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Re: [IP] Can someone please explain this basal regimen to me...

Bob Klein wrote:

> I've just started on the MM507c for a week now and I am
> having a hard time understanding the basal regimen I've been
> given.  My HMO is just starting out on pump usage so
> they have sent me to a research clinic here in town to get
> trained and learn.  At this clinic I have been given a set
> of
> basals that have given me great difficulty and I was hoping
> that you folks could 1) tell me if this is *typical* and
> 2) possibly explain to me how this is supposed to work to
> give me all the great flexibility I have heard about.

Looks like they should try doing the research BEFORE you get there.

> The details are as follows:
> I am on Humalog insulin with about 26u daily in basal and
> about 15u daily bolus.  The basals are set in 11 different
> time slices with the values going up after breakfast, lunch
> and dinner times.  The bolus values are only to vary by the
> amount of my Bg value at the time of the meal (i.e, a very
> simple sliding scale Bg < 100, 100...200, >200 (values +/-
> 1u).

Absolutely ridiculous. Basals are NOT meant to take care of meals, 
that's the job of boluses. Thing is that basals are designed
to be background for normal situations. You should be able to stay
on basals and not need to eat at any particular time. When you
DO want to eat, take a blood test and set your bolus for the meal 
and any minor correction that may be needed. Also any time you 
take a test that is either high or low adjust with bolus (high)
or temporary basal rate (low, and sometimes when high).

That's where the flexibility comes from, enough insulin to keep
going through the day, since our bodies always need SOME, then boluses
to handle ,meals, snacks, the occasional treat or whatever.

Sounds like they got the thing backwards, they're trying to
get you results based on "How do we make it as restictive and
non-forgiving as taking shots?"

Makes me wonder (though I hope I'm wrong) if the whole thing
was set up to get you to give up pumping infrustration so they
don't have to bother with any members wanting a pump......

Probably not true, but HMOs make me wonder sometimes!

There are all kinds of helpful ideas on the Insulin Pumper's
webpage, I suggest you go there for some study, then get back to
this "provider" and ask where in the world they got their 
information from, or do they stand on their heads all the time? <Grin>

Ted Quick
email @ redacted
MiniMed 506 for 5 years, now use MM5-7c

> After a week of this I have been falling down with many,
> many
> lows (the last two days at work I had 5 Bgs in the 40s).  I
> feel
> like I have to eat right on time as the basal values start
> kicking
> in after the meal times.  I am eating much more food than I
> want
> to eat.  In general I am pretty frustrated!  I have been
> reducing
> the basals daily by .1 u or so a day but the basic scheme
> does not
> make sense to me.
> I don't understand how I can get much flexibility with this
> kind of
> regimen.  Actually it is very much like my one-shot a day
> experience
> a long time ago before I went on MDI.
> Is this what you are all doing?  If so, how do you achieve
> the great
> flexibility I keep hearing about.
> Is this some experiental approach?  Can anyone explain the
> theory
> behind it?
> Whatever this approach is supposed to be, I can only say
> that so far
> it is not working very well for me and it is not at all what
> I expected.  I thought the basal was supposed to keep your
> Bgs constant if you did nothing and the boluses (with the
> neat square
> wave and dual wave technology from MM) were supposed to be
> used
> to deal with CHO intake.
> Any help and/or explanations would be greatly appreciated...
> thanks
> ...bob klein...
> email @ redacted
> ----------------------------------------------------------
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