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RE: [IP] Stacking Corrections



Kathleen wrote:

When I get into a situation where I find that I need more than one
correction, my pump trainer taught me to switch to temp basal.

Bob responds: I already more than doubled my basal, to cover the steroids!
I use the temp basal when I have some idea of what's going on.

The advantage of injecting 1.5 hrs worth of "estimated additional basal"
is 1) it brings down my BS quicker, and 2) I can see how well it works. I
do factor it into my temp basal as well )if it's not already maxed out at
200%) if I think the trend will continue, to keep the BS where it should.

I also learned the hard way last night that on the MM 512, even if you're
doubling a 0.95U/hr basal rate over the next couple hours, it uses the
MAXIMUM basal rate (in my case, 1.85 U/hr) to calculate the limit of how
much you can raise the basal. Thus I could only raise the 0.05 U/hr rate
by 108% !!  I had to nearly double my Max Basal Limit just to get a 0.1
U/hr rate last night.

Ricardo wrote:

Better control also came when I promoted myself to CEO of my medical
care in spite of some objections from my medical team.

I would still get
opinions from your Doctor and/ or CDE. If they cannot give you a valid
reason why your method should not be working as well as it is for you
or they cannot suggest an alternative that gives better results while
accounting for your steroid use, I would keep on doing as you do. Along
with a lot of testing to make sure you stay on track.

Bob responds:
I've already become the CEO of my medical team, in response to my other
problems. I'm a huge advocate of doing that to the best of your abilities,
and I'm more technically capable of that than most.

My Endo is satisfied with my control and judgment.  My latest A1c was
5.7%, and my BS has only been as low as 60 twice -- only once aided by
insulin, and never by pump. But high BS seriously disturbs my neuropathy,
so I look for advantage where I can find it, rather than just put up with
high BS.

I figure the folks on this list have a unique perspective to complement
what I get from my endo and my personal experience.

Thanks for the responses!

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