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Re: [IPk] Pump progression

Hi Louis,

When I first got my pump, I gained weight because my bgs were lower and I went
low and overate to correct them.  I also had trouble breaking out of the "I
had better eat x amount of food because what if my bg drops?" thought pattern.

Your sleeping pattern, whatever, it is, should present little challenge to
good diabetes control if your basals are right.  That is a BIG change from the
old 2-shots or MDI regimen, and it will probably take some getting used to.

Fruit salad is not going to be very low in CHO, unless you're talking about
one that's mostly watermelon.  I would suggest a piece of roast turkey
sandwich meat (I got some stuff labeled "light and lean award-winning" or
something like that at Sainsbury's last week that looks pretty good), a bit of
cheese, and some crackers or 1 piece of bread, perhaps.  Or, if volume is the
issue, maybe some popcorn instead of crackers or bread?  It's a good idea to
have some protein and a little fat to complement the carbs in a snack.

You may find, as you suggest, that the bedtime snack is more for comfort and
out of habit.  Have your morning bgs generally been good in the aftermath of
the 3 pieces of toast?  If so, I would guess that either you're bolusing right
on target for them or that your night-time basal is high.  If you try not
eating a snack and do a "middle-of-the-night" bg test (say, 4 hours after
you've gone to bed, whatever time that is) and find that you're quite low, you
could decrease your nighttime basal rate and skip the snack entirely.  If,
similarly, on another night you do eat a snack and then give the
middle-of-the-night test a go and find yourself high, you may want to lighten
up on the snack or bolus more for it.

I have had a pump for over 5 years and so didn't learn to use the
extended/square-wave boluses until I got my second pump 2 years ago.  I use
them when I eat American cheesecake or I'm munching at a party but I can sorta
project about how much I will eat within a given 2 hours or so.  I know others
on this list are very enthusiastic about the extended/square-wave options,

Since you're on Humalog, spacing your meals will probably not improve bg
control as much as having your basals and boluses right.  If you were on a
time-release insulin like Insulatard or lente or whatever, spacing your meals
would be key!

Melissa (20)

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