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[IP] Basal vs Bolus Insulin

Hi Sheila,

I was very interested reading your post.  I also have pretty high basal
rates, though not quite as high as yours (around 65% of my TDD).  And
like you I have very good results with these.  My last A1c was 5.8% and
don't have that many lows.  If i lower my basal rates, i am
consistantly high, and if i increase my boluses (my insulin to carb
ratio) i am always low after meals.

I seem to have more flexibility around meal times though, but like you,
am ALWAYS hungry.  I hadn't thought of the connection to basal rates,
but that might be something to look at.  I try to keep cut veggies and
little blocks of cheese around to snack on because i can rarely make it
from one meal to the next without some kind of snack.

Thinking on my feet here, but would it be possible to lower your basal
rate a bit in the few hours just before a meal?  I wonder if that would
help you not go low if your meal is delayed a bit.  It might mean quite
a few more basal rate changes during the day but that would be worth it
for more flexibility!

Hopefully others will have more suggestions.  
type 1 since '97
Cozmo pumper

Hi everyone,

I have a question regarding basal vs bolus insulin. Do you find that it

makes a difference in your control HOW you receive the insulin? My
have always favored (for me) a higher basal rate, so that my boluses
lower. With a higher basal, I have good blood sugars and good A1C's.
you're probably wondering what my problem is if I'm having good luck
increased basal rates (which by the way, is 70+% of my TDD.)

If I eat on a regular schedule, I have the great results I just
When a meal is considerably late, I go low. A couple of weeks ago I had
colonoscopy, and had to fast the day before. I was low almost all day
until it dawned on me that my basals are way too high if I'm not
eating. I 
should have done a temp basal alot earlier, but most times you don't
much of a warning and sometimes it's too late to change your basal. I
like I'm stuck between having good numbers and no flexibility, or
higher numbers and flexibility. Flexibility is the reason I went on the
in the first place.

I also believe that this extra basal insulin is causing me be overly
and have gained weight (about 20 lbs in the 3.5 years I've been
pumping) but 
every time I try to lower lower my basals, I see higher numbers.

If anyone has any comments or suggestions, I'd love to hear them.

Sheilagh Salvati
Diabetic 19.5 years

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