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Re: [IPk] Pump progression

In message <email @ redacted>, Louis Anson
<email @ redacted> writes
>My problems still remains with not being able to control when/how much I eat 
>(tho what I eat is actually "healthy" food) and also my sleeping pattern, 
>which obviously interferes with my diabetic control, as I sleep late/rise 
>late, and my meals are all pushed forward.
This suggests to me that you haven't got your basals sorted out yet.
You should be able to skip any meal, eating whenever you like.

I guess that fixing your basals will make most of your following
questions redundant.
>Specific questions for you experienced people as follows:
>- Does anyone know of any snacks that are low in carbohydrate but quite 
>filling that I could eat before bed time (perhaps fruit salad?) that will 
>not make my BG shoot up during the night???

>(currently I am used to going to bed on a full stomach - maybe three peices 
>of granary toast, and digesting this is preventing me from sleeping)

Hmmm... Why do you want to go to bed feeling full, if this prevents you
from sleeping?  With your basal set right, you would simply not eat
anything, or eat and take the appropriate bolus.  The one problem is if
you eat something which doesn't start to kick in for some times, in
fact, is so slow, that a square bolus would drive you hypo early in the
night, or not be big enough to bring you through to morning with a
normal bg.  For me, a large protein and fat snack with no CHO (6oz
cheese!) can do this.

If eating large blocks of cheese (or similar) is something you are
likely to want to do, you can set one of your three basal patterns (on
the minimed 508) to the equivalent of your standard basal, plus a
delayed start square wave bolus.

My guess is you are saying 'I have to eat a lot of carbohydrate at 11pm,
or I go hypo.  You don't have to eat.  You have to cut your basal.

>- do you use the square wave/extended bolus often??  I use it for 
>larger/fattier meals in the evening, splitting the bolus dose in half tho am 
>not convinced by its success yet.

It took me some time to start using it, and now I regularly use it both
at breakfast and dinner.  I really need to start working out what the
calories are in a meal, alongside the carbs, and doing maths.  Bother.
I hate maths.
>- do you believe that spacing meals out will improve BG control??   I tend 
>to eat my breakfast, lunch and dinner all between 11am and 11pm.

I have heard it said that the body isn't able to deal with a large
amount of injected insulin as effectively as with a small amount, so it
might be that you cannot eat all the calories you need at just two meals
- but it's your body, and experimentation will show this.

>Although I am 23, lean, and take lots of exercise (sorry this is not a 
>lonely hearts ad) I am worried that I am eating far too much and am eating 
>for comfort and not necessity.

I think there's nothing wrong with eating for enjoyment.  It's a
sensual, sensuous experience which is closely tied to some of the most
fundamental bits of our biology.  We eat for all sorts of reasons -
ranging from courtship rituals to providing nutrients for unborn
children.  As diabetics, we sometimes have to deal with a conflict
between what our body needs in terms of good blood glucose levels and
overall healthy eating, and what we need in terms of being fully
functioning human beings - and sometimes that _does_ mean coming down on
the side of the guestimated meal in a Chinese restaurant with friends
rather than something known and cooked at home alone, etc. etc.  The
right answer, in as much as there is one, is something which each
individual must decide for themselves on a mouthful by mouthful basis.

So, as to your worry that you are eating too much: I'd use the simple
objective test of standing on some scales every month or so.

Best wishes,


(dm 30+, 508 almost a year, getting hungry for lasagne)

>Any comments/thougths much appreciated.
>Regards............  Louis
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Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
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