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Re: [IP] basals

At 08:27 PM 9/10/99 -0700, you wrote:
>I don't mean to sound stupid, but what are basals?
>Kim S.
>Erika's mom, 20 y/o w/cystic fibrosis, diabetes, asthma, and epilepsy.
>email @ redacted

This will probably end up like asking someone what time it is and they
telling you how to build a watch.  i e this may be more than you want to know.

In a normal (non-diabetics) body the pancreas produces insulin in response
to signals that the body detects.  If a meal is eaten the generation and
release of insulin increases.  Between meals there is still a flow of
insulin into the body but the rate is lower than at mealtime.  The insulin
pump is constructed and programmed to attempt to simulate a healthy
pancreas.  The BOLUS (amount of insulin given at one time) is intended to
provide the insulin necessary to metabolize the food we eat.  Between
BOLUSES there is a period where insulin usage drops to some normal minimal
level.  This is between meals and while we sleep.  This lower rate of
insulin usage is called the BASAL rate.  It would be much easier if it were
constant but such is not the case.  The basal rate between lunch and supper
might be significantly different than the rate between 3:00 AM and 7:00 AM.
 My own personal experience (as an illustration) is that the rate between
meals (after bolus) is 1.0 units/hour and the rate between 3:00 AM and 7:00
is 1.3 units per hour.  The basal rate will vary over time.  There are
simple tests that involve skipping meals to find if the BG rises or drops
while fasting to evaluate the correctness of the basal being used.

Actually, MI users do much the same thing by using slow release insulin for
a basal and fast release (Humalog or regular) for the Bolus.

Basal is a number that reflects how much insulin per hour is added for
normal body needs.  Bolus is the amount of insulin in one, slug, that is
added for a meal.  Basals are not constant usually.  They vary during the
day.  In order to give good control, the pump must simulate, as closely as
possible, the normal action of the pancreas.  The pump delivery is
expressed in two numbers :
Bolus--Given in units and usually infused at one time.
Basal -- Given in units per hour and infused 24 hours a day (unless
programmed to do differently.  The basal rate usually differs during the day.

Bob Blakely
email @ redacted  

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