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[IP] raising basals

Melissa H wrote in response to Roselea's high bgs
>  Maybe raising your basils will help out.  My Endo told 
> me that if I go a few days of consecutive highs than I should 
> look into raising my basils a little.  

hmm, now my doctor says just the opposite, or rather, he does NOT encourage 
raising basals to fix highs.  sometimes those few high days just need more 
insulin due to infection or stress or bad site, which should be taken care of 
with conservative correction boluses....If you raise your basals, you may not 
notice the slight roller coaster you board....the increased insulin is more 
than you really need and it causes you to drop, which in turn causes your 
body to release counter-regulatory hormones to keep you from dying of 
"starvation" which is what your body THINKS if your bg drops more than about 
50points in a hour...THose hormones, including cortisol, adrenalin, and our 
favorite glycagen raise your bg...which in turns makes you take MORE 
insulin...to which your body says, "hmmmm I guess I didn't send out enough 
counter-regulatory hormone...I better send MORE next time," and thus you 
rebound up....boing boing boing.  Then you take a correction bolus to get you 
from 300 to 150 and you slam down there in less than an hour using Rocket 
fuel (aka Humalog), to which YOU might say "good" but again your body thinks 
you are dying from that more than 50 point drop and dumps in another load of 
hormones....boing Boing BOING!!

I scoffed at the idea at first that my basals could be too high, and that 
taking an entire correction bolus was not THE right thing to do...but just in 
the interest of showing doc how wrong he was, I lowered my basals by .1 and 
.2 across the board, and bolused for highs VERY conservatively...instead of 
taking 3 units to lower me from 300 to 150, I would take 1 unit every hour 
for 3 hours, resisting the urge to power bolus when i saw the numbers only 
CREEP down. And for about a week, he WAS "wrong" as I ran high most of the 
time, but I maintained the conservative boluses for those highs...not 
slamming myself down into an acceptable range, but creeping it down, and ALL 
OF A SUDDEN, my bgs started dropping....my body got USED to having less 
insulin on board, and since the body didn't expect those huge boluses 
anymore, it realized it wasnt required to dole out all those 
counter-regulatory hormones....My basals went from 14.4 a day to 11.8.  Of 
course, they still go up a tad during PMS week, but I am still running at 
those lower basals

Probably the best thing to do is to do a basal test to find out if in fact 
your basals are ok.  If during the fast you run low constantly, then your 
basals are too high...your body demands the hormones from the liver and so 
your bg soars....

Good luck and as always  YMMV

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