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[IP] Basal Testing Question
- Subject: [IP] Basal Testing Question
- From: Andrew Aronoff <email @ redacted>
- Date: Wed, 17 May 2000 14:34:55 +0200
>You say you don't think a single .1U dose is reproducible (sorry to take
>that out of context), yet Disetronic and Animas both say they can take
>that .1U and divide and deliver it to your body .005U at a time every 3
>minutes for an hour.
Delivering a 0.1 U dose, much less a 0.005 U one, is like standing 20 feet
from an air conditioner outlet vent and asking someone who's within arm's
reach of its thermostat dial to raise the setting by 0.1 degree F for one
hour. The AC may change its output slightly, but due to turbulence
(mixing), changes in cloud cover over the building, the way you're
standing, and the way your body's own radiator works, you'll never feel it.
Still, as an AC marketing type, I *have* to put in the ad that the
thermostat can be adjusted to the nearest tenth of a degree for as little
as an hour at a time.
>I saw enough BG readings to prove to myself that a .1U adjustment for a
>single hour of the night will cause a BG swing of about 50 points.
A 50 point change in BG for a single 0.1 U dose of insulin is *enormous*.
That raises a number of questions. Here are three:
1. How can one distinguish between a change of such magnitude that is NOT
due to a change in insulin delivery from one that is? IOW, say my body can
change BG by 50 points in an hour "all by itself", that is, due to factors
I don't currently measure or control. One day, I reduce the basal by 0.1 U.
An hour later, I see a 50 point increase in BG. How do I know it was due to
the change in basal that I made and not due to those "other" factors?
I've gone through some terrible periods of instability over my 25+ years of
IDDM. My BG was all over the map at times. I never did believe, and I do
not believe today, that all the BG changes I was observing were a direct
result of the insulin I was injecting. Instead, there was a significant
contribution from "other" things (e.g. infection, stress, activity, and
UGO's *) on my insulin requirement. To a large extent, it was my _insulin
requirement_ that was changing, not the effect, per se, of the injected
* UGO = Unidentified Glucose Object
2. What might happen if, during one of those nights you wake up to test
every 2 hours, an experiment was performed and the basal was either
temporarily reduced by 0.1 U for an hour or increased the same amount for
the same time? (I'm *not* suggesting you actually do this -- I'm just
hypothesizing.) Let's say this was done three times (not on successive
nights, PLEASE! <g>) when the BG was _stable_. It'd be an interesting
3. What's the effect of 0.1 U delivered intravenously as a single dose to a
NON-diabetic? (This must be known, but I don't know the answer.)
P.S.: Are you using Humalog or Regular or a mix?
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