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Re: [IP] Those morning highs after breakfasts

At 07:37 PM 3/5/1999  Natalie A. Sera wrote:
>My biggest problem with mornings is that, yes, I have a dawn effect, and
>even a moderate-carb breakfast will shoot me into the low to mid-200's
>BUT I also have a plunge that happens around 11 AM, and taking more
>insulin for breakfast puts me more at risk for a hypo later.
>The obvious tactic is not to eat breakfast, but I LOVE breakfast -- my
>favorite meal of the day!

If you change your basals and/or boluses you need to know what your 
"lead-time" is. Although Humalog starts working within 15 minutes for many 
people, for me it takes at least 45 minutes to an hour. I don't peak until 
about 3 hours later. So, if my dawn effect has me going high at 3am, I need 
to increase the basal at 2am... so that by 3am it will be starting to work. 
The same for my morning basals. When you turn the morning basals down, you 
need to account for the peak period. If you get low at 11am and you 
normally get a Humalog peak in 2 hours, you need to lower the basal by 
about 9am. This will take a little experimentation.

Boluses need to follow the same logic... it's no different than when you 
were taking injected insulin before meals... you need to allow for the 
insulin start-up time. So, you may need to bolus for breakfast earlier than 

I hope this makes sense...


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