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[IP] Novolog highs and lows straightened out

 I read with interest the posts in the archives about people on Novolog having
big highs after meals and then experiencing rapid crashes. I want to share my
experience in case it can benefit others. I switched to Novolog last month due
to site degradation with Humalog. For the first two weeks on Novolog I would
frequently get highs (300's) as long as 3 1/2 to 4 hours after a meal, and then
have a rapid drop to as low as 44 within a half hour period. My basals and
insulin to carb ratio were the same as they had been on straight Humalog and on
the Humalog/Regular mix that I'd been doing all summer to avoid the site
degradation problems. Naturally I assumed as others had posted, that the Novolog
was at fault. When I faxed my results to my new endo, she responded by lowering
my basals by about .2, from an average of .8 to .6. She also upped my insulin to
carb ratio from 1:12 to 1:8. When she told me to make these changes I thought
she would be wrong because I thought my basals ne!
  raising, not lowering, since the highs occured so long after the meals.
Anyway, she was absolutely right. It's been two weeks now and my blood sugars
have been the flattest they've ever been. Yesterday for instance I never varied
by more than 9 points all day long from before breakfast until bedtime. Even my
2 hrs. p.p. were the same as my before meals. So now I'm wondering if other
people's experiences with the giant swings could be avoided too by making
significant changes in basal and bolus ratios. Of course, it's always ymmv, but
worth discussing with your diabetes team.
Pam dx'd 1989, pumping 10 yrs with Minimed

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