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[IP] Re:basal vs bolus insulin

I'm trying to learn more about this too and was interested in your post. My 
basals are around 66% of my TDD and I, like you, have to eat frequently 
because of them, and my meal boluses are fairly low. I'm just starting to 
experiment with lower basals and what I'm finding is that, for the first 
time, I will really have to use square-wave boluses for any meal with fat 
and protein in it or any large meal. I've kind of taken for granted that my 
basal rates would clean up delayed highs after slowly digested meals, and 
seldom used square waves unless eating something really unusual. But with 
high basals/low boluses too many of my postprandials are a little too high, 
with a big drop 3-4 hrs after, and any day I eat substantially less I get 
very low as the day goes on. So I'm going to try this new idea and move 
basals down and boluses up and see if that is better. Does your pump have 
.05 increments in basals? I just tried one that did and found it helpful in 
this process.

At 02:13 PM 11/25/2003 -0800, you wrote:
>With a higher basal, I have good blood sugars and good A1C's. So,
>you're probably wondering what my problem is if I'm having good luck with
>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 mentioned.
>When a meal is considerably late, I go low. A couple of weeks ago I had a
>colonoscopy, and had to fast the day before. I was low almost all day long,
>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 have
>much of a warning and sometimes it's too late to change your basal. I feel
>like I'm stuck between having good numbers and no flexibility, or having
>higher numbers and flexibility. Flexibility is the reason I went on the pump
>in the first place.
>I also believe that this extra basal insulin is causing me be overly hungry
>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.
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