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[IP] Bumping Basals - Long

Hi Kevin-
It was great to get your last email and I hope you don't mind my posting it 
below to the IP list (IPers read Kevin's email to me below to get a glimpse 
of what we're discussing) as I know there must be others out there who have 
the same struggle we do, and they may get the digest like me and delete 
stuff when it gets too long. (I recently got 462 emails when I went out of 
town for a couple of days!)  I always ask people to respond to me directly 
at email @ redacted, not because I want to be exclusive but so I can 
make sure I get the responses.

There are people on this list I know that have NEVER lost concsciousness due 
to their diabetes claiming that others just aren't testing enough. I test 
between 8 and 12 times a day on the average, more if my problems are severe 
and always before driving.  Still, there is sleep and those times when I 
forget and over 35 years that's caused me problems.

My rates run as follows:

Mid - 2 a.m.     .6
2-6 a.m.        1.0  and currently going up
6 -10 a.m.      1.1  and currently going up
10 -12 noon      .9
1 p.m. -5 p.m.   .6  this is real stable
5pm- 8pm         .7  ditto
8pm- 10 pm       .5
10 pm.           .3  my most difficult time and goes from zero (I wish)
                     to.3 (my highest)
11pm.            .4  This varies a lot too

I do a complete fasting protocol every 2 weeks to try to keep on top of it-  
sometimes it even works! :-))

I go from perect fasting, stable rates = 17 units, to up to around 19 today 
and still not stable with rising BG between about 9 pm and 2 a.m. at 
present. Last night I was 135 at bedtime, took a Glucose Tab to goose me up 
to 150, by midnight I was 257.  I have to be careful taking extra insulin to 
lower my BG at night as I have very wide swings in what lowers it.  If I 
take my daytime rate ( 1 unit to lower it by 50) it MAY triple it's 
intensity and I wake up at 2 a.m. with a BG of 375, -gone hypo- other times 
(like now) 1/3 of my usual amount only lowers me 1/3 of the way, so a 350 BG 
only comes down to 300 - not much help. And so many nights I get up once 
each and every hour to check, and sometimes, like now my am BG is just 
rising and I increase the rates.

Confused?  Believe me, I am.  God forbid I should do something stupid like 
eating fried chicken for dinner (and 3 pieces too!!).  I try to limit my 
night time meals to just protein and vegies and to eat as early as possible 
to avoid having to 'fool' with my BG later.  If I'm 200 or less at bedtime 
(and there's heck to pay if I go bed at 11:30 and not 10 as usual).

I'm sorry this is so long, but I've lived in my little personal diabetes 
hell for so long, if you're not the light at the end of the tunnel, it's 
still nice to know I'm not alone here in my own dark cave.

No, I live alone and am so-called disabled - not that that helps my 
predicament much, but there you have it.  I moved to Hot Springs, AR - where 
I know very few people, from the Boston area after brain surgery 2 years 
ago.  I'm trying to bloom where I'm planted.  Rocky soil though.

Question:  What is dusk phenomenon?  Never heard that, although I can guess 
at it.   Would be very interested in anything your friend Lester has to say 
about 'our problems.  Probably others out there too.

You sound like you take good care of yourself and do the best you can.  Most 
of us do. No matter what 'others', including endos, mothers etc. say.  Hope 
to hear from you soon.


