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Re: [IP] Lily



On Sun, 28 Sep 1997 email @ redacted wrote:

> This is a test message to the new mailing list.  I read the article about
> Lily on the web page.  I'm curious.  All the manipulating with her basals,
> was that suggested by a doctor or cde, or has she just experimented on her
> own to come up with what works best for her.  It sounds like she is doing a
> great job.
> Beth
> 
No, that is partly Dad.  Adolescents have a lot of trouble with 
variations in bg's partly due in part to rapid hormonal changes and 
partly do to enormous appetites (and mis-calculation).  Lily has been 
carefully profiled and she is under real good control now.  About the 
last 6 months, she has taken over almost complete control of all insulin 
management, calculation, etc..  I'm really proud of her.  Evening 
fluctuations are still a problem if she has not fasted for 5 - 6 hours 
before retiring for bed.  Usually we are up at 3:00am for a quick check 
and about half the time she is below 70-80 or above 150.  Otherwise 
everything is ducky!  If she is able to eat early, this is never a problem.

The trick appears to be a good understanding of basal rate requirements 
for each day and each 'different' sleep pattern.

There is a message from Ted 'ZAXDADDY' inquiring about that subject, I 
guess I'll put my two cents worth in here.

Lily experienced the sharp rise after getting up in the morning 
ONLY on days she sleeps in.  We found that if she rises later than about 
9:00 am (she usually gets up at 6:30) then she needs a morning bolus in 
the neighborhood of 1.5 to 2 units.  After experimenting with this for 
several months and getting it right, we actually asked the doc about it.
That is Dr. Prendergast from the chat group, he is Lily's doc. He said 
that what we were seeing is similar to dawn effect and has to do with 
sleep rythm etc...  ZAXDADDY needs to 'carefully' check his fasting basal 
rate during the times he has the variations in ratio.  

The ratio change is most probably not real. The ratios should be constant 
within about 10-15% or less.  The underlying basal rate requirements change
A WHOLE BUNCH depending on physical activity, sleep pattern, health (or 
sickness), etc...

Do a rigiorous basal rate study Ted, there will be detailed instructions 
on how to do this on the web site in a couple of weeks.  (they are in the 
back issues of the digests, but I don't know which volume).

Michael