after the meal.


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