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[IP] YOUR CARBOHYDRATE RATIO probably WILL BE DIFFERENT



It's good when we can debate about something, but it's a little bit better,
sometimes, when you have a strong opinion about a tough issue such as
diabetes and its procedures.

You can read my history throughout the attached text, but the summary is:

Most of us ought to use a different carbohydrate ratio for different times
of
breakfast - during work days when you wake up at the same time, day by
day, the ratio would be the same, but if the same stretch (working days) you
are late e decide to have breakfast at the company's brakeroom, one hour
after your normal time, your carbohydrate ratio probably WILL BE DIFFERENT.

It's why some people describe about schedule changes... IT"S ABOUT TIME.

Please read my enclosed history - you'll understand.

Jose
email @ redacted



Date: Sat, 27 May 2000 11:54:41 -0800
From: "Michael" <email @ redacted>
Subject: Re: [IP] Interesting morning... another twist

Sorry for the long inclusion, but it is all relevant, see below

> What a morning.  I got up at 7:30 a.m. did a bg check, 135.
> Started my fast, in one hour (8:30 a.m.) bg was 207.  One hour after
> that was 201, hovered around 200 the rest of the morning when at
> 11:30 a.m. I said "enough, it's not going anywhere".  And I took a bolus
> to bring it down. Called my CDE who said "interesting".  She called me
>  back later and raised my am basal to 0.8. >
>

> Roselea,
> I have this phenom too.  My early am basal before waking is 1.0 from
> 4am to 9am, while the rest of the day is .7 and .8.   I tried tweeking
this
> 4-9am number for a couple of months, but still had the spike, up to
> 250-280 range, even without eating.  Finally what worked was to take
> a bolus about 1 unit if bg were ok, or more if out of range, upon waking.
> This did the trick.  A spike in bgs requires a spike in insulin (bolus) to
> cover, and not a slowly increasing basal.
>
> Now the very interesting and frustrating part.  The above worked
> great for the last six months.  The last two weeks, the spike is
> gone.  I crashed for several days straight, lowered the spike bolus,
> and finally did away with it.
>  Go figure, our bodies are constantly changing.  At least with a
>  pump we have a better tool to make the adjustments.


The presense or absence of the spike has a lot to do with how well
you are rested and the time of day you rise. Many times you can easily
reproduce the there/not there phenomena by changing your schedule or
observing what happens on weekends or days when you don't  get
enough sleep. One solution is to use a "wake up bolus" on the proto-typical
day when you expect a spike -- Lily has done this off and on with roughly a
1.5 to 2 unit bolus to preclude a morning spike for several years now with
pretty good success -- it's not always easy to predict or pre-guess the
pattern
so if you decide to try  this, you probably want to make very good records
of
when it occurs and talk to your medical team -- of course!

Michael
email @ redacted


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end

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