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Re: [IPk] temporary basal rate and walking

I've no idea when insulin is likely to be produced if it's still 
being made. I think my son still has some insulin production judging 
by his dose compared to body weight and relatively easy to control 
BGs (though I think this may be tailing off now). As far as we can 
tell is seems to be released at a fairly consistent but low level, so 
he needs plenty of insulin with food but seems to need less basal 
insulin. But it is probably an individual thing. I've heard others 
who say that the insulin is produced sporadically, in fits and spurts 
and they found BGs easier to control when production stopped, so the 
opposite of our experience.

It's possible that you would still have insulin on board from a lunch 
time bolus or the basal insulin before you need the low afternoon 
basal rate. The level of humalog (Novorapid is similar but lasts 
slightly longer I think) is quite high for 2 hours and then tails off 
during the third hour. This graph shows the level of Humalog in the 
blood over time, http://cgibin.rcn.com/johncm/images/HvsR.jpg. If you 
kept the low basal rate for 3-4 hours you might then see the glycagon 
caused increase mentioned before.

I thought Emily needed very low basal rates in the afternoon, but 
after various problems we decided to start from scratch again and re-
set basal rates to the recommended levels in the pump manual and 
adjusted from there. The basal rate total was quite a bit higher so 
we reduced bolus rates at the same time to balance this. We ended up 
with a similar basal pattern through most of the day though with 
fewer changes in basal rate and less of a difference between the 
highest and lowest rates. The daily basal total increased from 9 
units to 17.5 units. The afternoon basal rates are still the lowest 
during the day but are higher than they were (used to be 0.1 and 0.2 
but are now 0.6) and we are not getting afternoon hypos. Either her 
insulin needs have changed or we were always giving too much bolus 
insulin at lunch time which resulted in an artificially low afternoon 
basal rate. 

Best wishes,

On 10 Apr 2008 at 14:43, Tom Falconer wrote:

> Is it possible to only be producing insulin for a few hours a day?  I 
> have a very low rate, 0.05, for two hours each afternoon, and still go 
> hypo if I am not careful.
> Regards,
> Tom
> J wrote:
> > Is there any chance at all that you are still producing some of your 
> > own insulin? It seems amazing that you can be nearly completely 
> > without insulin (as you surely must be after about 3 hours at 0.05 
> > per hour) without seeing an increase in BG. Once insulin levels are 
> > that low there would be no way for glucose to enter your cells, your 
> > body would think it's starving and glucagon is released from the 
> > pancreas to convert glycogen to glucose in the liver. 
> >
> > The Ragnor Hanas has a good chapter about exercise and type 1 
> > diabetes and it's available on Google books, 
> > http://books.google.co.uk/books?id=2lyIu4_5r4IC&pg=PP1&dq=type+1+diabe
> > tes+ragnar+hanas&sig=AWgoiNjOxRsK92VmGbqRJLrqll4#PPA246,M1
> >
> > or mini link if the above wraps badly, 
> > http://lnk.nu/books.google.co.uk/jqs
> >
> > Jos
> >
> > On 10 Apr 2008 at 9:09, Fiona Hunt wrote:
> >
> >   
> >> Yes, we go walking for maybe 4- 7 hours and it can be quite tough and
> >>  hilly. I
> >> was in a blizzard last Sunday - so much for Spring! I use the same regime
> >> when cycling (on road) also. Sometimes I wonder whether zero basal would
> >> be better to save me eating so much but common sense prevails and I just
> >> set the pump to the lowest basal rate of 0.05. As I write this though, I
> >> realise I could set a profile with alternating 0.05 and 0 for each half
> >> hour which would effectively half the basal - I might try that!
> >>     
> > .
> .
> -- 
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