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RE: [IP] driving



The idea is from John Walsh...here is a good description

http://www.diabetesnet.com/diabetes_technology/super_bolus.php#axzz1CeOMCPTE

 It works for High GI foods or in my case where it takes sometimes as much as 90
minutes for a bolus to even begin to reduce my BG.
 Yes I only use this in extreme cases such as over 250 and climbing...if I get
caught off guard this can happen very fast to me.

 I don't want to remain that high for 4 hours or more so I have learned that
loading more up front and reducing the basal can
 Reduce the risk of a severe low....yes it is hard to guess how much more you
may need to bring a high down but in this case I do it straight.
 If I level out higher than I want, say 150 or so, then I can correct again
later but at least my BG is no longer lingering in the 300's.

 With my CGMS it is also easier to determine what has gone wrong (most of the
time)...was my BG good all day and sudden took off...have I been creeping up all
day and not bolusing correctly , did my basal needs shoot up (all my corrects
return to the same higher level)...and the usual reason...did my site suddenly
go bad (check the menu, yes you forgot to change the site on time).

 You can Google Super Bolus and get much more information, for me it is a great
tool but again some people have real issues with insulin sensitivity (you know
who you are....LOL)so YMMV.

 Dr. Bernstein promotes ideas, one that I keep in mind is that the variability
of larger shots of insulin can be extreme (29%).
 He recommends not inject (bolusing) more than 7 units at a time...what I take
away from this, is that is it better to bring your BG down
 Over the course of two corrections rather than one....otherwise I can find
myself in on the rollercoaster...again I am talking about extremes
 BG that can get to 250 + and climbing...if I have been cruising in the 100-150
range and suddenly shoot up over 300 I want it down fast.
 Not later in the day...but I don't want to hit rock bottom only to shoot back
up again....oh the fun of this diabeastes.

Tools in our arsenal....

Judy




-----Original Message-----
 From: email @ redacted
[mailto:email @ redacted] On Behalf Of Mary Donovan
Sent: Monday, January 31, 2011 11:52 AM
To: email @ redacted
Subject: RE: [IP] driving

Judy,
So you put two hours' worth of basal up front in addition to the correction
you give for the high bg?  Do you always do this or is there a threshold where
you would do this for a correction, say, over 250 or something?  I know that
the higher the bg, the more insulin past the usual correction factor it may
take to bring it down, but we've never been sure at what bg we should start to
add extra insulin beyond the correction.
Thanks,
MaryMom of Dan, 19, dx 01 pumping cozmo 03, dexcom 09

--- On Mon, 1/31/11, Harvey, Judy <email @ redacted> wrote:

From: Harvey, Judy <email @ redacted>
Subject: RE: [IP] driving
To: "email @ redacted" <email @ redacted>
Date: Monday, January 31, 2011, 1:27 PM

 It is not wrong to cover your highs with extra insulin you are supposed
too.....did you take extra to bring it down faster....perhaps. If that is the
case and I see that my BG is coming down too fast then I take a snack at 200
rather than wait for the low to get closer.

 The key I have found "for me" YMMV is to add two hours worth of the basal
insulin and then lower your basal temporary rate for two hours. So if you use
1.0 per hour you can add 2.0 to your bolus shoot and lower your basal rates
to
10% for 2 hours....OBVIOUSILY this is something you have to play with to find
what works for you...some people are way more sensitive to insulin and would
require a more cautious approach. I find it helps get my BG back in line
within
an hour or two instead of the usual several hours.

Judy

-----Original Message-----
 From: email @ redacted
[mailto:email @ redacted] On Behalf Of email @ redacted
Sent: Saturday, January 29, 2011 6:18 PM
To: email @ redacted
Subject: [IP] driving

The last time I had a reaction, maybe a couple of months ago, I was told by
my
superior that I may face losing my license. Well, I had two in the last
couple
of days, even with a CGM (which I don't think is loud enough). My provincial
(big boss) is coming to supper Monday night and that is going to be a topic
of
discussion. I am so fricking mad at how unfair life can be. Did I try to
cover
some highs with extra insulin? Yes. Am I wrong? Yes. But I want to do what I
always want to do when I get in trouble, just slide under a hole somewhere
and
hide.I hate the thought of not being able to go anywhere without a ride. It
will put a serious cramp to my efforts to find full time work. Please pray I
find a solution that will work. Dennis in KY

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