[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

RE: [IPk] changes in basal rates



There are a few theories on this - all of which need to be tested out by
research etc...
 
Insulin sensitivity can vary during the day - on top of that we have
different activity, hormone levels, weather etc.. can all play a role with
your BGL - before even thinking about food.  

Theoretically if you need different bolus ratios at different meals, it may
indicate you need to adjust the basal rates for that time of day (plus other
variations, eg: weekend/weekday).  

One way to test whether your basal rate is set correctly is the fasting
method (which gets you to check BGL every 2 hours with fasting over
different times, eg: over breakfast, next day over lunch, next day - over
evening meal). There may be seasonal variation and as we age - the basal
rates should be checked annually at least. You could also try & see if there
is a weekend/weekday trend. 

Other food related factors may be that 50g carbohydrate was part of an
extremely high fat or fibre meal which may be digested more slowly. Insulin
action may not correlate with the digestion and release of glucose into the
blood.

Patients using carb ratios on pen therapy may find they have different
ratios at different times of the day to correspond also to the action of
their cloudy insulin dose. 

If you want more clarification - please ring email me directly. Other
thoughts are welcome.

Julette Kentish
Diabetes Research Dietitian
Bournemouth Diabetes & Endocrine Centre
Royal Bournemouth Hospital
Castle Lane East
Bournemouth
BH7 7DW DORSET UK
Ph: 01202 704929
Fax: 01202 704759

		-----Original Message-----
		From:	Elizabeth OShea
[mailto:email @ redacted]
		Sent:	27 April 2001 10:23
		To:	email @ redacted
		Subject:	RE: [IPk] changes in basal rates

		> 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.

		This is something that I've never understood. Surely the
requirement for
		more insulin at a meal indicates a lack of background
insulin? So then it
		needs to be corrected in the basal, and you then have the
same bolus needs
		throughout the day - which I think is an important target
because it makes
		for fewer things to remember!

		Perhaps someone can explain to me why this doesn't work,
because it puzzles
		me.

		elizabeth
		----------------------------------------------------------
		for HELP or to subscribe/unsubscribe, contact:
HELP@insulin-pumpers.org
		help SUPPORT Insulin Pumpers
http://www.insulin-pumpers.org/donate.shtml
----------------------------------------------------------
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml