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Re: [IPk] ketones- again

In a message dated 4/14/2003 8:20:11 PM GMT Daylight Time, email @ redacted 

> It sounds as if it is often an absorption problem when you have a bad site. 
> I 
> suppose that you have tried inserting your sets in many areas. For myself, 
> I 
> use my thighs, buttocks and abdomen so that by the time I have done the 
> rounds and return to the same site again, several months will have passed. 
> Unfortunately, however, I know that many others can't use all of these 
> areas.
> The other thing that is hardly ever mentioned on here is the effect that a 
> little exercise can have on insulin sensitivity and absorption. For myself 
> just going for a short 30 min walk increases my insulin sensitivity. Of 
> course everybody is effected differently.
> Just one more point. If your insulin has a delayed effect, have you tried 
> giving your pre-meal boluses earlier?
Hi Ken,

Thanks for your thoughts - much appreciated, as always.

Yes, some of the time it's an absorption problem.  Absorption has been a 
problem for me for several years - I have only used thighs and abdo before, 
couldn't tolerate other sites, preferred thighs - still awful absorption 
after nearly 30 years of injections in them.  Abdo relatively new as gave up 
20 years ago, but even with rotation I reuse the site after five weeks and 
now have problems at some sites.  I seem to form scar tissue very easily.  
But more often the problem is that the cannula is in the wrong place - 
outside the skin or too shallow, and I can't tell that this has happened 
(sometimes hurts a bit, but then it does when it's OK and I'd waste a lot of 
sets if I removed one every time that happened).  There are also occasions 
when the set and site are OK when I get similar symptoms to Sarah, with no 
obvious reason, and that can also happen after breakfast on a non-changing 

(Sarah - I assume from what you wrote that when you get these highs you don't 
get ketones? - would explain why bg comes down eventually.)

The trouble is that these events are unpredictable.  One day when I change 
set/site things are great - yesterday, for example, in fact I might even go a 
bit low so giving extra insulin before changing isn't a good idea.  Next time 
as Sarah described, bgs through the roof despite doing almost exactly the 
same things, same breakfast and exercise etc and similar absorption at the 
two sites used.  And then there are the days when the cannula's in the wrong 

Re exercise: odd!  If high normal I can walk/power walk/swim for ages with no 
need for adjustment, but just doing a bit of heavy lifting (helping a pal 
move house etc) drops bg very quickly and by a lot - I always take CHO for 
this sort of activity.  But if bg's over about 12 it will go up with most 
exercise.  If lowish, then like you I'm very sensitive to the effect of any 

I take your point about giving an earlier pre-meal bolus.  This would only 
affect high carb lower fibre meals with low other things to buffer, which I 
don't eat that often apart from breakfast.  I will try low carb breakfasts on 
site/set change days from now on to see if there's any effect, and try the 
pre-meal bolus on other days to see if it helps the problem Sarah described.

Thanks, that's given me a few things to think about,


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