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Subject: [IP] Re: Question on Basals

Hi Brynn,
Yeah, I think you've just summed up why the pump isn't a cure, just a better
tool for controlling diabetes.  If you're pumping Humalog, the insulin you
pump now is going to start in 15 minutes, peak in 1.5-2 hr, and be gone by
3-5 hours.  So, if you want to exercise without eating extra carbs, you
really do have to lower your basal rates a couple of hours ahead.  Also,
when you bolus to correct a high sugar, make sure you take into account the
"unused insulin rule."  That just says that some insulin from previous meals
and/or high boluses may still be yet to take effect, and if you don't
account for it before you bolus again, you'll end up low.

We just got back from a weekend of camping and hiking with our church group.
Jenna doesn't like to hike much, being a kid who'd rather just run around
with friends, but when we've hiked before, we've had problems with her sugar
dropping like a rock and refusing to come up.  So, this time, we dropped her
basal rates to 20% about an hour before the hike, then she popped a couple
of lifesavers every 20 minutes or so for the duration of the hike.  She
ended the hike with a sugar of 204.  Not exactly target range, but the first
time she's hiked without being <40 at some point in the hike.  But, it does
take a bunch of preparation to exercise, even with the pump.

Nancy Morgan

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