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Re: [IP] Lily



On Sun, 28 Sep 1997 email @ redacted wrote:

> Michael,
> 
> >From  what I understood from "ZAXDADDY", he is not talking about his
> different BASAL rates, he is meaning his BOLUS rates. I get the impression
> that he should be actually on higher basal rates during the time that his
> needs are more for the boluses. Do you get me or am I not undetstanding it
> all?
> Karla
> 
Yes, I get you.  I had exactly the same problem with Lily.  We thought 
there were hugh variations from day to day depending on what she ate and 
on the time of day.  We actually went as far as counting protein intake 
and doing the residual carbo conversions to include that in her carbo 
counts.  All for naught.  It IS a basal rate variation (or is for her) 
that can be observed while fasting -- it varies dramatically depending on 
the time of day she gets up.  If she rises at 6:30, no additional insulin 
is needed, she is flat until noon and beyond (she has a mild steady dawn 
effect included in her basal, 0.7 until 11am)  if she rises at 9:30 or 
later, she needs an additional 1 to 2 units with breakfast or within an 
hour of rising to prevent a high bg (even if she does not eat).  This 
gives the appearance of a variable ratio.  I know from talking to the doc 
and from reading that some people dip instead of rise so the variability 
in bg's is almost entirely metabolic.  It is however predictable if 
adequate data is taken on fasting basal rates over several days (or 
weeks) for each wake/sleep  exercise/no exercise pattern.

Michael

P.S. I do believe we are talking about the same thing.