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Re: [IP] Basal Testing!--Q&COMMENT

In a message dated 11/22/02 email @ redacted writes:

<< If I eat ANYTHING with carbs after 8:00, it doesn't matter what it is and 
it doesn't matter how perfectly I count carbs and bolus, I wake up HIGH at 
2AM; then I take my correction bolus, go back to bed and when I wake up again 
around 6:30AM I usually have not gone down at all!  But if I am able to not 
eat anything after 8PM (VERY HARD FOR ME!) I sometimes wake up low at 2AM. >>

Yep, sounds familiar.  Not going to sleep till 5 hours after eating has been 
a suggestion I've gotten more than once to deal with this problem, but that's 
generally inconvenient, and sometimes just impossible.  I find that if I go 
to sleep before the food is digested, I end up needing quite a bit more 
insulin to cover it.  For me, the problem is worst with large meals (might be 
worst with high-fat meals if I ate high fat meals <gr.>), maybe just because 
of the additional time necessary to digest a larger meal.  With a large late 
meal, I am sometimes successful with bolusing slightly less than what would 
be my regular bolus for that amount of food at the time I eat, and then doing 
an additional 40% or so of the regular bolus as an extended bolus, starting 
when I am going to sleep.  But, of course, in that situation I would always 
wake up during the night to test.  It used to be that I seemed to start 
reacting to the meal very soon after going to sleep, but now it seems 
sometimes I really shouldn't start that extended bolus till the middle of the 

Of course, if it is a regular occurrence, you could always cover the food 
with increased overnight basals, just keeping in mind that you will have to 
lower them if you don't eat.  If you have a pump with different basal 
programs or profiles, you could set one up with high overnight basals for the 
evenings you eat late, and change to that when you are giving your meal 
bolus.  And remember to change back the next day <gr.>.  But I would do a lot 
of testing, either way.  YMMV

Linda Z
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