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Re: [IP] Post Basal testin bg spikes


I've always noticed this and simply plan on needing a bit more of a bolus 
after I am finished "challenging" my basal rates.

I'm not totally certain what causes it. One thought I've had is that there 
is always some "tail" (residual effect) to the insulin. For me, this tail 
seems a bit more pronounced for boluses than for basals - probably due to 
the total amount infused during a bolus. This residual effect from earlier 
boluses will sometimes "help" subsequent boluses. For example, why is it 
that I can graze for hours with virtually no rise in BG, yet if I try to 
ingest all those carbs at one sitting, my BG rises noticeably? Note: I see 
a tail with Humalog, Velosulin as well as a mix of H and V. The timing and 
duration of the tail is different with the different insulins, but it's 
there, none the less.

The other thought I've had is that your sub cutaneous tissue will absorb 
better if it's already "primed". A crude analogy is that a pre moistened 
sponge or cloth will usually absorb better than one which is "dry". It's 
possible a certain portion of the "post fasting" bolus simply goes to "re 
priming" the tissue. This might also be a factor in why some of us 
experience a rise in BG after exercising with reduced basal rates (happens 
to me very seldom, but I wonder).

Again, I've come to expect this when challenging my basal rates. I'm ready 
to bolus more than usual for the carbs and ready to make adjustments later. 
As with all things DM related, YMMV.

Bob Burnett
mailto:email @ redacted

At 11:38 PM 10/5/99 -0400, you wrote:
>Hi all:
>    Have any of you ever noted after the span that you fast for basal
>testing, that when you finally eat your bg goes way high?  This happens
>almost always for me.  For instance today I was rechecking my early
>morning and morning rates.  My sugar remained within 12 points from 4 am
>to 11 am at noon at my last check I was 83. I thought no problem and ate
>lunch and bolused for the meal.  60 g carbs low protein and fat.  At 3
>pm I was 228 and had to correct, at 5 pm I was still 180.  Normally my
>numbers are fine in the afternoon and if they aren't I am not so
>resistant when correct. Any ideas? Sheila

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