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Re: [IPk] changes in basal rates



Thankyou for clearing this up! I have been struggling to get my boluses
right before meals. My rep at Disetronic insists that I should always bolus
1 unit for every 15g of CHO and won't accept when I tell her it doesn't
work - I too seem to need a larger bolus at lunchtime for the same amount
(eg 2 slices of bread) that I had for breakfast and it has been puzzling me,
I assumed that my basal rates were wrong.

Zok
----- Original Message -----
From: "paulleonard" <email @ redacted>
To: <email @ redacted>
Sent: Wednesday, April 25, 2001 8:55 PM
Subject: [IPk] changes in basal rates


> I mailed the group several months ago about the apparent changes in
insulin
> requirements at different times of the day.  There was no response, so I
> assumed that you knew it all already - but that doesn't seem to be the
case
> (or you wouldn't have asked!). As a pumper who's also a medic (and yes,
there
> are some good guys out there who understand), I feel reasonably qualified
to
> respond to those queries.
>
> Each of us has an individually tailored circadian rhythm, and our
requirement
> for various hormones differs according to our lifesyles and sleep
patterns.
> In general this means that each person will need more insulin at certain
times
> of day and less at others.  Your basal rates should reflect this, but you
are
> unique and only you can determine what's right for you, by carrying out
> experiments where you don't eat, don't exercise and aren't stressed.  You
then
> have to add in the various factors affecting life, and personally I agree
that
> it's learning that counts, not loads of graphs (but each to his/her own).
What
> doesn't seem to be common knowledge is that your bolus insulin:carb ratio
may
> differ according to the time of day.  For example, you may have 50g C at
> breakfast with 2 IU insulin, but for the same amount of carb you may need
more
> (or less) insulin at lunch-time.  I personally need almost double the
ratio
> used at breakfast for midday meals - the stress factor seems to come into
play
> here!  Shift work also messes up the body clock; I used to and my husband
> still does work shifts, so our bodies are seldom attuned to a set pattern.
It
> takes about a week to adjust properly from a night shift to a day shift,
much
> the same as adjusting to jet lag, and I have to set my basal rates to cope
> with this.  Fortunately, the Minimed 508 which I use allows up to three
basal
> rate patterns to be set in advance.
>
> Hope this helps more than puzzles!
>
> Mary
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