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Re: [IP] Ideal Basal rates

>Just returned from my endocrinologist and she is adjusting my basal 
rates to 
>be more 'normal like your pancreas' - a maximum of three different 
rates per 
>day.  I always thought the pancreas, within limits, gave what it 
needed to in 
>order to keep the body healthy - not a magic number of rates.  I 
almost asked 
>her why the companies spend all that money giving you the option of 24 
>if you only need two - anybody else heard of this treatment paradigm? -

Okay...there are a lot of feelings on this one, based on reactions so 
far.  But, let's get into the mind of the doctor here for a moment. 
This doctor has probably dealt with FAR more diabetic patients than any 
of us have (unless you are an endocronologist).  In HER experience, 
three basal rates probably is what most people need and use 
effectively.  And, just because there are examples of people who have 
several more than that doesn't mean that they have the best basal 
regime...just that they found one that works.  Good example.  For 
myself, I had 6 basal rates...but as I've continued to tweak my rates, 
I'm now down to...you guessed it...3!  Part of it had to do with timing 
of rates.  For example, I have much higher rate in the morning 
hours...but I was having lows around noon time.  A first, my solution 
was to back down just before noon my basal rate considerably, and then 
raise it back up again a few hours later...but I then found out that if 
I just switched to my afternoon basal rate about two hours earlier than 
I had been, it avoided the lows AND avoided the need for an additional 
basal rate.

Now, the fact is that some people WILL need more than 3...but, I think 
the doctors are right to TRY to get the basals working with as few as 
necessary, because it makes it much easier to figure out what is going 
on.  Once you get fairly good control on 3, you can start tweaking and 
adding any additional rates, if need be.

Of course, I'm not suggesting that those who have more than 3 
shouldn't...only that the doctor is NOT an "idiot" for suggesting 3.  
That statement is probably made out of experience.  Perhaps her exact 
wording was not the best choice...but that might have been made 
casually to communicate the idea, not necessarily to be taken literally.

I certainly believe that each diabetic should "take control" of their 
own care...but the doctors frequently give advice that is worth 
trying.  I'm the type who does things my own way when it comes to 
diabetes.  My doctor was extremely uncomfortable when I decided to go 
to a 4-NPH-shot-a-day regimin to get better control...but I had done 
research, and it worked great (even better than the Lantus that I 
eventually switched to), albeit, inconvenient.  But, he often gave 
advice upon first thought I figured was just "craziness" on his 
part...but after much thought, and then giving it a try, he ended up 
being right, with some minor adjustment.  

So, in short...always question the advice of your doctor...but NEVER 
ignore it.  They have likely treated thousands of diabetics, and are 
quite aware of the differences in treatment...whereas you have only 
treated one.  :-)  Then again, I'm sure there are really ARE Endo's 
that are "idiots".  (I was fortunate enough to have switched from one 
that was an "idiot" to my current one at the University of Michigan 
Health System, who is great.) 
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