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[IP] inadaquate insulin, low basal rare high bgs

Now, I4m really desperate. In the last 3 or 4 days, Eileen has gotten very
high bg4s (480-500) on different occasions. She could spend the whole day
within the normal range and then, 480! No particular pattern. First 2 times
thought it was the set and changed it, thinking she wasn4t absorbing well. I
read in Pumping Insulin that when you have bg4s of over 300, the most
probable cause is that the person isnt getting insulin. Today, pre-breakfast
bg was 480!. Have corrected and didn4t send her to school. Will check again
in 2 hrs. to see whats happened. Last Wedenesday had to pick her up at lunch
time with bg of 500. She really is missing a lot of school. // smip
Certainly sounds like inadequate basal rate during the night. pronounced 
dawn phenomenon or bad site. But would doubt the latter because it happens 
regularly. Eileen needs some middle of the night early morning blood sugars 
to see what is going on. This often occurs during a growth spurt in a 
teenager.  Another cause is sexual maturation and menstruation even if 
there is no flow. Test during the night to see what the increase looks 
like. If a doctor in your area has a CGMS this might be a good use for if.
A Bender, M. D.
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