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Re: [IP] Treating NPH lows as opposed to Humalog lows

> This ol' lady has learned a lot from this list. There is something I've been
> curious about for awhile and think I can now put it into words:
>     I read often of parents treating their DM children's lows with xx# grams
> of carbs
> AND peanut butter crackers/sandwiches or string cheese, etc.
>     IF the basals are set correctly (which it sounds as though they
> diligently are), then why the added protein? That was what we did with NPH
> because of its lingering effect, BUT with Humalog in and out more quickly
> and the basal maintaining steadiness, why wouldn't the carbs be sufficient
> to bring the BG up to the correct level
> without the added snack stuff? Wouldn't that extra snack cause a spike
> later?

Many times, the low is caused by an overbolus or under count of carbs to 
begin with. The snack is both to bring current sugars up and to offset 
the remaining insulin that is still working (unused insulin rule). You 
can make an educated guess about the amount of insulin remaining by 
looking at the bg drop since the meal bolus or "event" occured and what 
the bg's should have been, bearing in mind that post prandial numbers 
usually should be higher than "normal". The remaining insulin/time has to 
be covered and longer lasting food works well. Humalog take up to 5 hours 
to clear the system if you include the looonnnnnggggg tail that it has.

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