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[IP] Rebounds/DKA - Insulin Resistance

The main thing that all this shows is that there are a lot of conditions
that make a person insulin resistant.  Adrenaline causes insulin resistance,
as do ketones, and dehydration, and illness, and lots of other little
things.  And when you're insulin resistant, it simply takes more insulin to
get things back under control.  The problem with bolusing extra insulin,
thought, is that, when the condition that's causing the insulin resistance
is over, if you've bolused a bunch extra, you can end up being very low, and
the roller coaster ride just isn't fun.  For Jenna, who usually drops
120-150 mg/dl with a unit of insulin, if she's insulin resistant, a unit of
insulin may only drop her 20-50 points.  I have her check (or if it's
nighttime, I check) her sugars every 2-3 hours, and bolus according to her
number, but realize that it's not going to lower her as much as it usually
would.   I've stopped giving her double or triple the amount of "high sugar
bolus" because I never know exactly when the adrenaline will be gone, and I
don't want her to end up being 40 when all that extra insulin kicks in.  I
would definitely not IGNORE the high sugars, that is a great way to go into
DKA, but I just don't get obsessed with getting them down to target range
before the adrenaline rush wears off.

Hope that helps clarify my message.

Nancy Morgan, mom of Jenna
> Hi when I reread this post on it taking 6 hours for your rebound to come
down to normal Shiela, I thought I don't have any problem like that at all.
However if I'm spilling ketones- and on my way to DKA- the usual amount of
insulin doesn't drop it fast enough as the ketones make that impossible.  I
would check for ketones when your daughter (?) runs that high, rather than
wait 6 hours.

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