>That's sad to hear there aren't more "of us".  One person I had heard
>about, and wondered if he had the same problem - was some guy (unknown
>to me) that did a media photo with Gingrich and maybe Clinton?  He was
>promoting pumps for people like himself, that cannot keep his DM controlled
>any other way.
>I suspect there are others like ourselves, that aren't on pumps, and their
>endos are tearing into them each time they see their A1cs.  Oh how I wish
>I had a stable basal (and carbo ratio)!
>I had similar response from my endo too.  Back when I was on MDI, I tried
>to show him how the need for bedtime NPH kept changing.  His response was
>that I was trying to over-correct too much.  He compared it to a person
>driving a car, and weaving all over the road....
>Back about 1993, I started taking high doses of vit E to slow down
>glycosylation (the ADA acknowledged this in 1998).  For me, I cannot
>take a full dose of vit E, until I gradually increase the dose.  Otherwise
>my Bgs and blood pressure go up quite a bit!  I told the endo about this
>effect, and he acted like it wasn't real.  But, I then told him I had
>emailed with other DMers who had the exact same effect.  He then
>backed down, and said that hasn't been studied yet...  Yet, I have read
>of this effect in several books, and heard about it from other DMers.
>I am in the process of trying to see if I can get into the Barbara Davis
>Center program (for IDDMers).  I think they charge a fair nominal fee, and
>have some decent DM experts working there (in Denver).  One other reason is
>to have access to their finger stick A1c machine.  My endo lives in the
>dark ages, always using veinous blood for A1cs, and I'm plain tired of it,
>when I KNOW I can use a finger stick instead.
>I think you are right about hormones. If you are interested, I have plots
>for growth hormone & cortisol on my webpage at work, if you want  to see
>how they change over the day:
>Growth hormone:  http://kevin.aar.com/gh.gif
>       Cortisol:  http://kevin.aar.com/cort.gif
>I got the plots from a pumper friend who was a physics professor, and
>decided to become an MD instead (in med school now).  I ought to pick
>his brain on this!
>Another thing that could be causing this, is the glycogenesis process
>from the liver.  If you've ever drunk a bunch of alcohol (who hasn't?),
>you know how it drives your sugars into the basement for quite sometime
>afterwards!   Those hormones directly affect the liver's production of
>glucose from glycogen - so they are tied into this too.
>Hope this isn't getting too long - but I'm glad to find someone else!
>What kind of daily insulin consumption do you have?  Just curious if
>we have lower than normal levels, since most of the pumpers I read about
>have higher basals than me.
>Here's how I am:
>time          Min     Max     Usual
>10pm - 2am:   .2      .6       .4
>2am - 3am:    .2      .3       .3
>3am - 5am:    .3      .6       .5
>5am - 8am:    .4     1.2       .8
>daytime:      .1      .4       .2-.3 (commonly drop it .1 from 2-5pm)
>Total:  usually 30-35 units (meals included), but was down to 18 units
>         last week, and the .1 was TOO MUCH.
>The carb:insulin and carb:Bg ratios change quite radically too!  They
>sorta seem related to the basal level during the day.
>Sorry about the bad hypo you had!  I'm not trying to pry, but are
>you married, or have someone you live with that can rescue you during
>such emergencies?  I've been married for 23 years now, and my wife
>knows when I'm hypo - BEFORE I do, just by the way I look and stand.
>Things are much better on the pump, but while driving the car, she's
>had me pull over, so she can get me to stop driving, and take over.
>Plus the nite time rescues!
>Your description of the hypo, reminded me of one wher I thought I had died
>too!  When I was a teen, we went cave exploring.  It required ropes to
>get down into the main part.  I went hypo, and could not get up the rope.
>My friend went for help (on bicycle).  I turned off the flashlight to save
>batteries, and ust have passed out for a while.  I awoke to voices and
>lights above me.  I started thinking it was angels coming to get me.
>It turned out to be a pickup truck of hippies, who helped out.  The
>most memorable part, was they had a rocking chair in the back of their
>pickup, which one guy sat in while they drive around :)  My dad came
>to help (he was summoned by phone), and paid them $20 for their help.
>I KNEW what they were gonna use that $20 for!
>Well, I'm gonna email my pumper friend, soon to be MD, and see if
>he knows anything.  I'll let you know if he has anything meaningful.
>His name's Lester, but he's not on the IP list.
>Kevin Hass WB0DPN      		Transportation Technology Center, Inc
>Senior Systems Programmer	P.O. Box 11130
>(719)-584-0596			Pueblo, CO 81001, USA
>email @ redacted

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