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Re: [IP] bg's after bolusing (was eating out)


I think maybe you *have* grasped the big picture here ;-) I think you do

I think it was Barb who advised some time ago to try managing Kayla's BGs
to the "mid range", or the "safe range", rather than trying to manage too

For years, the advice with pumps was trying to get your post prandial BGs
at the same level as pre meal, approximately 5 hours after eating. If you
were able to do this, it was felt you were doing well. This target is also
mentioned in the latest edition of Pumping Insulin. For years, people did
real well with pumps, using this target.

There really is no such thing as a perfectly "flat" BG curve. Non diabetics
have peaks in this range after meals. I think the important thing here *is*
the big picture. Kayla may peak, but she slowly comes back down over the
next three hours. Great ! That's what she should be seeing. Dropping to 150
or less one hour after eating, is not practical in many cases. Following
that up with a supplemental bolus to achieve this level can result in the
pumper "chasing their tail". They frequently end up going in circles. I
don't shoot for these post prandial targets, and I've been doing this for a
while ;-)

If you can manage Kayla so her BGs are predictable and within the "target
range" (sorry, I've been chided for using this term before), you are seeing
the big picture. Sounds like you are making the adjustments you need to
make. Fine tuning can take place over time - there's no extra credit given
for achieving normal glycemic levels immediately. Remember, Kayla has
diabetes. Humalog, pumps, or any insulin does not change that very basic fact.

My .02 ;-)


mailto:email @ redacted

>Hopefully someone can help me with this.  Kayla's bg is NEVER less than
>180 one hour after eating.  (She uses Humalog, so by Michael's post, she
>should be about where she was before eating - doesn't happen.)  However,
>within four hours she is back in the normal range.  But she's usually in
>the 200's one hour after eating and slowly comes back down over the next
>three hours.  If I compensated at one hour with more insulin, or even if
>I gave a bigger carb bolus, she'd be going low four hours later.  I
>can't seem to grasp "the big picture" of what is going on here.  Any
>email @ redacted

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