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Re: [IP] nightime basals AGAIN!

> Michael,
> We are seeing the same thing in Eve as in ruth's daughter the minute
> her head hits the pillow her numbers go up. Do you just add a unit
> of insulin or do you square wave this over a hour? Had her snack at
> 8:30 bolused enough for snack. She had a 2 carbo snack and bolused
> 2.4 units of insulin. Numbers tonight.

Actually, Lily stopped doing the temp rate at bed time this year, her 
bg's don't shoot up anymore when she sleeps, but they did for the 1st 
4 years pumping. 

No bolus. It really is a basal rate. It has varied from 0.8 to 1.2 or 
so over the years, but basically the procedure is always the same.

The temp basal starts when she climbs into bed and runs until the 
night time rate starts, however long is needed to accomplish the 
overlap. We set the rate so that it was equal to or a little higher 
than the night time rate if her bg's were stable and 100 - 120 
(profile meter, not plasma type). If her bg was lower, we reduced the 
rate by 0.1u/hr for each 10 points down to 70 (0.3 max) and did not 
do the rate if she was lower than that (insurance against a real 
low). If she was high, we raised the rate 0.1u/hr for each 10 points. 
This was not real scientific, just a ball park guess at needs. It 
seemed to work fairly well. 2:30 am checks indicated that at least 
the direction of our variation attempts were correct. Lily's 2:30 
numbers have never been real great except when she is NOT active 
which is almost never. I confess, that it took me a long while to 
gather the courage to administer the large basal immediately at 
bedtime. The same was true for the high night time basal rates in 
general. I was very cautious and spent many sleepless nights making 
sure she was OK. Her endo was as much in the dark as we were, though 
supportive. She encourage us to be aggressive as long as bg's were 
high and there was no evidence of a low during the night. Persistence 
and fortitude paid off in the end. 

Muster your courage, talk to the medical team and go for it....

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