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[IP] Re: Unused insulin rule

Sorry...I responded to this, but accidently send it with the digest
attached, so it bounced.  I'm sending it again...

 >  How exactly did you test to find what your individual unused insulin
 >rule was?
 >I'm mean I know most of us have gotten a general idea from experience
 >but is
 >there a more precise way?


 You have to do it several times to tweek it.  But here's what you do in
 general.  First, make sure your basal rate is correct.  :-)

 Second, at a time that you don't eat any carbs or protein (nor have you
 eaten any in the past several hours nor given any boluses), you give a
 correction for a high.  (Yes, you have to have a high to do this.)

 Then, test your BG level several times over the course of the next 4
 hours.  Obviously, the more often you test, the more accurate you get.
 Perhaps once every 30 minutes???

 You can chart each reading as your BG comes down, paying attention to
 when you have come down all the way (as in, there is little/no change
 in BG).  It is during that time that you know that the insulin is
 done.  For me, that is around the 3.3 hour mark (which is pretty
 consistant with the standard unused insulin rules I've seen elsewhere
 for Humalog).

 Okay, then take a percentage of the drop in each "zone" (each 30
 minutes) of the overall drop, and apply the same percentage to your
 insulin used.  For example, if you drop a total of 50 mg/dL from taking
 1 unit, but in the first hour you drop 30...then after one hour, you
 have used 60% of your insulin.  (This is a made-up number to

 Of course, doing this once isn't good enough, because different times
 of the day, activity, etc., can affect the number...so you need to do
 this several times, and kind of average your results.

 The end result is a pretty accurate unused-insulin rule for yourself
 that works MOST of the time fairly accurately.  (I don't think it is
 possible to ever be perfect.)

 It is important to keep in mind that in the first hour or so, using the
 unused insulin rule after eating is not a good idea, because there are
 still carbs getting into the body.  But after about an hour, the rule
 will work pretty well.

 At this time, my software only supports 2 "slopes" for the unused
 insulin rule, so I have gotten it set to calculate that 85% of the
 insulin is gone after the first 1.8 hours (or, 55% of 3.3 hours).  This
 matches my own curve pretty well.  In the future, I may allow for more
 customization of the unused insulin to be even more accurate.

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