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RE: [IP] tips for some of the concerns listed...long

>The AM BG is the most difficult to manage;increase basal 5-6Am and change
insulin to carb ratio @ breakfast (more insulin per carb).  Treat
hypoglycemia wirh glucose tablets;they are formulated to provide glucose.
Orange juice gives one the yoyo effect, quick up then back down.  Skim milk
is the best,if you want to use food.  Also,do not eat a carb alone,add a
protein with it,put peanut butter on your apple.   All carbs are NOT created
equally, some carbs affect BG more than others, especially white potatos,
white rice, white bread,orange juice, cornflakes. Check into the glycemic
index,it might help you fine tune management. Use whole fruit instead of
juice,add fiber rich foods to meal plan.<

While some of the guidelines listed above will work for SOME people, they
don't work for ALL pumpers. I have seen dawn phenomenon basals start at 2 or
3 am.  There are also people who have a late am dawn, sometimes lasting
until 10 or 12 noon.  It is important to do overnight basal testing at least
2 times to confirm.  Basal increases might need to run for 4 to 6 hours  (or
longer, but continued basal testing to verify is needed).  Usually, Humalog
basal increase will be one hour before the rising BG trend. (As always:
YMMV=Your mileage may vary.)

There is recent research from ADA and AADE (diabetes educators) presented at
both the ADA and AADE annual meetings that focuses on "evidence based
practice".  Much of the evidence on previous guidelines for low BG treatment
do not apply to all people in all situations. According to ADA and AADE
dietitian groups, there is no evidence of the benefit of adding protein to
the low BG treatment.
SOME gycemic index foods can cause problems for SOME individuals and not

Find out whatever guidelines work for YOU, keep records for reference, and
don't be surprised when something that worked a few months ago changes.

Barbara A. Bradley, MS, RN, CDE

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